{"title":"探索2型糖尿病促甲状腺激素和甲状腺激素之间的双向关系：一项系统综述和荟萃分析。","authors":"Alireza Amirabadizadeh, Alireza Ghorbani, Fereidoun Azizi, Hengameh Abdi, Atieh Amouzegar, Ladan Mehran","doi":"10.1007/s40200-025-01612-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) and thyroid dysfunction are some of the most prevalent endocrine disorders globally. Previous studies on the association and effect of thyroid hormones in patients with diabetes have yielded contradictory results. Therefore, this meta-analysis comprehensively examined the latest evidence regarding the bilateral association between thyrotropin and thyroid hormone levels in T2DM.</p><p><strong>Methods: </strong>A thorough search across multiple databases was conducted to investigate the bidirectional relationship between thyroid hormones and T2DM. Two researchers independently performed data extraction and study quality was assessed using the Newcastle-Ottawa scale, with prevalence, odds ratios, and hazard ratios calculated using a random-effects model.</p><p><strong>Results: </strong>After screening 4159 studies, 36 were deemed eligible based on the inclusion criteria. A one-unit increase in serum thyroid-stimulating hormone (TSH) level was associated with a 2.49-fold increased odds of T2DM (OR: 2.49, 95%CI: 1.97-3.0). Similarly, a one-unit increase in Triiodothyronine (FT3) levels was associated with a 17% (HR:1.17,95%CI: 1.07-1.26) increased risk of T2DM. The pooled risk estimates of T2DM were 3.63 (95%CI: 1.63-8.09) for hypothyroidism, and 16.33 (95%CI: 7.59-35.12) for overt hypothyroidism. Individuals with thyroid dysfunction exhibited significantly higher HbA1c levels (Hedges'g: - 0.26, 95% CI: - 0.47 to - 0.06) and fasting plasma glucose (FPG) levels (Hedges'g: - 0.33, 95% CI: - 0.61 to - 0.05) compared to those with normal thyroid function.</p><p><strong>Conclusions: </strong>Thyroid dysfunction, including both overt and subclinical hypo- and hyperthyroidism, significantly increases the risk of T2DM. Elevated TSH and FT3 levels are linked to higher diabetes risk, highlighting the need for regular thyroid screening and integrated clinical management.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40200-025-01612-w.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"24 1","pages":"98"},"PeriodicalIF":1.6000,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977088/pdf/","citationCount":"0","resultStr":"{\"title\":\"Exploring the bidirectional association between thyrotropin and thyroid hormones in type 2 diabetes: a systematic review and meta-analysis.\",\"authors\":\"Alireza Amirabadizadeh, Alireza Ghorbani, Fereidoun Azizi, Hengameh Abdi, Atieh Amouzegar, Ladan Mehran\",\"doi\":\"10.1007/s40200-025-01612-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) and thyroid dysfunction are some of the most prevalent endocrine disorders globally. Previous studies on the association and effect of thyroid hormones in patients with diabetes have yielded contradictory results. Therefore, this meta-analysis comprehensively examined the latest evidence regarding the bilateral association between thyrotropin and thyroid hormone levels in T2DM.</p><p><strong>Methods: </strong>A thorough search across multiple databases was conducted to investigate the bidirectional relationship between thyroid hormones and T2DM. Two researchers independently performed data extraction and study quality was assessed using the Newcastle-Ottawa scale, with prevalence, odds ratios, and hazard ratios calculated using a random-effects model.</p><p><strong>Results: </strong>After screening 4159 studies, 36 were deemed eligible based on the inclusion criteria. A one-unit increase in serum thyroid-stimulating hormone (TSH) level was associated with a 2.49-fold increased odds of T2DM (OR: 2.49, 95%CI: 1.97-3.0). Similarly, a one-unit increase in Triiodothyronine (FT3) levels was associated with a 17% (HR:1.17,95%CI: 1.07-1.26) increased risk of T2DM. The pooled risk estimates of T2DM were 3.63 (95%CI: 1.63-8.09) for hypothyroidism, and 16.33 (95%CI: 7.59-35.12) for overt hypothyroidism. Individuals with thyroid dysfunction exhibited significantly higher HbA1c levels (Hedges'g: - 0.26, 95% CI: - 0.47 to - 0.06) and fasting plasma glucose (FPG) levels (Hedges'g: - 0.33, 95% CI: - 0.61 to - 0.05) compared to those with normal thyroid function.</p><p><strong>Conclusions: </strong>Thyroid dysfunction, including both overt and subclinical hypo- and hyperthyroidism, significantly increases the risk of T2DM. Elevated TSH and FT3 levels are linked to higher diabetes risk, highlighting the need for regular thyroid screening and integrated clinical management.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40200-025-01612-w.</p>\",\"PeriodicalId\":15635,\"journal\":{\"name\":\"Journal of Diabetes and Metabolic Disorders\",\"volume\":\"24 1\",\"pages\":\"98\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-04-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977088/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Diabetes and Metabolic Disorders\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s40200-025-01612-w\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Diabetes and Metabolic Disorders","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s40200-025-01612-w","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Exploring the bidirectional association between thyrotropin and thyroid hormones in type 2 diabetes: a systematic review and meta-analysis.
Background: Type 2 diabetes mellitus (T2DM) and thyroid dysfunction are some of the most prevalent endocrine disorders globally. Previous studies on the association and effect of thyroid hormones in patients with diabetes have yielded contradictory results. Therefore, this meta-analysis comprehensively examined the latest evidence regarding the bilateral association between thyrotropin and thyroid hormone levels in T2DM.
Methods: A thorough search across multiple databases was conducted to investigate the bidirectional relationship between thyroid hormones and T2DM. Two researchers independently performed data extraction and study quality was assessed using the Newcastle-Ottawa scale, with prevalence, odds ratios, and hazard ratios calculated using a random-effects model.
Results: After screening 4159 studies, 36 were deemed eligible based on the inclusion criteria. A one-unit increase in serum thyroid-stimulating hormone (TSH) level was associated with a 2.49-fold increased odds of T2DM (OR: 2.49, 95%CI: 1.97-3.0). Similarly, a one-unit increase in Triiodothyronine (FT3) levels was associated with a 17% (HR:1.17,95%CI: 1.07-1.26) increased risk of T2DM. The pooled risk estimates of T2DM were 3.63 (95%CI: 1.63-8.09) for hypothyroidism, and 16.33 (95%CI: 7.59-35.12) for overt hypothyroidism. Individuals with thyroid dysfunction exhibited significantly higher HbA1c levels (Hedges'g: - 0.26, 95% CI: - 0.47 to - 0.06) and fasting plasma glucose (FPG) levels (Hedges'g: - 0.33, 95% CI: - 0.61 to - 0.05) compared to those with normal thyroid function.
Conclusions: Thyroid dysfunction, including both overt and subclinical hypo- and hyperthyroidism, significantly increases the risk of T2DM. Elevated TSH and FT3 levels are linked to higher diabetes risk, highlighting the need for regular thyroid screening and integrated clinical management.
Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01612-w.
期刊介绍：
Journal of Diabetes & Metabolic Disorders is a peer reviewed journal which publishes original clinical and translational articles and reviews in the field of endocrinology and provides a forum of debate of the highest quality on these issues. Topics of interest include, but are not limited to, diabetes, lipid disorders, metabolic disorders, osteoporosis, interdisciplinary practices in endocrinology, cardiovascular and metabolic risk, aging research, obesity, traditional medicine, pychosomatic research, behavioral medicine, ethics and evidence-based practices.As of Jan 2018 the journal is published by Springer as a hybrid journal with no article processing charges. All articles published before 2018 are available free of charge on springerlink.Unofficial 2017 2-year Impact Factor: 1.816.
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