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.
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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
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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
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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
Research works printed but not linked: 1
- 10.1210/jcem.87.2.8182 · DOI · Paper page
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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
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