Association between thyroid hormone parameters and dyslipidemia among type 2 diabetes mellitus patients: Comparative cross-sectional study

Wolide, Amare Desalegn; Zawdie, Belay; Alemayehu, Tilahun; Tadesse, Samuel

doi:10.1016/j.dsx.2016.12.041

Cited by 10 publications

(13 citation statements)

References 57 publications

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“…We found, in our first examination of the literature, that though the findings were not unanimous, there was general consistency of the data. In general, consistent with prior work (8), AF (25)(26)(27)(28)(29)(30)(31), osteoporosis (32)(33)(34)(35)(36)(37)(38)(39), and cancer (40)(41)(42)(43) were associated with higher thyroid function that was defined by using TSH and/or thyroid hormone levels, across and beyond the reference range, and steatohepatitis (44)(45)(46) and other features of the metabolic syndrome (19,(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66) were associated with lower thyroid function. Both high and low thyroid function, as compared with mid-range thyroid function, were associated with clinical and pathological features of cognitive decline (26,…”

Section: Resultssupporting

confidence: 84%

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Clinical Parameters Are More Likely to Be Associated with Thyroid Hormone Levels than with Thyrotropin Levels: A Systematic Review and Meta-Analysis

Fitzgerald

Bean

Falhammar

et al. 2020

Thyroid

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Background: Though the functional states of other endocrine systems are not defined on the basis of levels of controlling hormones, the assessment of thyroid function is based on levels of the controlling hormone thyrotropin (TSH). We, therefore, addressed the question as to whether levels of thyroid hormones [free thyroxine (fT4), total triiodothyronine (TT3)/free triiodothyronine (fT3)], or TSH levels, within and beyond the reference ranges, provide the better guide to the range of clinical parameters associated with thyroid status. Methods: A PubMed/MEDLINE search of studies up to October 2019, examining associations of levels of thyroid hormones and TSH, taken simultaneously in the same individuals, with clinical parameters was performed. We analyzed atrial fibrillation, other cardiac parameters, osteoporosis and fracture, cancer, dementia, frailty, mortality, features of the metabolic syndrome, and pregnancy outcomes. Studies were assessed for quality by using a modified Newcastle-Ottawa score. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. A meta-analysis of the associations was performed to determine the relative likelihood of fT4, TT3/fT3, and TSH levels that are associated with the clinical parameters. Results: We identified 58 suitable articles and a total of 1880 associations. In general, clinical parameters were associated with thyroid hormone levels significantly more often than with TSH levels-the converse was not true for any of the clinical parameters. In the 1880 considered associations, fT4 levels were significantly associated with clinical parameters in 50% of analyses. The respective frequencies for TT3/fT3 and TSH levels were 53% and 23% (p < 0.0001 for both fT4 and TT3/fT3 vs. TSH). The fT4 and TT3/fT3 levels were comparably associated with clinical parameters (p = 0.71). More sophisticated statistical analyses, however, indicated that the associations with TT3/fT3 were not as robust as the associations with fT4. Conclusions: Thyroid hormones levels, and in particular fT4 levels, seem to have stronger associations with clinical parameters than do TSH levels. Associations of clinical parameters with TSH levels can be explained by the strong negative population correlation between thyroid hormones and TSH. Clinical and research components of thyroidology currently based on the measurement of the thyroid state by reference to TSH levels warrant reconsideration.

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Section: Resultssupporting

confidence: 84%

“…found 22 studies(19,26,30,31,34,35,39,41,44,45,48,55,(60)(61)(62)65,66,71,75,78,79,91) that examined associations with fT4, TT3/fT3, and TSH and a further 36 studies(26,29,33,(36)(37)(38)40,42,43,45,47,49,(52)(53)(54)56,63,64,69,73,74,76,77,(80)(81)(82)86,90,(92)(93)…”

mentioning

confidence: 99%

Clinical Parameters Are More Likely to Be Associated with Thyroid Hormone Levels than with Thyrotropin Levels: A Systematic Review and Meta-Analysis

Fitzgerald

Bean

Falhammar

et al. 2020

Thyroid

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“…Observationally, higher TSH, even within the normal range, is associated with higher risk of CVD events 23 . In some, but not all observational studies, higher TSH and lower FT4 are associated with unhealthier lipids and glucose metabolism, such as an association of higher TSH with higher total cholesterol 24 , higher low-density lipoprotein (LDL)-cholesterol 24 , lower high-density lipoprotein (HDL)-cholesterol 25 , and higher HbA 1c 25 , and of higher FT4 with lower LDL-cholesterol 26 , higher HDL-cholesterol 27 , and lower fasting glucose 26 . However, some studies have found no association 27 – 31 .…”

Section: Introductionmentioning

confidence: 99%

Thyroid function and ischemic heart disease: a Mendelian randomization study

Zhao

Schooling

2017

Sci Rep

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To clarify the role of thyroid function in ischemic heart disease (IHD) we assessed IHD risk and risk factors according to genetically predicted thyroid stimulating hormone (TSH), free thyroxine (FT4) and thyroid peroxidase antibody (TPOAb) positivity. Separate-sample instrumental variable analysis with genetic instruments (Mendelian randomization) was used in an extensively genotyped case (n = 64,374)-control (n = 130,681) study, CARDIoGRAMplusC4D. Associations with lipids, diabetes and adiposity were assessed using the Global Lipids Genetics Consortium Results (n = 196,475), the DIAbetes Genetics Replication And Meta-analysis case (n = 34,380)-control (n = 114,981) study, and the Genetic Investigation of ANthropometric Traits (body mass index in 152,893 men and 171,977 women, waist-hip ratio in 93,480 men and 116,741 women). Genetically predicted thyroid function was not associated with IHD (odds ratio (OR) per standard deviation for TSH 1.05, 95% confidence interval (CI) 0.97 to 1.12; for FT4 1.01, 95% CI 0.91 to 1.12; for TPOAb positivity 1.10, 95% CI 0.83 to 1.46) or after Bonferroni correction with risk factors, except for an inverse association of FT4 with low-density lipoprotein-cholesterol. The associations were generally robust to sensitivity analyses using a weighted median method and MR Egger. This novel study provides little indication that TSH, FT4 or TPOAb positivity affects IHD, despite potential effects on its risk factors.

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“…In a cross sectional study conducted in India, the prevalence of hypothyroidism among type 2 diabetics was about 17.05%. 12 Also the prevalence of deranged lipid profile was higher in diabetics than in non-diabetics. In another study 13 , patients having TSH >2.5 IU/ml were having high levels of high density lipoprotein (HDL).…”

Section: Resultsmentioning

confidence: 94%

Hypothyroidism and its relationship with lipid profile in patients with Type II diabetes mellitus.

Memon

Khan

Siddiqi³

2020

TPMJ

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Objectives: To determine the frequency of hypothyroidism in type II diabetic patients and to compare the lipid profile of diabetic patients with and without hypothyroidism. Study Design: Cross Sectional Study. Setting: Medicine Unit I Shaikh Zayed Hospital Lahore. Period: 5th August 2016 to 5th February 2017. Material & Methods: A total of 350 patients, aged 35-80 years, of both gender and having type II DM diagnosed at least 1 year ago were enrolled in our study. Fasting (12hr) blood samples were obtained and sent to the laboratory for measurement of serum TSH, total cholesterol, LDL and TGs. Patients with TSH value >10 μg/ml were labeled as hypothyroid. Two groups (hypothyroid diabetic and euthyroid diabetic) were made and lipid profile was compared in both groups. Results: Frequency of hypothyroidism in type II diabetic patients was recorded as 13.42% (n=47). When lipid profile of hypothyroid diabetic patients (group I) was compared with euthyroid diabetics (group II), it was noted that patients in group I had mean total cholesterol of 170.32 ± 12.90 mg/dl whereas in group II, it was 138.81 ± 28.89 mg/dl. Mean triglyceride level in group I was 176.21 ± 15.98 mg/dl, whereas in group II, it was 151.02 ± 27.78mg/dl. Mean LDL in group I was 87.17±15.97mg/dl, and 71.35±20.40 mg/dl in group II. Conclusions: Frequency of hypothyroidism in type II diabetic patients is higher as compared to general population. Moreover, dyslipidemia is significantly higher in hypothyroid diabetics when compared with euthyroid diabetics.

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Association between thyroid hormone parameters and dyslipidemia among type 2 diabetes mellitus patients: Comparative cross-sectional study

Cited by 10 publications

References 57 publications

Clinical Parameters Are More Likely to Be Associated with Thyroid Hormone Levels than with Thyrotropin Levels: A Systematic Review and Meta-Analysis

Clinical Parameters Are More Likely to Be Associated with Thyroid Hormone Levels than with Thyrotropin Levels: A Systematic Review and Meta-Analysis

Thyroid function and ischemic heart disease: a Mendelian randomization study

Hypothyroidism and its relationship with lipid profile in patients with Type II diabetes mellitus.

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