Subclinical hypothyroidism is a risk factor for nephropathy and cardiovascular diseases in type 2 diabetic patients.
Abstract
AIMS: The purpose of this study was to determine the relationship between subclinical hypothyroidism and prevalence of retinopathy and nephropathy, incident cardiovascular disease, and mortality in Type 2 diabetic patients without taking thyroid medication. METHODS: Serum thyrotropin and free thyroxine concentrations were measured in 588 Type 2 diabetic subjects in Taipei Veterans General Hospital, Taiwan. In a cross-sectional study, we examined the prevalence of retinopathy and nephropathy. In a longitudinal study, we examined the risk of cardiovascular disease events, cardiovascular mortality and total mortality in the 4-year follow-up. RESULTS: In the cross-sectional analysis, subclinical hypothyroidism was associated with a greater prevalence of diabetic nephropathy (odds ratio, 3.15 [95% CI, 1.48-6.69]) and did not show a high prevalence of diabetic retinopathy (odds ratio, 1.15 [95% CI, 0.59-2.26]) compare to euthyroid diabetics. During the 44.0 +/- 7.4 months of follow-up, 51 participants had cardiovascular events. The risk of cardiovascular events was significantly increased in Type 2 diabetics with subclinical hypothyroidism after adjustment for age, sex, A1C, other standard cardiovascular risk factors and medication (hazard ratio, 2.93; 95% CI, 1.15-7.48; P = 0.024), but it became nonsignificant after additional adjustment for urinary albumin-to-creatinine ratio (hazard ratio, 2.06; 95% CI, 0.67-6.36; P = 0.211). The rates of cardiovascular-related and total mortality did not significantly differ by thyroid status. CONCLUSIONS: Type 2 diabetic patients with subclinical hypothyroidism are associated with an increased risk of nephropathy and cardiovascular events, but not with retinopathy. Our data suggest that the higher cardiovascular events in subclinical hypothyroidism with Type 2 diabetes may be mediated with nephropathy.
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Patients with hypothyroidism and preexisting comorbidities (such as cardiovascular disease) have reduced health-related quality of life.
“Patients with hypothyroidism and preexisting comorbidities (such as cardiovascular disease) have reducedhealth-related quality of life. 44”
From Hypothyroidism: A Review (2025) · cites this paper as [44]
In a prospective, population-based cohort study of 147,201 adults in the Netherlands, of the 4537 people receiving thyroid hormone therapy, 70% had a score below the age- and sex-specific cutoff values for the RAND 36-Item Short Form Health Survey in the mental health domain compared with 50% of people not receiving thyroid hormone therapy (P < .001).
“In a prospective, populationbasedcohortstudyof147 201adultsintheNetherlands,ofthe4537 people receiving thyroid hormone therapy, 70% had a score below the age- and sex-specific cutoff values for the RAND 36-Item Short FormHealthSurvey(aquality-of-life measure) in the mental health domain of the general health dimension compared with 50% of people not receiving thyroid hormone therapy ( P < .001)”
From Hypothyroidism: A Review (2025) · cites this paper as [44]
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- Authors
- Chen, H. ‐., Wu, T. ‐. J., Jap, T. ‐., Lu, R. ‐., Wang, M. ‐., Chen, R. ‐., & Lin, H. ‐.
- Affiliations
- Taipei Veterans General Hospital (TW)
- National Yang Ming University (TW)
- ORCID
- Chen, H.‐S.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2007-11-26
- Volume
- 24
- Issue
- 12
- Pages
- 1336-1344
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W2052124893
- Cited by
- 189
- References
- 37
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 10 · 2023: 19 · 2022: 12 · 2021: 14 · 2020: 16 · 2019: 12 · 2018: 13 · 2017: 9 · 2016: 11 · 2015: 8 · 2014: 16 · 2013: 11 · 2012: 6
- FWCI
- 3.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- subclinical hypothyroidism, type 2 diabetes, diabetic nephropathy, diabetic retinopathy, cardiovascular disease, cardiovascular mortality, all-cause mortality, albumin-creatinine ratio, thyroid-stimulating hormone, free thyroxine, thyroid function
- MeSH terms
- Aged, Cardiovascular Diseases, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Diabetic Retinopathy, Female, Humans, Hypothyroidism, Male, Middle Aged, Risk Factors, Taiwan, Thyrotropin, Thyroxine, Cohort Studies, Incidence, Odds Ratio
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