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Subclinical Hypothyroidism and Type 2 Diabetes: A Systematic Review and Meta-Analysis
Open accessAbstract
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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“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]
In the citing paper
“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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Background
Metadata
- 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
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-08-13
- Volume
- 10
- Issue
- 8
- Pages
- e0135233
- ISSN
- 1932-6203 (ISSN-L)
- 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
- gold
- doi.org
- 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
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 ›
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