Ittermann T, Schipf S, Dörr M, Thuesen B H, Jørgensen T, Völzke H, Markus M R P
Institute for Community Medicine, University Medicine Greifswald, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Germany.
Institute for Community Medicine, University Medicine Greifswald, Germany; DZD (German Center for Diabetes Research), Site Greifswald, Germany.
Nutr Metab Cardiovasc Dis. 2018 Feb;28(2):173-179. doi: 10.1016/j.numecd.2017.10.016. Epub 2017 Oct 25.
A potential causal relationship between thyroid function and type 2 diabetes mellitus is currently under debate, but the current state of research is limited. Our aim was to investigate the association of thyroid hormone levels with prevalent and incident type 2 diabetes mellitus (T2DM) in two representative studies.
Analyses are based on data from the Study of Health in Pomerania (SHIP), a German population based cohort with 4308 individuals at baseline and 3300 individuals at a five-year follow-up, and from INTER99, a Danish population-based randomized controlled trial with 6784 individuals at baseline and 4516 individuals at the five-year-follow-up. Serum thyroid-stimulating hormone (TSH) and free thyroxine (fT4) concentrations were measured in both studies, while free triiodothyronine was measured in SHIP only. T2DM was defined by self report or intake of anti-diabetic medication. Neither in SHIP nor in INTER99 we detected significant associations of serum TSH levels with prevalent or incident T2DM. Serum fT4 levels were significantly positively associated with prevalent T2DM in SHIP and INTER99. In longitudinal analyses baseline levels of fT4 were significantly positively associated with incident T2DM in SHIP (RR per pmol/L = 1.07; 95%-CI = 1.05-1.10), while this association barely missed statistical significance in INTER99 (RR per pmol/L = 1.03; 95%-CI = 0.99-1.06). In SHIP baseline fT3 levels were significantly associated with incident T2DM (RR per pmol/L = 1.21; 95%-CI = 1.16-1.27).
We demonstrated positive associations of thyroid hormones with prevalent and incident type 2 diabetes mellitus suggesting that hyperthyroxinemia may contribute to the pathogenesis of this condition.
甲状腺功能与2型糖尿病之间潜在的因果关系目前仍存在争议，但当前的研究状况有限。我们的目的是在两项代表性研究中调查甲状腺激素水平与2型糖尿病（T2DM）的患病率及发病率之间的关联。
分析基于来自德国波美拉尼亚地区健康研究（SHIP）的数据，这是一项基于人群的队列研究，基线时有4308人，五年随访时有3300人；以及来自丹麦INTER99研究的数据，这是一项基于人群的随机对照试验，基线时有6784人，五年随访时有4516人。两项研究均测量了血清促甲状腺激素（TSH）和游离甲状腺素（fT4）浓度，而仅在SHIP中测量了游离三碘甲状腺原氨酸。T2DM通过自我报告或抗糖尿病药物的服用情况来定义。在SHIP和INTER99中，我们均未检测到血清TSH水平与T2DM的患病率或发病率之间存在显著关联。在SHIP和INTER99中，血清fT4水平与T2DM的患病率显著正相关。在纵向分析中，SHIP中fT4的基线水平与T2DM的发病率显著正相关（每皮摩尔/升的相对危险度=1.07；95%可信区间=1.05-1.10），而在INTER99中这种关联几乎没有达到统计学显著性（每皮摩尔/升的相对危险度=1.03；95%可信区间=0.99-1.06）。在SHIP中，基线fT3水平与T2DM的发病率显著相关（每皮摩尔/升的相对危险度=1.21；95%可信区间=1.16-1.27）。
我们证明了甲状腺激素与2型糖尿病的患病率及发病率呈正相关，提示甲状腺素血症可能参与了这种疾病的发病机制。
