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Subclinical thyroid dysfunction and incident diabetes: a systematic review and an individual participant data analysis of prospective cohort studies

Lookup NU author(s): Dr Salman Razvi



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Bioscientifica Ltd., 2022.

For re-use rights please refer to the publisher's terms and conditions.


Objective: 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. Methods: 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. Results: 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. Conclusions: 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.Registration: Prospero CRD 42021259695

Publication metadata

Author(s): 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, Giovane CD

Publication type: Article

Publication status: Published

Journal: European Journal of Endocrinology

Year: 2022

Volume: 187

Issue: 5

Pages: S35-S46

Print publication date: 01/11/2022

Online publication date: 30/09/2022

Acceptance date: 07/09/2022

Date deposited: 14/09/2022

ISSN (print): 0804-4643

ISSN (electronic): 1479-683X

Publisher: Bioscientifica Ltd.


DOI: 10.1530/EJE-22-0523

ePrints DOI: 10.57711/08q8-mj60

PubMed id: 36070417


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