Abstract
ContextThyroid hormone influences glucose homeostasis through central and peripheral regulations. To date, the link between sensitivity to thyroid hormones and prediabetes remains unknown. We aimed to investigate the association between thyroid hormones sensitivity and risk of prediabetes in both general and euthyroid populations.MethodsParticipants with serum free triiodothyronine (FT3), free thyroxine (FT4), and thyrotropin (TSH) measurements from the health checkup programs of the First Hospital of China Medical University were collected. We measured the parameters representing central and peripheral sensitivities to thyroid hormones (central sensitivity, assessed by calculating Thyroid Feedback Quantile-based Index (TFQI), TSH Index (TSHI), and Thyrotroph Thyroxine Resistance Index (TT4RI); peripheral sensitivity, evaluated by FT3/FT4 ratio). Associations between thyroid hormones sensitivities and risk of prediabetes were assessed with logistic regression.ResultsA total of 4378 participants (mean age ± SD, 49 ± 11 years) were included, with 1457 (33%) subjects had prediabetes. The risk of prediabetes was negatively associated with levels of TSHI (odds ratio [OR] 0.91; 95% confidence interval [CI], 0.85–0.97), TT4RI (OR 0.91; 95% CI, 0.84–0.99) and Parametric TFQI (PTFQI) (OR 0.89; 95% CI, 0.83–0.95) among all subjects. The association remained significant in euthyroid subjects and euthyroid subjects with negative thyroid autoimmunity. Higher FT3/FT4 ratio was associated with a mild increased risk of prediabetes (95% CI 1.09; 1.02–1.16). Compared with subjects in the lowest quartile of PTFQI, those in the highest quartile had lower risk of prediabetes (0.70; 95% CI, 0.58–0.84).ConclusionsDecreased central sensitivity to thyroid hormones is associated with lower risk of prediabetes. This demonstrates the complex interaction between thyroid system and glucose metabolism. Future studies are warranted to confirm our findings and underlying mechanisms.
Highlights
Prediabetes is a condition of intermediate hyperglycemia below the diagnostic threshold of type 2 diabetes mellitus (T2DM)
We investigated the odds ratio (OR) of prediabetes with per SD change of indices of thyroid hormone sensitivity in three adjusted models
With per SD increase of TSH index (TSHI), TSH T4 resistance index (TT4RI), and Parametric Thyroid Feedback Quantile-based Index (PTFQI), the odds ratio of prediabetes was 0.91, 0.91, and 0.89, respectively
Summary
Prediabetes is a condition of intermediate hyperglycemia below the diagnostic threshold of type 2 diabetes mellitus (T2DM). It is well established that patients with thyroid disorders were more likely to develop obesity, metabolic syndrome and diabetes than healthy individuals [5]. Both hypothyroidism and hyperthyroidism has been suggested to be associated with diabetes [6,7,8]. Even variations of thyroid function within normal range might be associated with development and progression of diabetes [9]. These contradictory findings from previous studies suggest there are more complex pathophysiologic mechanisms linking the relationship between thyroid hormones and glucose metabolism
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