Subclinical thyroid dysfunction and incident diabetes: a systematic review and an individual participant data analysis of prospective cohort studies.

Alwan, Heba; Villoz, Fanny; Feller, Martin; Dullaart, Robin P F; Bakker, Stephan J L; Peeters, Robin P; Kavousi, Maryam; Bauer, Douglas C; Cappola, Anne R; Yeap, Bu B; Walsh, John P; Brown, Suzanne J; Ceresini, Graziano; Ferrucci, Luigi; Gussekloo, Jacobijn; Trompet, Stella; Iacoviello, Massimo; Moon, Jae Hoon; Razvi, Salman; Benseñor, Isabela M; ... (2022). Subclinical thyroid dysfunction and incident diabetes: a systematic review and an individual participant data analysis of prospective cohort studies. European journal of endocrinology, 187(5), S35-S46. BioScientifica Ltd. 10.1530/EJE-22-0523

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OBJECTIVE

Few prospective studies have assessed whether persons with subclinical thyroid dysfunction are more likely to develop diabetes, with conflicting results. We conducted a systematic review of the literature and an individual participant data analysis of multiple prospective cohorts to investigate the association between subclinical thyroid dysfunction and incident diabetes.

METHODS

We performed a systematic review of the literature in Medline, Embase, and the Cochrane Library from inception to February 11 2022. A two-stage individual participant data analysis was conducted to compare participants with subclinical hypothyroidism and subclinical hyperthyroidism versus euthyroidism at baseline and the adjusted risk of developing diabetes at follow-up.

RESULTS

Among 61,178 adults from 18 studies, mean age was 58 years, 49% were females, and mean follow-up time was 8.2 years. At last available follow-up, there was no association between subclinical hypothyroidism and incidence of diabetes (OR=1.02, 95% confidence interval (CI): 0.88-1.17, I2=0%), or subclinical hyperthyroidism and incidence of diabetes (OR=1.03, 95% CI: 0.82-1.30, I2=0%), in age- and sex-adjusted analyses. Time-to-event analysis showed similar results (hazard ratio for subclinical hypothyroidism: 0.98, 95% CI: 0.87-1.11; hazard ratio for subclinical hyperthyroidism: 1.07, 95% CI: 0.88-1.29). The results were robust in all subgroup and sensitivity analyses.

CONCLUSIONS

This is the largest systematic review and individual participant data analysis to date investigating the prospective association between subclinical thyroid dysfunction and diabetes. We did not find an association between subclinical thyroid dysfunction and incident diabetes. Our results do not support screening patients with subclinical thyroid dysfunction for diabetes.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Al-Alwan, Heba; Villoz, Fanny; Feller, Martin; Bauer, Douglas Charles; Rodondi, Nicolas and Del Giovane, Cinzia

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0804-4643

Publisher:

BioScientifica Ltd.

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Pubmed Import

Date Deposited:

08 Sep 2022 10:17

Last Modified:

05 Dec 2022 16:23

Publisher DOI:

10.1530/EJE-22-0523

PubMed ID:

36070417

BORIS DOI:

10.48350/172737

URI:

https://boris.unibe.ch/id/eprint/172737

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