OR33-2 Thyroid Function and Type 2 Diabetes Risk: A Population-Based Prospective Cohort Study

Program: Abstracts - Orals, Poster Previews, and Posters
Session: OR33- Non-Neoplastic Thyroid Disorders - Thyroid Immunology
Bench to Bedside
Sunday, April 3, 2016: 11:45 AM-1:15 PM
Presentation Start Time: 12:00 PM
Hall B2 (BCEC)

Health Disparities

Outstanding Abstract Award
Layal Chaker*1, Symen Ligthart2, Tim IM Korevaar3, Albert Hofman4, Oscar H Franco2, Abbas Dehghan2 and Robin P. Peeters5
1Erasmus Medical Center, Rotterdam, 2Erasmus MC, Rotterdam, 3Erasmus MC, Rotterdam, Netherlands, 4Erasmus Medical Center, 5Erasmus Univ Rotterdam, Rotterdam, Netherlands
Thyroid function and type 2 diabetes risk: a population-based prospective cohort study

L. Chaker1,2,3, S. Ligthart3, T.I.M. Korevaar1,2,3, A. Hofman3, O.H. Franco3, A. Dehghan3*, R.P. Peeters1,2,3*

1Rotterdam Thyroid Center, 2Department of Internal Medicine, 3Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands

* these authors contributed equally to this work

Abstract

Background: Several mechanisms have been proposed linking thyroid function to type 2 diabetes, including body-mass index and insulin resistance. However, the association of thyroid function with future risk of diabetes has not been established. Furthermore, the association of thyroid function with prediabetes risk remains elusive.
Objective: We aimed to investigate the association of thyroid function with incident prediabetes, incident diabetes and progression from prediabetes to diabetes in a prospective population-based cohort study.
Methods: We included 8,452 participants (mean age 65 years) from the Rotterdam Study with thyroid function measurement and longitudinal assessment of prediabetes and diabetes. Cases of prediabetes and diabetes were ascertained according to WHO guidelines through active follow-up using general practitioners’ records, hospital discharge letters and serum glucose measurements from research center visits. Cox-models were used to investigate the association of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) with incident prediabetes, incident diabetes and progression from prediabetes to diabetes and additionally restricting to thyroid function within the reference range of TSH and FT4. Multivariable models adjusted for age, sex, HDL cholesterol, blood pressure and glucose at baseline amongst others.
Results: During a mean follow-up of 7.9 years, 1100 participants developed prediabetes and 798 developed diabetes. Higher TSH levels were associated with a higher diabetes risk (Hazard Ratio [HR] 1.13, 95% confidence interval [CI], 1.08-1.18, per logTSH), even within the reference range of thyroid function (HR 1.24, CI, 1.06-1.45). Higher FT4 levels were associated with a lower diabetes risk in all (HR 0.96, CI, 0.93-0.99, per pmol/L) and in those within the reference range (HR 0.96, CI, 0.92-0.99). The risk of progression from prediabetes to diabetes was 1.4 times higher comparing the lowest to the highest tertile within the normal range of thyroid function (p= 0.002).
Conclusion: Low and low-normal thyroid function are risk factors for incident diabetes, especially in individuals with prediabetes. Future studies should investigate whether screening for and treatment of (subclinical) hypothyroidism is beneficial in subjects at risk of developing diabetes.
Sources of Research support: Erasmus University Medical Center and Erasmus University, Rotterdam.
The authors have nothing to disclose

Nothing to Disclose: LC, SL, TIK, AH, OHF, AD, RPP

*Please take note of The Endocrine Society's News Embargo Policy at https://www.endocrine.org/news-room/endo-annual-meeting/pr-resources-for-endo