Association of subtle alterations in thyroid function with presarcopenia in patients with type 2 diabetes mellitus. Issue 4 (14th November 2021)

• Record Type: Journal Article
• Authors: Li, Ping; Ding, Li; Zhen, Jinyang; Hu, Jingxin; Fan, Yuxin; Liu, Ming
• Is Part Of: Journal of diabetes investigation. Volume 13:Issue 4(2022)
• Page Start: 696
• Page End: 705
• Publication Date: 2021-11-14
• Subjects: Presarcopenia -- Thyroid function -- Type 2 diabetes; Diabetes -- Periodicals; Diabetes -- Research -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1111/jdi.13703
• Languages: English
• ISSNs: 2040-1116

Abstract

ABSTRACT: Aims/Introduction: To investigate the association of subtle alterations in thyroid function with presarcopenia among patients with type 2 diabetes mellitus. Materials and Methods: A total of 1, 865 adult patients with type 2 diabetes mellitus were enrolled in this cross‐sectional study, excluding patients with overt thyroid dysfunction. Skeletal muscle mass measured by dual energy X‐ray absorptiometry was used to assess presarcopenia. Logistic regression models were used to estimate the effects of thyroid hormones on presarcopenia, and subgroup analyses were carried out in different strata of age, sex and body mass index, respectively. Results: Compared with the euthyroid group (Euthy), the subclinical hyperthyroidism group had an increased odds of presarcopenia (multivariate‐adjusted odds ratio 1.99, 95% confidence interval 1.09–3.63), but the subclinical hypothyroidism group did not ( P > 0.05). In the subclinical hyperthyroidism group, age and body mass index <24 kg/m 2 were independent risk factors for presarcopenia. In the overall Euthy group, an increased odds of presarcopenia was correlated with the elevated free thyroxine : free triiodothyronine ratio (all P for trend <0.05), whereas not with increment in free triiodothyronine level ( P for trend >0.05). Additionally, in Euthy subgroup analyses stratified by middle‐age, sex and body mass index, a similar association was noted (all P for trend <0.05), but not in the older‐aged patients ( P for trend >0.05). Conclusions: Subclinical hyperthyroidism was an independent risk factor for presarcopenia in patients with type 2 diabetes mellitus, but subclinical hypothyroidism was not. In the Euthy group with type 2 diabetes mellitus, a high free thyroxine : free triiodothyronine ratio was a good index of presarcopenia in addition to older age. Abstract : Type 2 diabetes mellitus and overt thyroid dysfunction are two common endocrine causes of sarcopenia; however, whether subtle thyroid function alterations is a contributing factor of sarcopenia remains unclear, and data regarding patients with type 2 diabetes mellitus are scarce. In this study, we first investigated the effects of subtle alterations in thyroid function on presarcopenia among patients with type 2 diabetes mellitus. Our findings provided a novel insight into the role of the free thyroxine : free triiodothyronine ratio in presarcopenia in different subgroups among euthyroid patients with type 2 diabetes mellitus, and implied that the older‐aged diabetes patients might have another potential pathogenesis of sarcopenia, which is different from that of the middle‐aged patients.