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Acta Diabetol. 2019 Apr;56(4):431-440. doi: 10.1007/s00592-018-1231-y. Epub 2018 Sep 27.

Thyroid-stimulating hormone levels in the normal range and incident type 2 diabetes mellitus.

Author information

1
Department of Vascular Medicine, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
2
Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands.
3
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
4
Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
5
Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
6
Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
7
Department of Vascular Medicine, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. J.Westerink-3@umcutrecht.nl.

Abstract

AIM:

To evaluate the relationship between thyroid-stimulating hormone (TSH) levels within the normal range and the risk of type 2 diabetes mellitus (T2DM) in a cohort of patients at high cardiovascular risk, and to perform a systematic review and meta-analysis of previous studies.

METHODS:

We included 5542 patients without T2DM from the prospective Secondary Manifestations of ARTerial disease study with TSH levels between 0.35 and 5.0 mIU/L without anti-thyroid medication or thyroid-hormone replacement therapy. Cox regression was used to investigate the relationship between baseline plasma TSH levels and incident T2DM. MEDLINE, EMBASE, and Cochrane were searched for prospective cohorts assessing TSH and incident T2DM. Hazard ratios (HR) from included prospective cohort studies were pooled using a random-effects model.

RESULTS:

In patients at high cardiovascular risk, higher plasma TSH levels in the normal range were not associated [HR 1.07 per mIU/L increase in TSH (95% confidence interval (95% CI) 0.95-1.22)] with an increased risk of T2DM, adjusted for age, sex, smoking, total and HDL cholesterol, and triglycerides. In the meta-analysis involving three prospective cohort studies, including the present study, including 29,791 participants with 1930 incident events, there was no relation between plasma TSH levels in the normal range and incident T2DM [pooled HR 1.06 (95% CI 0.99-1.14)].

CONCLUSION:

There is no apparent relation between plasma TSH levels in the normal range and incident T2DM in patients at high cardiovascular risk.

KEYWORDS:

Diabetes mellitus; Euthyroidism; Prospective study; Thyroid-stimulating hormone

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