Association between thyroid dysfunction and insulin resistance: a retrospective cohort study

作者：Hari Krishnan Krishnamurthy, Chithra Suresh, Thushani Siriwardhane, Karthik Krishna, Qi Song, Vasanth Jayaraman, Tianhao Wang, Kang Bei, John J. Rajasekaran · 发表于：BMJ Open · 年份：2025 · DOI：10.1136/bmjopen-2023-076397 · 被引用次数：6 · 研究领域：Thyroid Disorders and Treatments、Thyroid Cancer Diagnosis and Treatment、Vitamin D Research Studies

OBJECTIVE: To evaluate the association between thyroid disease and diabetes markers. DESIGN: Retrospective cohort study. SETTING: The study was conducted in a diagnostic setting where the primary care providers recommended the patients to test for thyroid and diabetes panels. PARTICIPANTS: The thyroid and diabetes markers were tested in 32 787 subjects with suspected thyroid and related conditions who visited Vibrant America Clinical Laboratory between January 2015 and June 2019. RESULTS: Our general prevalence results showed that homeostatic model assessment-insulin resistance (HOMA-IR) was elevated in overt hypothyroid subjects (43.7%) and overt hyperthyroid subjects (42.2%). Glycated hemoglobin (HbA1C) was elevated in subclinical hypothyroid subjects (19.2%), overt hypothyroid subjects (22.3%) and overt hyperthyroid subjects (21.2%). Glucose was significantly elevated in subclinical hypothyroid subjects (24.2%) and overt hyperthyroid subjects (31.0%). Insulin was significantly elevated in overt hypothyroid subjects (15.1%). Interestingly, we found that 70.3% of subjects who had their HOMA-IR score escalated from negative (HOMA-IR<2.7) to positive (HOMA-IR>2.7) during their multiple visits had anti-thyroid peroxidase (anti-TPO) 369 (±242) days prior to the onset of this change. CONCLUSION: Our findings showed that anti-TPO levels are elevated before the onset of insulin resistance, indicating its potential use as a predictive marker.