Amirabadizadeh Alireza, Mehran Ladan, Amouzegar Atieh, Asgari Samaneh, Khalili Davood, Azizi Fereidoun
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Front Endocrinol (Lausanne). 2024 Dec 13;15:1475286. doi: 10.3389/fendo.2024.1475286. eCollection 2024.
Type 2 diabetes mellitus (T2DM) poses a significant public health challenge, contributing to considerable morbidity and mortality worldwide, which necessitates urgent preventive measures. Thyroid disorders, prevalent in many individuals, are intricately linked to metabolic health, yet studies on their relationship with T2DM yield inconsistent results-some suggesting an increased risk with abnormal thyroid hormone levels, while others indicate potential protective effects. This study investigated the association between changes in serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels and the incidence of type 2 diabetes mellitus.
Data from 1938 individuals aged ≥20 in the Tehran Thyroid Study cohort were used, spanning four examination cycles from 1999 to 2012, with three-year intervals. TSH and FT4 levels were log-transformed and modeled as time-varying exposures to study their association with incident T2DM.
During a median follow-up of 9.43 years, 135 new T2DM cases were identified. The multivariable-adjusted joint model (JM) revealed that each unit increase in log-transformed TSH level was associated with a 25% decrease in T2DM incidence [HRs (95% CI): 0.75 (0.64-0.90)]. Conversely, each unit increase in FT4 level showed a marginally significant higher risk [1.06 (0.99-1.13); p-value=0.06].
The findings of this study suggest that dynamic changes in serum thyroid hormones are associated with the development of T2DM. Rising TSH and decreasing FT4 over time are associated with a lower risk of diabetes. These findings suggest a complex interplay between thyroid function and the risk of T2DM, emphasizing the importance of monitoring thyroid hormone levels as a part of T2DM prevention strategies.
2型糖尿病（T2DM）对公共卫生构成重大挑战，在全球范围内导致相当高的发病率和死亡率，因此需要采取紧急预防措施。甲状腺疾病在许多人中普遍存在，与代谢健康密切相关，但关于它们与T2DM关系的研究结果并不一致——一些研究表明甲状腺激素水平异常会增加患病风险，而另一些研究则表明可能具有保护作用。本研究调查了血清促甲状腺激素（TSH）和游离甲状腺素（FT4）水平变化与2型糖尿病发病率之间的关联。
使用德黑兰甲状腺研究队列中1938名年龄≥20岁个体的数据，该队列涵盖了1999年至2012年的四个检查周期，间隔为三年。对TSH和FT4水平进行对数转换，并将其建模为随时间变化的暴露因素，以研究它们与新发T2DM的关联。
在中位随访9.43年期间，共确定了135例新的T2DM病例。多变量调整后的联合模型（JM）显示，对数转换后的TSH水平每增加一个单位，T2DM发病率降低25%[风险比（95%置信区间）：0.75（0.64 - 0.90）]。相反，FT4水平每增加一个单位，风险略有显著升高[1.06（0.99 - 1.13）；p值 = 0.06]。
本研究结果表明，血清甲状腺激素的动态变化与T2DM的发生有关。随着时间推移TSH升高和FT4降低与较低的糖尿病风险相关。这些发现表明甲状腺功能与T2DM风险之间存在复杂的相互作用，强调了监测甲状腺激素水平作为T2DM预防策略一部分的重要性。
