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TSH increment and the risk of incident type 2 diabetes mellitus in euthyroid subjects

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Abstract

Purpose

Thyroid function is known to influence glucose metabolism, and thyroid-stimulating hormone is the most useful parameter in screening for thyroid dysfunction.

Therefore, the aim of this study was to investigate the incidence of type 2 diabetes according to baseline thyroid-stimulating hormone level and thyroid-stimulating hormone change in euthyroid subjects.

Methods

We identified and enrolled 17,061 euthyroid subjects without diabetes among participants who had undergone consecutive thyroid function tests between 2006 and 2012 as a part of yearly health check-up program. Thyroid-stimulating hormone changes were determined by subtracting baseline thyroid-stimulating hormone level from thyroid-stimulating hormone level at 1 year before diagnosis of diabetes or at the end of follow-up in subjects who did not develope diabetes.

Results

During 84,595 person-years of follow-up, there were 956 new cases of type 2 diabetes. Cox proportional hazards models showed the risk of incident type 2 diabetes was significantly increased with each 1 μIU/mL increment in TSH after adjustment for multiple confounding factors (hazard ratio = 1.13, 95% confidence interval: 1.07–1.20, P < 0.001). Compared with individuals in the lowest tertile (−4.08 to 0.34 μIU/mL), those in the highest thyroid-stimulating hormone change tertile (0.41–10.84 μIU/mL) were at greater risk for incident type 2 diabetes (hazard ratio = 1.25, 95% confidence interval: 1.05–1.48, P for trend = 0.011). However, baseline thyroid-stimulating hormone level and tertile were not associated with the risk for diabetes.

Conclusions

Prominent increase in thyroid-stimulating hormone concentration can be an additional risk factor for the development of type 2 diabetes in euthyroid subjects.

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Abbreviations

DM:

Diabetes mellitus

TSH:

Thyroid-stimulating hormone

T3:

Triiodothyronine

T4:

Thyroxine

BMI:

Body mass index

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

TG:

Triglyceride

LDL:

low-density lipoprotein

HDL:

High-density lipoprotein

HbA1c:

Glycated hemoglobin

HOMA-IR:

The homeostasis model assessment of insulin resistance.

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Ji Eun Jun, Sang-Man Jin, Kyu Yeon Hur, Moon-Kyu Lee, Sun Wook Kim & Jae Hyeon Kim

  2. Department of Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Jae Hwan Jee

  3. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea

    Ji Cheol Bae

  4. Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea

    Jae Hyeon Kim

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  1. Ji Eun Jun
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Correspondence to Jae Hyeon Kim.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Jun, J.E., Jin, SM., Jee, J.H. et al. TSH increment and the risk of incident type 2 diabetes mellitus in euthyroid subjects. Endocrine 55, 944–953 (2017). https://doi.org/10.1007/s12020-016-1221-1

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