131170 20250130163245.0 doi 10.2337/dc18-1410 sideral 110368 ART-2019-110368 eng Laclaustra, M. (orcid)0000-0003-3963-0846 Impaired Sensitivity to Thyroid Hormones Is Associated With Diabetes and Metabolic Syndrome 2019 Access copy available to the general public Unrestricted OBJECTIVE: Diabetes prevalence and incidence increase among individuals with hypothyroidism but also among those with hyperthyroxinemia, which seems contradictory. Both high free thyroxine (fT4) and high thyroid-stimulating hormone (TSH) are present in the resistance to thyroid hormone syndrome. A mild acquired resistance to thyroid hormone might occur in the general population and be associated with diabetes. We aimed to analyze the association of resistance to thyroid hormone indices (the Thyroid Feedback Quantile-based Index [TFQI], proposed in this work, and the previously used Thyrotroph T4 Resistance Index and TSH Index) with diabetes. RESEARCH DESIGN AND METHODS: We calculated the aforementioned resistance to thyroid hormone indices based on a U.S. representative sample of 5, 129 individuals =20 years of age participating in the 2007-2008 National Health and Nutrition Examination Survey (NHANES). Also, to approximate TFQI, a U.S.-referenced Parametric TFQI (PTFQI) can be calculated with the spreadsheet formula =NORM.DIST(fT4_cell_in_pmol_per_L, 10.075, 2.155, TRUE)+NORM.DIST(LN(TSH_cell_in_mIU_per_L), 0.4654, 0.7744, TRUE)-1. Outcomes of interest were glycohemoglobin =6.5%, diabetes medication, diabetes-related deaths (diabetes as contributing cause of death), and additionally, in a fasting subsample, diabetes and metabolic syndrome. Logistic and Poisson regressions were adjusted for sex, age, and race/ethnicity. RESULTS: Odd ratios for the fourth versus the first quartile of TFQI were 1.73 (95% CI 1.32, 2.27) (Ptrend = 0.002) for positive glycohemoglobin and 1.66 (95% CI 1.31, 2.10) (Ptrend = 0.001) for medication. Diabetes-related death rate ratio for TFQI being above versus below the median was 4.81 (95% CI 1.01, 22.94) (Ptrend = 0.015). Further adjustment for BMI and restriction to normothyroid individuals yielded similar results. Per 1 SD in TFQI, odds increased 1.13 (95% CI 1.02, 1.25) for diabetes and 1.16 (95% CI 1.02, 1.31) for metabolic syndrome. The other resistance to thyroid hormone indices showed similar associations for diabetes-related deaths and metabolic syndrome. CONCLUSIONS: Higher values in resistance to thyroid hormone indices are associated with obesity, metabolic syndrome, diabetes, and diabetes-related mortality. Resistance to thyroid hormone may reflect energy balance problems driving type 2 diabetes. These indices may facilitate monitoring treatments focused on energy balance. info:eu-repo/grantAgreement/EUR/ERDF-ESF/Investing in your future info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI14-00009 info:eu-repo/grantAgreement/ES/ISCIII-FIS/PI17-01709 info:eu-repo/semantics/openAccess by http://creativecommons.org/licenses/by/3.0/es/ 16.019 2019 ENDOCRINOLOGY & METABOLISM 4 / 143 = 0.028 2019 Q1 T1 6.48 2019 Advanced and Specialized Nursing 2019 Q1 Internal Medicine 2019 Q1 Endocrinology, Diabetes and Metabolism 2019 Q1 info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion Moreno-Franco, B. Universidad de Zaragoza (orcid)0000-0003-0604-5042 Lou-Bonafonte, J.M. Universidad de Zaragoza (orcid)0000-0001-9578-6525 Mateo-Gallego, R. Universidad de Zaragoza (orcid)0000-0001-6650-8294 Casasnovas, J.A. Universidad de Zaragoza (orcid)0000-0002-9887-2629 Guallar-Castillon, P. Cenarro, A. Civeira, F. Universidad de Zaragoza (orcid)0000-0001-7043-0952 1006 255 Universidad de Zaragoza Dpto. Fisiatría y Enfermería Área Enfermería 1005 410 Universidad de Zaragoza Dpto. Farmacología y Fisiolog. Área Fisiología 1007 610 Universidad de Zaragoza Dpto. Medicina, Psiqu. y Derm. Area Medicina 1008 615 Universidad de Zaragoza Dpto. Microb.Med.Pr.,Sal.Públ. Área Medic.Prevent.Salud Públ. 42, 2 (2019), 303-310 Diabetes care Diabetes care 0149-5992 Supplementary material https://doi.org/10.2337/dc18-1410/-/DC1 932882 http://zaguan.unizar.es/record/131170/files/texto_completo.pdf Postprint 859322 http://zaguan.unizar.es/record/131170/files/texto_completo.jpg?subformat=icon icon Postprint oai:zaguan.unizar.es:131170 articulos driver 2025-01-30-16:31:06 ARTICLE