دورية أكاديمية
Thyroid-Stimulating Hormone and Thyroid Hormones and Incidence of Diabetes: Prospective Results of the Brazilian Longitudinal Study of Adult Health (ELSA-BRASIL).
| العنوان: | Thyroid-Stimulating Hormone and Thyroid Hormones and Incidence of Diabetes: Prospective Results of the Brazilian Longitudinal Study of Adult Health (ELSA-BRASIL). |
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| المؤلفون: | Birck MG; Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil., Almeida-Pititto B; Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil., Janovsky CCPS; Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de Sao Paulo, Sao Paulo, Brazil., Goulart AC; Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de Sao Paulo, Sao Paulo, Brazil., Santos IS; Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de Sao Paulo, Sao Paulo, Brazil., Teixeira PFDS; Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil., Sgarbi JA; Thyroid Unit, Division of Endocrinology and Metabolism, Department of Medicine, Faculdade de Medicina de Marilia, Marilia, Brazil., Barreto SM; Medical School and Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Duncan BB; Postgraduate Program in Epidemiology and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Schmidt MI; Postgraduate Program in Epidemiology and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Lotufo PA; Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de Sao Paulo, Sao Paulo, Brazil., Bensenor IM; Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de Sao Paulo, Sao Paulo, Brazil. |
| المصدر: | Thyroid : official journal of the American Thyroid Association [Thyroid] 2022 Jun; Vol. 32 (6), pp. 694-704. Date of Electronic Publication: 2022 May 24. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Mary Ann Liebert Publishers Country of Publication: United States NLM ID: 9104317 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-9077 (Electronic) Linking ISSN: 10507256 NLM ISO Abbreviation: Thyroid Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Mary Ann Liebert Publishers, |
| مواضيع طبية MeSH: | Diabetes Mellitus*/epidemiology , Thyroid Diseases*, Adult ; Aged ; Brazil/epidemiology ; Cohort Studies ; Female ; Humans ; Incidence ; Longitudinal Studies ; Male ; Middle Aged ; Obesity ; Overweight ; Prospective Studies ; Thyroid Function Tests ; Thyroid Hormones ; Thyrotropin ; Thyroxine ; Triiodothyronine |
| مستخلص: | Background: There are conflicting data regarding the association of thyroid function with incident diabetes. We prospectively investigated thyrotropin (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and its conversion ratio (fT3:fT4) with the risk of developing diabetes in euthyroid subjects and those with subclinical thyroid dysfunction. Our hypothesis is that this relationship is a U-shaped curve since both subclinical thyroid diseases may be associated with diabetes. Methods: ELSA-Brasil is a highly admixed cohort study of 35-74 years old at baseline (2008-2010). Levels of TSH, fT4, fT3, and fT3:fT4 ratio were evaluated at baseline and incident diabetes was estimated over an 8.2-year follow-up (2017-2019). Diabetes was identified based on medical diagnosis, prescriptions, and laboratory tests. The risk of diabetes was evaluated according to quintiles of TSH, fT4, fT3, and fT3:fT4 ratio using Poisson regression with robust variance presented as relative risk (RR) with confidence interval [CI] of 95% after multivariable adjustment for sociodemographic and cardiovascular risk factors (reference third quintile), and as continuous variables. Results: We included 7948 participants (mean age, 50.2 [standard deviation 8.6] years; 54.4% female): 7177 euthyroid, 726 with subclinical hypothyroidism, and 45 with subclinical hyperthyroidism. Incidence of diabetes was 14.8%. No association was found for TSH, fT4, fT3, and fT3:fT4 ratio quintiles with incident diabetes. Using continuous variables, the increase of 1-unit (1-U) of fT4 decreased the risk of diabetes (RR 0.94 [CI 0.91-0.99]), while the increase of 1-U of the fT3:fT4 ratio increased the diabetes risk (RR 1.37 [CI 1.15-1.63]). The increase of 1-U of fT3 was associated with an increased risk of diabetes, but without significance after multivariable adjustment. In body mass index-stratified analysis, people with overweight or obesity presented a modest significantly higher risk of diabetes in the lowest quintile of fT4 (RR 1.04 [CI 1.01-1.07]) and an inverse association with incident diabetes in the first quintile of fT3:fT4 ratio (RR, 0.95 [CI 0.93-0.98]). The analyses using continuous variables presented similar findings. Conclusion: These findings suggest that fT4 and fT3 levels and the conversion rate might be additional risk factors associated with incident diabetes, especially in the presence of overweight or obesity. However, they need to be confirmed in future studies. (ClinicalTrials.gov Identifier: NCT02320461). |
| فهرسة مساهمة: | Keywords: diabetes; incidence; thyroid hormones; thyroid-stimulating hormone |
| سلسلة جزيئية: | ClinicalTrials.gov NCT02320461 |
| المشرفين على المادة: | 0 (Thyroid Hormones) 06LU7C9H1V (Triiodothyronine) 9002-71-5 (Thyrotropin) Q51BO43MG4 (Thyroxine) |
| تواريخ الأحداث: | Date Created: 20220427 Date Completed: 20220616 Latest Revision: 20220722 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1089/thy.2021.0533 |
| PMID: | 35473396 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1557-9077 |
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| DOI: | 10.1089/thy.2021.0533 |