The DOI matches its Crossref record; 37 of the 37 references it cites were found in a registry or an index.
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“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 the citing paper
“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]
Citations
Cites
Hollowell, J. G., Staehling, N. W., Flanders, W. D., Hannon, W. H., Gunter, E. W., Spencer, C. A., & Braverman, L. E. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.87.2.489 · Cited by 4,279
Thyroid hormone and the cardiovascular system.
Klein, I., & Ojamaa, K. (2001) · New England Journal of Medicine · doi:10.1056/nejm200102153440707 · Cited by 2,300
Subclinical Thyroid Disease: Scientific Review and Guidelines for Diagnosis and Management
Surks, M. I., Ortiz, E., Daniels, G. H., Sawin, C. T., Col, N. F., Cobin, R. H., Franklyn, J. A., Hershman, J. M., Burman, K. D., Denke, M. A., et al. (2004) · JAMA · doi:10.1001/jama.291.2.228 · Cited by 1,800
Hak, A. E., Pols, H. A. P., Visser, T. J., Drexhage, H. A., Hofman, A., & Witteman, J. C. M. (2000) · Annals of Internal Medicine · doi:10.7326/0003-4819-132-4-200002150-00004 · Cited by 1,336
Diabetes and Decline in Heart Disease Mortality in US Adults
Gu, K. (1999) · JAMA · doi:10.1001/jama.281.14.1291 · Cited by 856
Manson, J. E. (1991) · Archives of Internal Medicine · doi:10.1001/archinte.1991.00400060077013 · Cited by 675
Fade, J. V., Franklyn, J. A., Cross, K. W., Jones, S. C., & Sheppard, M. C. (1991) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1991.tb01739.x · Cited by 567
Subclinical thyroid dysfunction as a risk factor for cardiovascular disease
Walsh, J. P., Bremner, A. P., Bulsara, M. K., O’Leary, P., Leedman, P. J., Feddema, P., & Michelangeli, V. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.21.2467 · Cited by 536
Cooper, D. S. (2001) · New England Journal of Medicine · doi:10.1056/nejm200107263450406 · Cited by 530
Subclinical hypothyroidism and the risk of heart failure, other cardiovascular events, and death
Rodondi, N., Newman, A. B., Vittinghoff, E., de Rekeneire, N., Satterfield, S., Harris, T. B., & Bauer, D. C. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.21.2460 · Cited by 503
Effects of Subclinical Thyroid Dysfunction on the Heart
Biondi, B., Palmieri, E. A., Lombardi, G., & Fazio, S. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-137-11-200212030-00011 · Cited by 443
Frequency of Thyroid Dysfunction in Diabetic Patients: Value of Annual Screening
Perros, P., McCrimmon, R. J., Shaw, G., & Frier, B. M. (1995) · Diabetic Medicine · doi:10.1111/j.1464-5491.1995.tb00553.x · Cited by 441
Profile for Estimating Risk of Heart Failure
Kannel, W. B., D’Agostino, R. B., Silbershatz, H., Belanger, A. J., Wilson, P. W. F., & Levy, D. A. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.11.1197 · Cited by 428
Subclinical Hypothyroidism Is Mild Thyroid Failure and Should be Treated
McDermott, M. T., & Ridgway, E. C. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.10.7959 · Cited by 398
Meier, C., Staub, J.-J., Roth, C.-B., Guglielmetti, M., Kunz, M., Miserez, A. R., Drewe, J., Huber, P., Herzog, R. F. K., & Müller-Stich, B. P. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.10.7973 · Cited by 397
Gharib, H., Tuttle, R. M., Baskin, H. J., Fish, L. H., Singer, P. A., & McDermott, M. T. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1231 · Cited by 394
Lo, J. C.-M., Chertow, G. M., Go, A. S., & Hsu, C. (2005) · Kidney International · doi:10.1111/j.1523-1755.2005.00169.x · Cited by 372
Left Ventricular Diastolic Dysfunction in Patients with Subclinical Hypothyroidism
Biondi, B., Fazio, S., Palmieri, E. A., Carella, C., Panza, N., Cittadini, A., Bonè, F., Lombardi, G., & Saccà, L. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.6.5733 · Cited by 334
Cardiovascular and Atherogenic Aspects of Subclinical Hypothyroidism
Kahaly, G. J. (2000) · Thyroid · doi:10.1089/10507250050137743 · Cited by 310
Monzani, F., Di Bello, V., Caraccio, N., Bertini, A., Giorgi, D., Giusti, C., & Ferrannini, E. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.3.7291 · Cited by 308
Screening for Thyroid Disease: An Update
Helfand, M., & Redfern, C. C. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-129-2-199807150-00020 · Cited by 304
Caraccio, N., Ferrannini, E., & Monzani, F. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.4.8378 · Cited by 294
Díez, J. J., & Iglesias, P. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-032061 · Cited by 281
Correlation between severity of thyroid dysfunction and renal function
den Hollander, J. G., Wulkan, R. W., Mantel, M. J., & Berghout, A. (2005) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2005.02236.x · Cited by 263
The Treatment of Subclinical Hypothyroidism Is Seldom Necessary
Chu, J. W., & Crapo, L. M. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.10.7961 · Cited by 231
Thyroid Hormone and the Kidney
Katz, A. I., Emmanouel, D. S., & Lindheimer, M. D. (2008) · The Nephron journals/Nephron journals · doi:10.1159/000180514 · Cited by 186
Of mice and men and elephants: Metabolic rate sets glomerular filtration rate
Singer, M. A. (2001) · American Journal of Kidney Diseases · doi:10.1016/s0272-6386(01)80073-1 · Cited by 160
Screening for thyroid dysfunction in diabetics.
Feely, J., & Isles, T. E. (1979) · BMJ · doi:10.1136/bmj.1.6179.1678 · Cited by 119
Microalbuminuria in Patients With NIDDM: An Overview
Alzaid, A. (1996) · Diabetes Care · doi:10.2337/diacare.19.1.79 · Cited by 110
Simmons, D. S., Fleming, C., Voyle, J., Fou, F., Feo, S., & Gatland, B. (1998) · Diabetic Medicine · doi:10.1002/(sici)1096-9136(199802)15:2 · Cited by 76
Relation of Thyroid Disfunction, Thyroid Autoantibodies, and Renal Function
Süher, M., Koç, E., Ata, N., & Ensari, C. (2005) · Renal Failure · doi:10.1080/08860220500243338 · Cited by 60
Diabetic Nephropathy: Future avenue
Viberti, G. C., Yip-Messent, J., & Morocutti, A. (1992) · Diabetes Care · doi:10.2337/diacare.15.9.1216 · Cited by 40
Should mild subclinical hypothyroidism be treated?
Chu, J. W., & Crapo, L. M. (2002) · The American Journal of Medicine · doi:10.1016/s0002-9343(02)01073-2 · Cited by 17
Should thyroid function tests be done annually in all patients with diabetes?
Badman, M. K., & Chowdhury, T. A. (2002) · Diabetic Medicine · doi:10.1046/j.1464-5491.19.s3.3.x · Cited by 16
Urinary beta-2 microglobulin in renal dysfunction associated with hypothyroidism
Algün, E., Topal, C., Öztürk, M., Şekeroğlu, M. R., & Durmuş, A. (2004) · International Journal of Clinical Practice · doi:10.1111/j.1368-5031.2004.0014.x · Cited by 15
Chen, H.-S., Wu, T.-E., Jap, T., Lee, S.-H., Wang, M.-L., Lu, R.-A., Chen, R.-L., & Lin, H.-D. (2006) · Journal of the Chinese Medical Association · doi:10.1016/s1726-4901(09)70252-7 · Cited by 8
Evoked potentials in neurological diagnosis.
Mastaglia, F. L., & Carroll, W. M. (1982) · BMJ · doi:10.1136/bmj.285.6356.1678 · Cited by 8
Research works printed but not linked: 1
- 10.1210/jcem.87.2.8182 · DOI · Paper page
Cited by
Sorted by citations
Thyroid dysfunction and diabetes mellitus: two closely associated disorders
Biondi, B., Kahaly, G. J., & Robertson, R. P. (2019) · Endocrine Reviews · doi:10.1210/er.2018-00163 · Cited by 598
Thyroid Disorders and Diabetes Mellitus
Hage, M. P., Zantout, M. S., & Azar, S. T. (2011) · Journal of Thyroid Research · doi:10.4061/2011/439463 · Cited by 344
“Furthermore, an increased risk of nephropathy was shown in type 2 diabetic patients with subclinical hypothyroidism [51] which could be explained by the decrease in cardiac output and increase in peripheral vascular resistance seen with hypothyroidism and the resulting decrease in renal flow and glomerular filtration…”
BackgroundPrevalence of Subclinical Hypothyroidism in Patients with Chronic Kidney Disease
Chonchol, M., Lippi, G., Salvagno, G. L., Zoppini, G., Muggeo, M., & Targher, G. (2008) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.00800208 · Cited by 266
“Moreover, subclinical primary hypothyroidism has been identified as a strong predictor of all-cause mortality in chronic dialysis patients and as a risk factor for nephropathy and cardiovascular events in type 2 diabetic patients (8,9).”
BackgroundTreatment with thyroid hormone
Biondi, B., & Wartofsky, L. (2014) · Endocrine Reviews · doi:10.1210/er.2013-1083 · Cited by 259
Subclinical hypothyroidism and type 2 diabetes: A systematic review and meta-analysis
Han, C., He, X., Xia, X., Li, Y., Shi, X., Shan, Z., & Teng, W. (2015) · PLoS ONE · doi:10.1371/journal.pone.0135233 · Cited by 258
“0 mIU/L CC 4 In total 501 869 1665 3892 Relationship between DR and SCH Chen HS [47] 2007 Taipei 67.”
Background
Metadata
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review