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Abstract
Aims It is uncertain whether subclinical thyroid dysfunction is associated with cardiovascular disease (CVD) events and mortality in people with type 2 diabetes. The aim of this study was to determine whether undetected thyroid disease increases the risk of incident CVD and death in type 2 diabetes. Methods One thousand two hundred fifty participants with type 2 diabetes (mean age 65.3 years, 56.5% males, median diabetes duration 8.0 years) without known thyroid disease and not taking medications known to affect thyroid function were categorised, based on baseline serum free thyroxine (FT4) and thyrotropin (TSH) concentrations, as euthyroid, overt hypothyroid (increased TSH, low FT4), subclinical hypothyroid (increased TSH, normal FT4), overt thyrotoxic (decreased TSH, raised FT4) or subclinical thyrotoxic (decreased TSH, normal FT4). Incident myocardial infarction, incident stroke, all-cause and cardiovascular mortality were ascertained during a mean 6.2-6.7 years of follow-up. Results Most participants with newly-detected thyroid dysfunction had subclinical hypothyroidism (77.2%) while overt/subclinical thyrotoxicosis was infrequent. Compared to participants with TSH 0.34-2.9 mU/L, those with TSH > 5.1 mU/L were not at increased risk of incident myocardial infarction (adjusted hazard ratio (95% confidence limits) 1.77 (0.71, 2.87)), incident stroke (1.66 (0.58, 4.78)), all-cause mortality (0.78 (0.44, 1.37)) or cardiovascular mortality (1.16 (0.38, 3.58)). Independent baseline associates of subclinical hypothyroidism included estimated glomerular filtration rate and systolic blood pressure. Conclusions Subclinical hypothyroidism was not independently associated with CVD events or mortality in community-dwelling people with type 2 diabetes despite its associations with CVD risk factors, questioning strategies to identify and/or treat mild thyroid dysfunction outside usual care.
Original language | English |
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Pages (from-to) | 1615-1624 |
Number of pages | 10 |
Journal | Acta Diabetologica |
Volume | 59 |
Issue number | 12 |
DOIs | |
Publication status | Published - Dec 2022 |
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Dive into the research topics of 'The relationship between thyroid dysfunction, cardiovascular morbidity and mortality in type 2 diabetes: The Fremantle Diabetes Study Phase II'. Together they form a unique fingerprint.Projects
- 2 Finished
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The Fremantle Diabetes Study Phase II - A Community Based Study of Diabetes Care Control Complications & Cost
Davis, T. (Investigator 01), Bruce, D. (Investigator 02), Davis, W. (Investigator 03), Chubb, S. (Investigator 04), Starkstein, S. (Investigator 05), Clarke, P. (Investigator 06), McAullay, D. (Investigator 07) & Norman, P. (Investigator 08)
NHMRC National Health and Medical Research Council
1/01/13 → 31/12/18
Project: Research
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The Fremantle Diabetes Study Phase II - A Community Based Study of Diabetes Care Control Complications and Cost
Davis, T. (Chief Investigator), Bruce, D. (Chief Investigator), Davis, W. (Chief Investigator), Davis, E. (Chief Investigator), Geelhoed, E. (Chief Investigator) & Knuiman, M. (Chief Investigator)
1/01/08 → 31/12/12
Project: Research