Poor glycemic control is associated with the risk of subclinical hypothyroidism in patients with type 2 diabetes mellitus

Cho, Jaeho; Kim, Ho Jin; Lee, Jun Ho; Park, Il Rae; Moon, Jun Sung; Yoon, Ji Sung; Lee, Inkyu; Won, Kyu Chang; Lee, Hyoung Woo

doi:10.3904/kjim.2015.198

Cited by 37 publications

(27 citation statements)

References 33 publications

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“…34,35 This could be due to the high prevalence of thyroid disorders among Keralites making them extremely common among T2DM patients when compared to other complications of DM. 36 Significantly higher participants who did not attain ADA glycemic goal had overt hypothyroidism which is similar to previous reports suggesting altered thyroid hormones in participants with poor glycemic control 37 which is thought to be due to abolition or blunting of nocturnal TSH peak and reduced response of TSH to TRH and due to the impairment of peripheral conversion of T4 to T3 which normalizes with glycemic control.…”

Section: Discussionsupporting

confidence: 84%

Observational Study Evaluating Association of Type 2 Diabetes Mellitus and Thyroid Dysfunction

Jacob¹,

Varghese²,

Oommen³

2018

jebmh

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BACKGROUND Type 2 diabetes mellitus (T2DM) appears to influence thyroid function by various mechanisms. The exact association between T2DM and thyroid dysfunction has not been documented from Kerala; hence this study is conducted to determine the prevalence of thyroid dysfunction among T2DM patients and to determine the association between T2DM and thyroid dysfunction. MATERIALS AND METHODS Our prospective observational study enrolled 150 T2DM patients diagnosed using ADA diagnostic criteria. Institutional Ethics Committee approved the study and written informed consent was obtained from all study participants. Data was collected in case record forms, which included history, examination findings and laboratory investigations assessing glycaemic control and thyroid function. Values are expressed as mean (standard deviation). Analysis was done using R® and tests of significance used were independent sample 't' test, ANOVA and Chi square test. p <0.05 was considered statistically significant. RESULTS Mean age, duration of T2DM and glycated haemoglobin (HbA1c) of the study participants were 60.1 (7.9) years, 13 (5.9) years and 7.7 (0.8)% respectively 56.7% participants were having higher than normal Body Mass Index (BMI). 80% of participants were females and thyroid dysfunction was seen in 16.7% participants. Among the study participants, 13.3% (n=20) had overt hypothyroidism, 2% (n=3) had subclinical hypothyroidism and 1.3% (n=2) had overt hyperthyroidism. Significant difference in weight (p=0.01), BMI (p<0.001) and HbA1c (p=0.006) was observed when participants were categorized based on thyroid swelling. Significant difference in BMI (p<0.001) and fasting plasma glucose (p<0.001) was observed when participants were categorized based on type of thyroid dysfunction. Significant difference in thyroid stimulating hormone (p<0.001) and HbA1c (p=0.02) was observed when participants were categorized according to BMI. Association was observed between ADA glycaemic goal and type of thyroid dysfunction (p<0.001). CONCLUSION 16.7% of the T2DM patients had thyroid dysfunction, hypothyroidism was the predominant dysfunction. Failure to recognize the presence of thyroid dysfunction among T2DM patients may be a primary reason for poor management of diabetes. We recommend screening for thyroid dysfunction and regular monitoring of thyroid function in T2DM patients.

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Section: Discussionsupporting

confidence: 84%

Observational Study Evaluating Association of Type 2 Diabetes Mellitus and Thyroid Dysfunction

Jacob¹,

Varghese²,

Oommen³

2018

jebmh

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“…A study shows prevalence of 18.3% of SH in patients with Type 2 diabetes mellitus. The prevalence was found more in patients with age more than 50 years [45].…”

Section: Discussionmentioning

confidence: 83%

Relationship of TSH with BMI in subclinical hypothyroid patients

2019

Biointerface Res Appl Chem

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Thyroid hormones (T3 and T4) synthesized by thyroid gland and play an essential role in normal body development and tissue metabolism. Iodine is an essential factor that is required for the synthesis of thyroid hormones. The secretion of thyroid hormones is regulated by Negative feedback mechanism. After reached in blood circulation the majority of T4 and T3 bound with carrier proteins called thyroxine binding proteins (TBG) which shows higher affinity for T4. The common diseases related to thyroid hormones include Hypothyroidism, hyperthyroidism, thyroiditis, goiter, nodes, and tumors of thyroid glands (benign and malignant). Subclinical hypothyroidism also called mild thyroid failure is defined as normal thyroid hormones but mildly elevated TSH (5 – 10 uIU/ml) with no or mild sign and symptoms. The thyroid disorders are more prevalent in females than males. Hypothyroidism is associated with obesity and various studies conducted to find out the relationship between TSH and BMI observed different finding in the particular study. In the present study, a poor positive correlation between TSH and BMI was observed in the total euthyroid subjects. A poor negative association between TSH and BMI in euthyroid males and poor positive (r value – 0.21) relationship was observed in euthyroid females. In Subclinical hypothyroid patients (total, male and female), Poor negative correlation was observed between TSH and BMI. The conclusion of this study is, as TSH increased the BMI will also increase in (mostly females) euthyroid subjects. The Inverse or poor negative correlation was observed within TSH and BMI among euthyroid males and an inverse correlation was noticed in patients with subclinical hypothyroidism.

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“…It is reported that the prevalence of hypothyroidism in diabetics varies from 0.2% to 1.7% [10]. However, a cross-sectional study showed that the prevalence of SCH was similar between patients with diabetes mellitus and healthy controls [11]. Therefore, we analysed molecular characters in patients with SCH (S), patients with SCH complicated with type 2 diabetes (SD), and healthy controls (N) by transcriptome sequencing to explore whether type 2 diabetes was associated with SCH.…”

Section: Introductionmentioning

confidence: 93%

Identification of related long non-coding RNAs and mRNAs in subclinical hypothyroidism complicated with type 2 diabetes by transcriptome analysis — a preliminary study

Jiang

Sun

et al. 2020

Endokrynologia Polska

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Introduction: The pathology mechanism of subclinical hypothyroidism and subclinical hypothyroidism complicated with type 2 diabetes remained uncertain. We aimed to find potential related long non-coding RNAs (lncRNAs) and mRNAs in the above diseases. Material and methods: Transcriptome sequencing was performed in three patients with subclinical hypothyroidism (S), three patients with subclinical hypothyroidism complicated with type 2 diabetes (SD), and three healthy controls (N). Differentially expressed mRNAs (DEmRNAs) and differentially expressed lncRNAs (DElncRNAs) were screened in S vs. N, SD vs. N, and SD vs. S group, and the nearby and co-expressed DEmRNAs of DElncRNAs were screened in S vs. N and SD vs. N. Moreover, functional analysis of DEmRNAs was then performed by Metascape. Results: In total, 465, 1058, and 943 DEmRNAs were obtained in S vs. N, SD vs. N, SD vs. S, respectively, and 191 overlapping genes were obtained in S vs. N and SD vs. N group. Among which, LAIR2, PNMA6A, and SFRP2 were deduced to be involved in subclinical hypothyroidism, and GPR162, APOL4, and ANK1 were deduced to be associated with subclinical hypothyroidism complicated with type 2 diabetes. A total of 50, 100, and 88 DElncRNAs were obtained in S vs. N, SD vs. N and SD vs. S, respectively. Combining with the interaction network of DElncRNA-DEmRNA, PAX8-AS1, co-expressed with KIR3DL1, was identified to function in subclinical hypothyroidism, and JHDM1D-AS1, co-expressed with ANK1, was deduced to play a role in subclinical hypothyroidism complicated with type 2 diabetes. Conclusions: Dysfunctional lncRNAs and mRNAs may be involved in the development of subclinical hypothyroidism and subclinical hypothyroidism complicated with type 2 diabetes.

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Poor glycemic control is associated with the risk of subclinical hypothyroidism in patients with type 2 diabetes mellitus

Cited by 37 publications

References 33 publications

Observational Study Evaluating Association of Type 2 Diabetes Mellitus and Thyroid Dysfunction

Observational Study Evaluating Association of Type 2 Diabetes Mellitus and Thyroid Dysfunction

Relationship of TSH with BMI in subclinical hypothyroid patients

Identification of related long non-coding RNAs and mRNAs in subclinical hypothyroidism complicated with type 2 diabetes by transcriptome analysis — a preliminary study

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