Amirabadizadeh Alireza, Ghorbani Alireza, Azizi Fereidoun, Abdi Hengameh, Amouzegar Atieh, Mehran Ladan
Endocrine Research Center, Research Institute for Endocrine Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.
J Diabetes Metab Disord. 2025 Apr 7;24(1):98. doi: 10.1007/s40200-025-01612-w. eCollection 2025 Jun.
Type 2 diabetes mellitus (T2DM) and thyroid dysfunction are some of the most prevalent endocrine disorders globally. Previous studies on the association and effect of thyroid hormones in patients with diabetes have yielded contradictory results. Therefore, this meta-analysis comprehensively examined the latest evidence regarding the bilateral association between thyrotropin and thyroid hormone levels in T2DM.
A thorough search across multiple databases was conducted to investigate the bidirectional relationship between thyroid hormones and T2DM. Two researchers independently performed data extraction and study quality was assessed using the Newcastle-Ottawa scale, with prevalence, odds ratios, and hazard ratios calculated using a random-effects model.
After screening 4159 studies, 36 were deemed eligible based on the inclusion criteria. A one-unit increase in serum thyroid-stimulating hormone (TSH) level was associated with a 2.49-fold increased odds of T2DM (OR: 2.49, 95%CI: 1.97-3.0). Similarly, a one-unit increase in Triiodothyronine (FT3) levels was associated with a 17% (HR:1.17,95%CI: 1.07-1.26) increased risk of T2DM. The pooled risk estimates of T2DM were 3.63 (95%CI: 1.63-8.09) for hypothyroidism, and 16.33 (95%CI: 7.59-35.12) for overt hypothyroidism. Individuals with thyroid dysfunction exhibited significantly higher HbA1c levels (Hedges'g: - 0.26, 95% CI: - 0.47 to - 0.06) and fasting plasma glucose (FPG) levels (Hedges'g: - 0.33, 95% CI: - 0.61 to - 0.05) compared to those with normal thyroid function.
Thyroid dysfunction, including both overt and subclinical hypo- and hyperthyroidism, significantly increases the risk of T2DM. Elevated TSH and FT3 levels are linked to higher diabetes risk, highlighting the need for regular thyroid screening and integrated clinical management.
The online version contains supplementary material available at 10.1007/s40200-025-01612-w.
2型糖尿病（T2DM）和甲状腺功能障碍是全球最常见的内分泌疾病。先前关于糖尿病患者甲状腺激素的关联和影响的研究结果相互矛盾。因此，本荟萃分析全面审查了有关T2DM中促甲状腺激素与甲状腺激素水平之间双向关联的最新证据。
对多个数据库进行全面检索，以研究甲状腺激素与T2DM之间的双向关系。两名研究人员独立进行数据提取，并使用纽卡斯尔-渥太华量表评估研究质量，使用随机效应模型计算患病率、比值比和风险比。
在筛选的4159项研究中，36项根据纳入标准被认为合格。血清促甲状腺激素（TSH）水平每增加一个单位，T2DM的发病几率增加2.49倍（OR：2.49，95%CI：1.97-3.0）。同样，三碘甲状腺原氨酸（FT3）水平每增加一个单位，T2DM的风险增加17%（HR：1.17，95%CI：1.07-1.26）。甲状腺功能减退症的T2DM合并风险估计值为3.63（95%CI：1.63-8.09），显性甲状腺功能减退症为16.33（95%CI：7.59-35.12）。与甲状腺功能正常的个体相比，甲状腺功能障碍个体的糖化血红蛋白（HbA1c）水平（Hedges'g：-0.26，95%CI：-0.47至-0.06）和空腹血糖（FPG）水平（Hedges'g：-0.33，95%CI：-0.61至-0.05）显著更高。
甲状腺功能障碍，包括显性和亚临床甲状腺功能减退和亢进，显著增加了T2DM的风险。TSH和FT3水平升高与更高的糖尿病风险相关，凸显了定期进行甲状腺筛查和综合临床管理的必要性。
在线版本包含可在10.1007/s40200-025-第1612页获取的补充材料。 （注：原文中的“10.1007/s40200-025-01612-w”可能有误，推测可能是页码之类的标识，这里根据实际情况翻译为“第1612页”，具体需根据原文实际信息确定）
