Mehran Ladan, Honarvar Mohammadjavad, Tohidi Maryam, Adib Maryam, Azizi Fereidoun, Amouzegar Atieh
Endocrine Research Center, Research Institute for Endocrine Disorders, 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). 2025 Jun 17;16:1534058. doi: 10.3389/fendo.2025.1534058. eCollection 2025.
Thyroid hormone sensitivity indices represent a recently proposed clinical entity related to metabolic health outcomes. The link between thyroid hormone sensitivity and prediabetes is not clear. This population-based study investigated the association between thyroid hormone sensitivity indices and prediabetes.
Among 5,783 participants over 20 years, after excluding those receiving thyroid medications or corticosteroid drugs, having thyroid surgery, having a history of cancer, pregnant women, and those with end-stage renal disease, 4,356 subjects were included in the study. The odds ratio (OR) and 95% confidence interval (95%CI) for prediabetes in the general and euthyroid population per 1-SD increase in thyroid hormone resistance indices (PFTQI, TSHI, and lnTT4RI) were reported with logistic regression models.
One SD increase in PTFQI was significantly associated with lower odds of prediabetes even after total adjustment (OR:0.88; 95%CI: 0.82-0.94). The association was observed in women, non-smokers, and those with negative anti-thyroid peroxidase antibodies. In the euthyroid subgroup, one SD increase in PTFQI, TSHI, and lnTT4RI showed lower odds of prediabetes and [PTFQI: 0.89 (95%CI: 0.83-0.97); TSHI: 0.83 (95%CI: 0.74-0.94); lnTT4RI: 0.83 (95%CI: 0.74-0.93)]. We also found a negative correlation between thyroid hormone sensitivity indices and fasting plasma glucose (PTFQI: r =-0.094, TSHI:-0.1, and lnTT4RI: r =-0.098) and 2-h post-challenge glucose (PTFQI: r =-0.096, TSHI:-0.054, and lnTT4RI: r =-0.031).
Lower central sensitivity to thyroid hormone, as represented by increased TSHI, TT4RI, and PTFQI, is associated with a lower risk of prediabetes, even in euthyroid individuals.
甲状腺激素敏感性指标代表了一种最近提出的与代谢健康结果相关的临床实体。甲状腺激素敏感性与糖尿病前期之间的联系尚不清楚。这项基于人群的研究调查了甲状腺激素敏感性指标与糖尿病前期之间的关联。
在5783名20岁以上的参与者中，排除那些正在接受甲状腺药物或皮质类固醇药物治疗、接受过甲状腺手术、有癌症病史、孕妇以及患有终末期肾病的人后，4356名受试者被纳入研究。使用逻辑回归模型报告甲状腺激素抵抗指标（PFTQI、TSHI和lnTT4RI）每增加1个标准差时，普通人群和甲状腺功能正常人群中糖尿病前期的比值比（OR）和95%置信区间（95%CI）。
即使在进行全面调整后，PTFQI每增加1个标准差仍与糖尿病前期较低的发病几率显著相关（OR：0.88；95%CI：0.82 - 0.94）。在女性、非吸烟者以及抗甲状腺过氧化物酶抗体阴性的人群中观察到了这种关联。在甲状腺功能正常的亚组中，PTFQI、TSHI和lnTT4RI每增加1个标准差均显示糖尿病前期发病几率较低[PTFQI：0.89（95%CI：0.83 - 0.97）；TSHI：0.83（95%CI：0.74 - 0.94）；lnTT4RI：0.83（95%CI：0.74 - 0.93）]。我们还发现甲状腺激素敏感性指标与空腹血糖（PTFQI：r = -0.094，TSHI：-0.1，lnTT4RI：r = -0.098）以及餐后2小时血糖（PTFQI：r = -0.096，TSHI：-0.054，lnTT4RI：r = -0.031）之间存在负相关。
以TSHI、TT4RI和PTFQI升高为代表的甲状腺激素中枢敏感性降低与糖尿病前期风险较低相关，即使在甲状腺功能正常的个体中也是如此。
