Journal
EUROPEAN JOURNAL OF ENDOCRINOLOGY
Volume 187, Issue 5, Pages S35-S46Publisher
OXFORD UNIV PRESS
DOI: 10.1530/EJE-22-0523
Keywords
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Categories
Funding
- Swiss National Science Foundation [SNSF 32003B_200606]
- National Institute on Aging (NIA) [N01-AG-6-2101, N01-AG-6-2103, N01 -AG-6-2106]
- NIA [R01-AG028050]
- NINR [R01-NR012459]
- Intramural Research Program of the NIH
- National Institute on Aging
- National Heart, Lung, and Blood Institute (NHLBI) [HHSN268201200036C, HHSN268200800007C, HHSN268201800001C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, 75N92021D00006, U01HL080295, U01HL130114]
- National Institute of Neurological Disorders and Stroke (NINDS)
- National Institutes of Health
- National Institute on Aging (NIA)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
- National Center for Advancing Translational Sciences (NCATS)
- NIH [U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, R01 AG066671, UL1 TR000128]
- National Health and Medical Research Council of Australia
- Medical Research Council UK
- Cancer Research UK
- Dutch 375 Ministry of Health, Welfare and Sports
- Bristol-Myers Squibb
- Erasmus MC and Erasmus University, Rotterdam, the Netherlands
- Netherlands Organisation for Scientific Research (NWO)
- Netherlands Organisation for the Health Research and Development (ZonMw)
- Research Institute for Diseases in the Elderly (RIDE)
- Ministry of Education, Culture and Science
- the Dutch Ministry for Health, Welfare and Sports
- European Commission (DG XII)
- Municipality of Rotterdam
- Dutch Kidney Foundation [E.033]
- Italian Ministry of Health [ICS 110.1jRS97.71]
- US NIA [263-MD-9164-13, 263-MD-821336]
- Brazilian Ministry of Health
- Brazilian Ministry of Science and Technology [0106 0010.00 RS, 01 06 0212.00 BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00 SP, 01 06 0071.00, 01 10 0643-03, 01 10 0742-00, 01 12 0284-00, 01 10 0746-00, 01 10 0773-00, 01110093-01]
- FAPESP - Fundacao de Amparo a Pesquisa do Estado de Sao Paulo [2015/17213-2]
- National Research Council (CNPq)
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences of Iran
- CIBERDEM (Ministerio de Economia, Industria y Competitividad-ISCIII), Instituto de Salud Carlos III [PI11-02755, PI14/00710, PI14/01104, PI14/00970, PI14/00874, PIE14/00031, PI20/01322]
- Consejeria de Salud y familias [PI-0144-2018]
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This study conducted a systematic review and individual participant data analysis to investigate the association between subclinical thyroid dysfunction and incident diabetes. The results showed no clear association between subclinical thyroid dysfunction and the development of diabetes.
ObjectiveFew 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. MethodsWe 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. ResultsAmong 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, I-2 = 0%) or subclinical hyperthyroidism and incidence of diabetes (OR = 1.03, 95% CI: 0.82-1.30, I-2 = 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. ConclusionsThis 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 statementEvidence 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.
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