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Diabetes does not increase thyroid disorder risk
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Adults with diabetes or prediabetes have a similar rate of thyroid disorders as healthy adults, according to findings from researchers in Iran.
Fereidoun Azizi, MD, director of the Endocrine Research Center in the Research Institute for Endocrine Sciences at Shahid Beheshti University of Medical Sciences in Tehran, Iran, and colleagues evaluated data from the Tehran Thyroid Study on adults with diabetes (n = 420; mean age, 49.9 years) or prediabetes (n = 608; mean age, 54.1 years) and healthy controls (n = 2,104; mean age, 42.4 years) to assess the prevalence and incidence and predictive factors of thyroid disorders.
Overall, the prevalence of thyroid disorders was 18.9% in participants with diabetes, 19.3% in participants with prediabetes and 13.5% in healthy controls; however, no significant differences were found among the groups after adjustment for age, sex, smoking, blood pressure, BMI, thyroid peroxidase antibody (TPOAb), thyrotropin, insulin resistance index, triglycerides and cholesterol.
Among participants with diabetes, the prevalence of thyroid disorders was higher among participants with previously diagnosed diabetes (19.9%) compared with participants with newly diagnosed diabetes (18%; P = .7). Participants with diabetes had a higher prevalence of subclinical hyperthyroidism than controls (P = .02), and participants with prediabetes had a lower prevalence of clinical hypothyroidism than controls (P = .04). Women with prediabetes (P = .008) and female controls (P < .001) had a higher prevalence of thyroid disorders than men. No difference was found in prevalence of thyroid disorders between women and men with diabetes. Adults older than 50 years with diabetes had a higher prevalence of thyroid disorders than those younger than 50 years (P = .02). Participants with TPOAb levels at least 40 IU/mL had a higher prevalence of thyroid disorders than those with TPOAb levels less than 40 IU/mL in all three groups.
The incidence of thyroid disorders was lower in participants with diabetes (14 per 1,000 person-years) than those with prediabetes (18 per 1,000) and healthy controls (21 per 1,000); incidence remained higher in participants with diabetes compared with controls after adjustment for age, sex, smoking, BP, BMI, TPOAb, insulin resistance index, triglycerides and cholesterol (OR = 0.59; 95% CI, 0.36-0.95). However, no differences were found among the groups after adjustment for all variables, including baseline thyrotropin. Participants with diabetes had a higher incidence of subclinical hypothyroidism compared with controls (OR = 0.47; 95% CI, 0.25-0.89).
“A large sample size representative of the urban population of Tehran, simultaneous conduction of all thyroid tests at the same time in each patient, using same assay methods for each test, and a long follow-up period are among the main strengths of our study,” the researchers wrote. “Moreover, our study is the first to be conducted to determine the prevalence and incidence of [thyroid disorder] in prediabetics. A cohort study with a larger sample size and longer follow-up period is recommended to focus on the assessment of [thyroid disorder] in diabetics and prediabetics to gain more insight into this topic.” – by Amber Cox
Disclosures: The authors report no relevant financial disclosures.
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