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Cited by 258Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryDiabetes, Cardiovascular Risks, and Lipoproteins

Subclinical hypothyroidism and type 2 diabetes: A systematic review and meta-analysis

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Han, Cheng, He, Xue, Xia, Xinghai, Li, Yongze, Shi, Xiaoguang, Shan, Zhongyan, Teng, Weiping·2015·PLoS ONE
DOI 10.1371/journal.pone.0135233PMC PMC4535849
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Abstract

BACKGROUND: Abundant evidence suggests an association between subclinical hypothyroidism (SCH) and type 2 diabetes mellitus (T2DM), but small sample sizes and inconclusive data in the literature complicate this assertion. OBJECTIVE: We measured the prevalence of SCH in T2DM population, and investigated whether T2DM increase the risk of SCH and whether SCH was associated with diabetic complications. METHODS: We conducted a meta-analysis using PubMed, EMBASE, Web of Science, Wan Fang, CNKI and VIP databases for literature search. We obtained studies published between January 1, 1980 to December 1, 2014. The studies were selected to evaluate the prevalence of SCH in T2DM subjects, compare the prevalence of SCH in T2DM subjects with those non-diabetics, and investigate whether diabetic complications were more prevalent in SCH than those who were euthyroid. Fixed and random effects meta-analysis models were used, and the outcome was presented as a pooled prevalence with 95% confidence interval (95% CI) or a summary odds ratio (OR) with 95% CI. RESULTS: Through literature search, 36 articles met the inclusion criteria and these articles contained a total of 61 studies. Funnel plots and Egger's tests showed no publication bias in our studies, except for the pooled prevalence of SCH in T2DM (P = 0.08) and OR for SCH in T2DM (P = 0.04). Trim and fill method was used to correct the results and five potential missing data were replaced respectively. The adjusted pooled prevalence of SCH in T2DM patients was 10.2%, meanwhile, T2DM was associated with a 1.93-fold increase in risk of SCH (95% CI: 1.66, 2.24). Furthermore, SCH might affect the development of diabetic complications with an overall OR of 1.74 (95% CI: 1.34, 2.28) for diabetic nephropathy, 1.42 (95% CI: 1.21, 1.67) for diabetic retinopathy, 1.85 (95% CI: 1.35, 2.54) for peripheral arterial disease, and 1.87 (95% CI: 1.06, 3.28) for diabetic peripheral neuropathy. CONCLUSIONS: T2DM patients are more likely to have SCH when compared with healthy population and SCH may be associated with increased diabetic complications. It is necessary to screen thyroid function in patients with T2DM, and appropriate individualized treatments in addition to thyroid function test should be given to T2DM patients with SCH as well.

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  • Subclinical hypothyroidism might favor diabetic complications with an odds ratio of 1.74 for nephropathy, 1.42 for retinopathy, 1.85 for peripheral arterial disease, and 1.87 for peripheral neuropathy.

    “Moreover, SCH might favor diabetic complications with an OR of 1.74 (nephropathy), 1.42 (retinopathy), 1.85 (peripheral arterial disease), and 1.87 (peripheral neuropathy) (103).”

    From L-T4 therapy in the presence of pharmacological interferents (2020) · cites this paper as [103]

  • Hypothyroidism negatively impacts glucose and lipid metabolism, possibly favoring insulin resistance and hypercholesterolemia, which may be at least partly reverted by replacement therapy.

    “Finally, the presence of hypothyroidism negatively impacts glucose and lipid metabolism possibly favoring the onset of insulin resistance and hypercholesterolemia which may, at least in part, be reverted by replacement therapy [9, 10].”

    From Thyroid and heart, a clinically relevant relationship (2021) · cites this paper as [9]

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Authors
Han, C., He, X., Xia, X., Li, Y., Shi, X., Shan, Z., & Teng, W.
Affiliations
First Hospital of China Medical University (CN)
Corresponding author
Shi, Xiaoguang
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2015-08-13
Volume
10
Issue
8
Pages
e0135233
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0135233
PMC
PMC4535849
OpenAlex
W1766479548
Cited by
258
References
65
Citations by year
2026: 10 · 2025: 31 · 2024: 25 · 2023: 36 · 2022: 23 · 2021: 29 · 2020: 31 · 2019: 25 · 2018: 24 · 2017: 10 · 2016: 11 · 2015: 3
FWCI
2.41
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
China Medical University
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
subclinical hypothyroidism, type 2 diabetes, prevalence, diabetes complications, diabetic nephropathy, diabetic retinopathy, peripheral arterial disease, diabetic peripheral neuropathy, thyroid function
MeSH terms
Diabetes Mellitus, Type 2, Diabetic Nephropathies, Diabetic Neuropathies, Diabetic Retinopathy, Humans, Hypothyroidism, Risk Factors, Prevalence, Odds Ratio

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