Top

Journal of Endocrinological Investigation

Published in:

01-12-2016 | Original Article

The effect of glycaemic control in type 2 diabetic patients with subclinical hypothyroidism

Authors: X. Fu, H. Xia, H. Mao, S. Zhao, Z. Wang

Published in: Journal of Endocrinological Investigation | Issue 12/2016

Abstract

Objective

The purpose of this study was to investigate the effect of glycaemic control on subclinical hypothyroidism (SCH) in Chinese type 2 diabetic patients.

Methods

The study included 476 diabetic patients with SCH admitted for treatment of type 2 diabetes. The controls were selected euthyroid patients with similar characteristics regarding [age, body mass index (BMI), gender, previous hypertension or duration of diabetes, and smoke]. Total cholesterol (TC), LDL cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), the homeostatic model assessment of insulin resistance ratio (HOMA-IR), fasting plasma glucose, hemoglobin A_1c (HbA_1c), as well as plasma levels of thyrotrophin, and free thyroxine (FT4) were assessed at baseline and after 6 months of glycaemic control treatment.

Results

The LDL-C level and HOMA-IR value were significantly higher in the SCH group. Glycaemic control reduced HOMA-IR, HbA_1c, LDL-C, and TG level in patients with SCH. Furthermore, glycaemic control plays a negative effect on thyrotrophin in the SCH group, while this effect was not observed in euthyroid subjects. HbA_1c plays a positive correlation with HOMA-IR (r = 0.048, p < 0.001), fasting plasma glucose (r = 0.086, p < 0.001), LDL-C (r = 0.062, p < 0.001) and TG (r = 0.021, p = 0.009).

Conclusion

Our study shows that glycaemic control may bring some benefits to type 2 diabetic patients with SCH.

Cooper DS, Biondi B (2012) Subclinical thyroid disease. Lancet 379(9821):1142–1154CrossRefPubMed

Biondi B, Cooper DS (2008) The clinical significance of subclinical thyroid dysfunction. Endoce Rev 29:76–131CrossRef

Nanchen D, Gussekloo J, Westendorp RG, Stott DJ, Jukema JW, Trompet S, Ford I, Welsh P, Sattar N, Macfarlane PW, Mooijaart SP, Rodondi N (2012) Subclinical thyroid dysfunction and the risk of heart failure in older persons at high cardiovascular risk. J Clin Endocrinol Metab 97(3):852–861CrossRefPubMed

Sgarbi JA, Matsumura LK, Kasamatsu TS, Ferreira SR, Maciel RM (2010) Subclinical thyroid dysfunctions are independent risk factors for mortality in a 7.5-year follow-up: the Japanese-Brazilian thyroid study. Eur J Endocrinol 162:569–577CrossRefPubMed

Rodondi N, Elzen WP, Bauer DC, Cappola AR, Razvi S, Walsh JP, Asvold BO, Iervasi G, Imaizumi M, Collet TH, Bremner A, Maisonneuve P, Sgarbi JA, Khaw KT, Vanderpump MP, Newman AB, Cornuz J, Franklyn JA, Westendorp RG, Vittinghoff E, Gussekloo J (2010) Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA 304:1365–1374CrossRefPubMedPubMedCentral

Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA et al (2002) Serum TSH, T4, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 87(2):489–499CrossRefPubMed

Zhao W, Han C, Shi X, Xiong C, Sun J, Shan Z et al (2014) Prevalence of goiter and thyroid nodules before and after implementation of the universal salt iodization program in mainland China from 1985 to 2014: a systematic review and meta-analysis. PLoS One 9(10):e109549CrossRefPubMedPubMedCentral

Yasuda T, Kaneto H, Kuroda A, Yamamoto T, Takahara M, Naka T, Miyashita K, Fujisawa K, Sakamoto F, Katakami N, Matsuoka T, Shimomura I (2011) Subclinical hypothyroidism is independently associated with albuminuria in people with type 2 diabetes. Diabetes Res Clin Pract 94:e75–e77CrossRefPubMed

Yang JK, Shi J, Liu W (2010) YB, Li. An association between subclinical hypothyroidism and sight threatening diabetic retinopathy in type 2 diabetic patients. Diabetes Care 33:1018–1020CrossRefPubMedPubMedCentral

10.

Chen HS, Wu TE, Jap TS, Lu RA, Wang ML, Chen RL, Lin HD (2007) Subclinical hypothyroidism is a risk factor for nephropathy and cardiovascular disease in type 2 diabetic patients. Diabet Med 24:1336–1344CrossRefPubMed

11.

Tagami T, Tamamaha T, Shimazu S, Honda K, Nanba K, Nomura H, Yoriko SU, Usui T, Shimatsu A (2010) M. Naruse.Lipid profiles in the untreated patients with Hashimoto thyroiditis and the effects of thyroxine treatment on subclinical hypothyroidism with Hashimoto thyroiditis. Endocr J 57:253–258CrossRefPubMed

12.

Takashima N, NiwamMannami T, Tomoike H, Iwai N (2007) Characterization of subclinical thyroid dysfunction from cardiovascular and metabolic viewpoints: the Suita study. Circ J 71:191–195CrossRefPubMed

13.

Bell RJ, Rivera-Woll L, Davison SL, Topliss DJ, Donath S, Davis SR (2007) Well- being, health-related quality of life and cardiovascular disease risk profile in women with subclinical thyroid disease-a community-based study. Clin Endocrinol 66:548–556

14.

Bakker SJ, Maaten JC, Snijders CP, Slaets JP, Heine RJ, Gans RO (2001) The relationship between thyrotropin and low density lipoprotein cholesterol is modified by insulin sensitivity in healthy euthyroid subjects. J Clin Endocrinol Metab 86:1206–1211PubMed

15.

Pearce EN et al (2012) Update in lipid alterations in subclinical hypothyroidism. J Clin Endocrinol Metab 97(2):326–333CrossRefPubMed

16.

Walsh JP, Bremner AP, Bulsara MK, O’leary P, Leedman PJ, Feddema P, Michelangeli V (2005) Thyroid dysfunction and serum lipids: a community-based study. Clin Endocrinol 63:670–675CrossRef

17.

Lai Y, Wang J, Jiang F, Wang B, Chen Y, Li M, Liu H, Li C, Xue H, Li N, Yu J, Shi L, Bai X, Hou X, Zhu L, Lu L, Wang S, Xing Q, Teng X, Teng W, Shan Z (2011) The relationship between serum thyrotropin and components of metabolic syndrome. Endocr J 58:23–30CrossRefPubMed

18.

Marwaha RK, Tandon N, Garg MK, Kanwar R, Sastry A, Narang A, Arora S, Bhadra K (2011) Dyslipidemia in subclinical hypothyroidism in an Indian population. Clin Biochem 44:1214–1217CrossRefPubMed

19.

Khan HA, Sobki SH, Khan SA (2007) Association between glycaemic control and serum lipids profile in type 2 diabetic patients: HbA1c predicts dyslipidaemia. Clin Exp Med 7:24–29CrossRefPubMed

20.

Tian L, Song Y, Xing M et al (2010) A novel role for thyroid-stimulating hormone: up-regulation of hepatic 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase expression through the cyclic adenosine monophosphate/protein kinase A/cyclic adenosine monophosphate-responsive element binding protein pathway. Hepatology 52:1401–1409CrossRefPubMed

21.

Ness GC, Chambers CM (2000) Feedback and hormonal regulation of hepatic 3-hydroxy-3-methylglutaryl coenzyme A reductase: the concept of cholesterol buffering capacity. Proc Soc Exp Biol Med 224:8–19CrossRefPubMed

22.

Sigal GA, Medeiros G, Vinagre JC, Diament J, Maranhão RC (2011) Lipid metabolism in subclinical hypothyroidism: plasma kinetics of triglyceride-rich lipoproteins and lipid transfer to high-density lipoprotein before and after levothyroxine treatment. Thyroid 21:347–353CrossRefPubMed

23.

Gray S, Smith AF, Clarke BF (1981) Hypercholesterolemia in diabetics with clinically unrecognized primary thyroid failure. Horm Metab Res 13:508–510CrossRefPubMed

24.

Krysiak R, Okrzesik J, Okopien B (2015) Different effects of metformin on the hypothalamic-pituitary-thyroid axis in bromocriptine- and cabergoline-treated patients with Hashimoto’s thyroiditis and glucose metabolism abnormalities. Exp Clin Endocrinol Diabetes 123:561–566CrossRefPubMed

25.

Krysiak R, Gdula-Dymek A, Okopien B (2013) Monocyte-suppressing effect of high-dose metformin in fenofibrate-treated patients with impaired glucose tolerance. Phamracol Rep 65:1311–1316

26.

Krysiak R, Okopien B (2012) Lymphocyte-suppressing and systemic anti- inflammatory effects of high-dose metformin in simvastatin-treated patients with impaired fasting glucose. Atherosclerosis 225:403–407CrossRefPubMed

27.

Krysiak R, Okopien B (2011) The effect of levothyroxine and selenomethionine on lymphocyte and monocyte cytokine release in women with Hashimoto’s thyroiditis. J Clin Endocrinol Metab 96:2206–2215CrossRefPubMed

28.

Tuzcu A, Bahceci M, Gokalp D, Tuzum Y, Gunes K (2005) Subclinical hypothyroidism may be associated with elevated high-sensitive C reactive protein (low grade inflammation) and fasting hyperinsulinemia. Endocr J 58:89–94CrossRef

29.

Lambadiari V, Mitrou P, Maratu E, Raptis AE, Tountas N, Raptis SA, Dimitriadis G (2010) Thyroid hormone are positively associated with insulin resistance early in the development of type 2 diabetes. Endocrine 39:28–32CrossRefPubMed

30.

Maratou E, Hadjidakis DJ, Kollias A, Tsegka K, Peppa M, Alevizaki M, Mitrou P, Lambadiari V, Boutati E, Nikzas D, Tountas N, Economopoulos T, Raptis SA, Dimitriadis G (2009) Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. Eur J Endocrinol 160:785–790CrossRefPubMed

31.

Dimitriadis G, Mitrou P, Lambadiari V, Boutati E, Maratou E, Panagiotakos DB, Koukkou E, Tzanela M, Thalassinos N, Raptis SA (2006) Insulin action in adipose tissue and muscle in hypothyroidism. J Clin Endocrinol Metab 91:4930–4937CrossRefPubMed

32.

Cettour-Rose P, Theander-Carrillo C, Asensio C, Klein M, Visser TJ, Burger AG, Meier CA, Rohner-Jeanrenaud F (2005) Hypothyroidism in rats decreases peripheral glucose utilization, a defect partially corrected by central leptin infusion. Diabetologia 48:624–633CrossRefPubMed

33.

Kim BY, Kim CH, Jung CH, Mok JO, Suh KI, Kang SK (2011) Association between subclinical hypothyroidism and severe diabetic retinopathy in Korean patients with type 2 diabetes. Endocr J 58:1065–1070CrossRefPubMed

34.

Furukawa S, Yamomoto S, Todo Y, Maruyama K, Miyake T, Ueda T et al (2014) Association between subclinical hypothyroidism and diabetic nephropathy in patients with type 2 diabetes mellitus. Endocr J 61(10):1011–1018CrossRefPubMed

Title: The effect of glycaemic control in type 2 diabetic patients with subclinical hypothyroidism
Authors: X. Fu
H. Xia
H. Mao
S. Zhao
Z. Wang
Publication date: 01-12-2016
Publisher: Springer International Publishing
Published in: Journal of Endocrinological Investigation / Issue 12/2016
Electronic ISSN: 1720-8386
DOI: https://doi.org/10.1007/s40618-016-0519-4

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 12/2016

Negative correlation between tumour size and cortisol/ACTH ratios in patients with Cushing’s disease harbouring microadenomas or macroadenomas

Saint Wilgefortis: sudden hirsutism to prevent an unwanted marriage

Association between type 1, type 2 cytokines, diabetic autoantibodies and 25-hydroxyvitamin D in children with type 1 diabetes

The phenotype of newly diagnosed Graves’ disease in Italy in recent years is milder than in the past: results of a large observational longitudinal study

The use of serum anti-Mullerian hormone (AMH) levels and antral follicle count (AFC) to predict the number of oocytes collected and availability of embryos for cryopreservation in IVF

Does vitamin D have any role in the improvement of diabetic peripheral neuropathy in type 1 diabetic patients?

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials