Subclinical thyroid dysfunction and incident diabetes: a systematic review and an individual participant data analysis of prospective cohort studies
Year: 2022
Type: review
Abstract: Objective: Few prospective studies have assessed whether individuals with subclinical thyroid dysfunction are more likely to develop diabetes, with conflicting results. In this study, we conducted a systematic review of the literature and an individual participant data analysis of multiple prospective cohorts to investigate the association between subclinical thyroid dysfunction and incident diabetes. Methods: We performed a systematic review of the literature in Medline, Embase, and the Cochrane Library from inception to February 11, 2022. A two-stage individual participant data analysis was conducted to compare participants with subclinical hypothyroidism and subclinical hyperthyroidism vs euthyroidism at baseline and the adjusted risk of developing diabetes at follow-up. Results: Among 61 178 adults from 18 studies, 49% were females, mean age was 58 years, and mean follow-up time was 8.2 years. At the last available follow-up, there was no association between subclinical hypothyroidism and incidence of diabetes (odds ratio (OR) = 1.02, 95% CI: 0.88-1.17, I2 = 0%) or subclinical hyperthyroidism and incidence of diabetes (OR = 1.03, 95% CI: 0.82-1.30, I2 = 0%), in age- and sex-adjusted analyses. Time-to-event analysis showed similar results (hazard ratio for subclinical hypothyroidism: 0.98, 95% CI: 0.87-1.11; hazard ratio for subclinical hyperthyroidism: 1.07, 95% CI: 0.88-1.29). The results were robust in all sub-group and sensitivity analyses. Conclusions: This is the largest systematic review and individual participant data analysis to date investigating the prospective association between subclinical thyroid dysfunction and diabetes. We did not find an association between subclinical thyroid dysfunction and incident diabetes. Our results do not support screening patients with subclinical thyroid dysfunction for diabetes. Significance statement: Evidence is conflicting regarding whether an association exists between subclinical thyroid dysfunction and incident diabetes. We therefore aimed to investigate whether individuals with subclinical thyroid dysfunction are more prone to develop diabetes in the long run as compared to euthyroid individuals. We included data from 18 international cohort studies with 61 178 adults and a mean follow-up time of 8.2 years. We did not find an association between subclinical hypothyroidism or subclinical hyperthyroidism at baseline and incident diabetes at follow-up. Our results have clinical implications as they neither support screening patients with subclinical thyroid dysfunction for diabetes nor treating them in the hope of preventing diabetes in the future.
DOI: 10.1530/eje-22-0523
Authors: Heba Alwan, Fanny Villoz, Martin Feller, Robin P F Dullaart, Stephan J L Bakker, Robin P Peeters, Maryam Kavousi, Douglas C Bauer, Anne R Cappola, Bu B Yeap, John P Walsh, Suzanne J Brown, Graziano Ceresini, Luigi Ferrucci, Jacobijn Gussekloo, Stella Trompet, Massimo Iacoviello, Jae Hoon Moon, Salman Razvi, Isabela M Bensenor, Fereidoun Azizi, Atieh Amouzegar, Sergio Valdés, Natalia Colomo, Nick J Wareham, J Wouter Jukema, Rudi G J Westendorp, Ki Woong Kim, Nicolas Rodondi, Cinzia Del Giovane
Institutions: University of Bern, University Medical Center Groningen, University of Groningen, Erasmus MC, University of California, San Francisco, University of Pennsylvania, The University of Western Australia, Fiona Stanley Hospital, Sir Charles Gairdner Hospital, University of Parma, National Institutes of Health, National Institute on Aging, Leiden University Medical Center, University of Foggia, Seoul National University, Seoul National University Bundang Hospital, Newcastle University, Hospital Universitário da Universidade de São Paulo, Research Institute for Endocrine Sciences, Shahid Beheshti University, Shahid Beheshti University of Medical Sciences, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, University of Cambridge, Wellcome/MRC Institute of Metabolic Science, MRC Epidemiology Unit, Netherlands Heart Institute, University of Copenhagen, University Hospital of Bern
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,841
Funders: National Science Foundation, Bristol-Myers Squibb, Cancer Research UK, European Commission, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Fundação de Amparo à Pesquisa do Estado de São Paulo, ZonMw, Nierstichting, Ministero della Salute, Ministerie van Onderwijs, Cultuur en Wetenschap, Nederlandse Organisatie voor Wetenschappelijk Onderzoek, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Financiadora de Estudos e Projetos, Shahid Beheshti University of Medical Sciences, Ministério da Saúde, Ministerio de Asuntos Económicos y Transformación Digital, Gobierno de España, Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas, National Institutes of Health, Medical Research Council, National Health and Medical Research Council, Instituto de Salud Carlos III, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Nursing Research, National Institute of Neurological Disorders and Stroke, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Center for Advancing Translational Sciences, National Institute on Minority Health and Health Disparities
Awards: G100949702, G1023702118, G1031917901, G1083180012, G1091621553, G1097528416, G1220223050, G125972088, G1261314546, CORONARY HEART DISEASE AND STROKE, CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, G1338207769, G1343185973, G1401438683, Determinación de marcadores epigenéticos asociados al desarrollo de diabetes mellitus tipo 2 en la población española, G1438302022, G1467792223, G1549444152, G1578487144, G1580098252, G1605143468, CORONARY HEART DISEASE AND STROKE, G1622933434, G1696540499, G1726490033, G1751314254, G1787333407, G1789381357, G1916108176, G1951774866, G1978499345, G2026126115, G2194386449, CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, G2245013492, G2391884931, G239771632, G2441403366, G247538147, G2597636997, CORONARY HEART DISEASE &STROKE IN THE ELDERLY, G270907595, Incidencia de diabetes tipo 2 en el estudio [email protected]: papel de los ácidos grasos y del sistema de transporte regulado por VEGFB en el desarrollo de enfermedades metabólicas, G2741792843, G2767018405, G2800149121, G2815873878, G2857511458, G2863169789, Subclinical thyroid dysfunction in the elderly, G288989767, G2929263391, G2948719655, G3045517347, G3137375862, G3220743633, G322252321, G3243374678, G3256118428, G327188308, G3396628412, G34347772, CHS research resources for the cardiovascular health of older adults, G3559709381, G3570525151, G3609537244, Identificación de variaciones de secuencia y de metilación e hidroximetilación en el exoma asociadas al desarrollo de diabetes tipo 2, G373744689, G3860090032, G3896857593, G3990106893, CENTRAL BLOOD ANALYSIS LABORATORY FOR CHS, G4092387480, G4156743036, Incidencia de diabetes y prevalencia de diabetes monogénica en el estudio [email protected]., G4219624527, G423252844, G4253755194, G4276072587, Valor predictivo de los miRNA séricos en el desarrollo de enfermedades metabólicas y su relación con el grado de exposición a partículas y otros contaminantes del aire, G4402799499, G4622379297, G4680823173, G4712859843, G484463738, G4942589162, G5054771556, G5145575165, G5148796768, G5251985303, G5281952516, G5303470639, G537455924, G5439707361, G544148272, G5479317095, G5490141068, G5531298794, G555675153, G5612504302, G5716432674, G5797542657, G581554933, G581887176, G585648573, CHS Events Follow-up Study, G6210582792, G6226795708, G624497702, G634386134, G6401035755, G6551505877, G6566566152, G659495149, G6635224560, G6638118516, G670738241, G687823276, G6986132784, Midcareer Investigator Award in Patient-Oriented Research in Aging, G7058527481, G7176672723, G7201305826, G7217924807, G7315168720, G7423759087, G7446983892, G7523308555, G764651519, G766700449, G766843672, G7858397257, ReliabilitY of opto-Transceivers for Health Monitoring Systems, G7991420222, G806768229, G8068269535, G8260701975, Resolving controversies in the management and the role of autoimmunity in subclinical hypothyroidism: a prospective evaluation of risks and of therapy impact, G8511401681, G8518686724, G8550958401, G861947890, CHS-Transition Phase -268055222, G870119955, HISPANIC SECONDARY STROKE PREVENTION INITIATIVE, G8827260454, G88327988, G8892155751, G9000001086, G9000005319, G9000012074, G9000027259, G9000032347, G9000033571, G9000036658, G9000046001, G9000050931, G9000066146, G9000069887, G9000071222, G9000085452, G9000088132, G9000102855, G9000111449, G9000124008, G9000125773, G9000130823, G9000139054, G9000153370, G9000155215, G9000160606, G9000283869, G9000284156, G9000288314, G9000305395, G9000324732, G905887895, G91958607
OpenAlex ID: W4294898172