Thyroid hormone sensitivity and diabetes onset: a longitudinal cross-lagged cohort

Front Endocrinol (Lausanne). 2023 Oct 16:14:1267612. doi: 10.3389/fendo.2023.1267612. eCollection 2023.

Abstract

Purpose: Thyroid hormones sensitivity is a newly proposed clinical entity closely related with metabolic health. Prior studies have reported the cross-sectional relationship between thyroid hormones sensitivity and diabetes; however, the longitudinal association is unclear to date. We aimed to explore the relationship between impaired thyroid hormone sensitivity at baseline and diabetes onset using a cohort design.

Methods: This study enrolled 7283 euthyroid participants at the first visit between 2008 and 2009, and then annually followed until diabetes onset or 2019. Thyrotropin (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were measured to calculate thyroid hormone sensitivity by thyroid feedback quantile-based index (TFQI), Chinese-referenced parametric thyroid feedback quantile-based index (PTFQI), thyrotropin index (TSHI), thyrotroph thyroxine resistance index (TT4RI) and FT3/FT4 ratio. Cox proportional hazard model and cross-lagged panel analysis were used.

Results: The mean baseline age was 44.2 ± 11.9 years, including 4170 (57.3%) male. During a median follow-up of 5.2 years, 359 cases developed diabetes. There was no significant association between thyroid hormones sensitivity indices and diabetes onset, and adjusted hazard ratios per unit (95% CIs) were 0.89 (0.65-1.23) for TFQI, 0.91 (0.57-1.45) for PTFQI, 0.95 (0.70-1.29) for TSHI, 0.98 (0.70-1.01) for TT4RI and 2.12 (0.17-5.78) for FT3/FT4 ratio. Cross-lagged analysis supported the temporal association from fasting glucose to impaired thyroid hormones sensitivity indices.

Conclusions: Our findings could not demonstrate that thyroid hormones sensitivity status is a predictor of diabetes onset in the euthyroid population. Elevated fasting glucose (above 7.0 mmol/L) appeared to precede impaired sensitivity indices of thyroid hormones.

Keywords: TSH (thyroid stimulating hormone); cross-lagged analysis; free thyroxine; free triiodothyronine (FT3); thyroid hormones sensitivity; type 2 diabetes onset.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Diabetes Mellitus* / epidemiology
  • Diabetes Mellitus* / metabolism
  • Female
  • Glucose / metabolism
  • Humans
  • Male
  • Middle Aged
  • Thyroid Gland* / metabolism
  • Thyroid Hormones / metabolism
  • Thyrotropin / metabolism
  • Thyroxine / metabolism

Substances

  • Thyroxine
  • Thyroid Hormones
  • Thyrotropin
  • Glucose

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by the Science and Technology Development Project of JiLin Province (20210203062SF, 20200601007JC, YDZJ202201ZYTS093).