Subclinical thyroid dysfunction and incident diabetes: a systematic review and an individual participant data analysis of prospective cohort studies.
Subclinical thyroid dysfunction and incident diabetes: a systematic review and an individual participant data analysis of prospective cohort studies.
复制标题
DOI：
10.1530/eje-22-0523
复制
发表时间：
2022-11-01
影响因子：
5.8
通讯作者：
Del Giovane C
中科院分区：
文献类型：
--
作者：
Alwan H;Villoz F;Feller M;Dullaart RPF;Bakker SJL;Peeters RP;Kavousi M;Bauer DC;Cappola AR;Yeap BB;Walsh JP;Brown SJ;Ceresini G;Ferrucci L;Gussekloo J;Trompet S;Iacoviello M;Moon JH;Razvi S;Bensenor IM;Azizi F;Amouzegar A;Valdés S;Colomo N;Wareham NJ;Jukema JW;Westendorp RGJ;Kim KW;Rodondi N;Del Giovane C
很少有前瞻性研究评估亚临床甲状腺功能障碍患者是否更有可能患糖尿病，但结果相互矛盾。我们对文献进行了系统回顾，并对多个前瞻性队列进行了个体参与者数据分析，以调查亚临床甲状腺功能障碍与糖尿病发生之间的关联。我们对 Medline、Embase 和 Cochrane 图书馆的文献进行了系统回顾，从开始到 2022 年 2 月 11 日。进行了两阶段的个体参与者数据分析，以比较基线时患有亚临床甲状腺功能减退症和亚临床甲状腺功能亢进症的参与者与甲状腺功能正常的参与者，以及随访时患糖尿病的调整风险。在 18 项研究的 61,178 名成年人中，平均年龄为 58 岁，49% 为女性，平均随访时间为 8.2 年。在最后一次随访中，经年龄和性别调整后，亚临床甲状腺功能减退症与糖尿病发病率（OR=1.02，95%置信区间（CI）：0.88-1.17，I2=0%）或亚临床甲状腺功能亢进与糖尿病发病率（OR=1.03，95% CI：0.82-1.30，I2=0%）之间没有关联。 分析。事件发生时间分析显示相似的结果（亚临床甲状腺功能减退症的风险比：0.98，95% CI：0.87-1.11；亚临床甲状腺功能亢进的风险比：1.07，95% CI：0.88-1.29）。所有亚组和敏感性分析的结果都是稳健的。这是迄今为止最大规模的系统评价和个体参与者数据分析，调查亚临床甲状腺功能障碍与糖尿病之间的前瞻性关联。我们没有发现亚临床甲状腺功能障碍与糖尿病之间存在关联。我们的结果不支持对亚临床甲状腺功能障碍患者进行糖尿病筛查。普洛斯彼罗 CRD 42021259695
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. 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. 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. 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. Prospero CRD 42021259695