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Links between Thyroid Disorders and Glucose Homeostasis
Young Sil Eom, Jessica R. Wilson, Victor J. Bernet
Diabetes Metab J. 2022;46(2):239-256.   Published online March 24, 2022
  • 11,840 View
  • 666 Download
  • 24 Web of Science
  • 21 Crossref
AbstractAbstract PDFPubReader   ePub   
Thyroid disorders and diabetes mellitus often coexist and are closely related. Several studies have shown a higher prevalence of thyroid disorders in patients with diabetes mellitus and vice versa. Thyroid hormone affects glucose homeostasis by impacting pancreatic β-cell development and glucose metabolism through several organs such as the liver, gastrointestinal tract, pancreas, adipose tissue, skeletal muscles, and the central nervous system. The present review discusses the effect of thyroid hormone on glucose homeostasis. We also review the relationship between thyroid disease and diabetes mellitus: type 1, type 2, and gestational diabetes, as well as guidelines for screening thyroid function with each disorder. Finally, we provide an overview of the effects of antidiabetic drugs on thyroid hormone and thyroid disorders.


Citations to this article as recorded by  
  • Linkage and association of rs3110045 and rs28499085 variants in the thyrotropin-releasing hormone receptor (TRHR) gene with the risk of familial type 2 diabetes
    Rongling Wu, Claudia Gragnoli
    Aspects of Molecular Medicine.2024; 3: 100037.     CrossRef
  • Obesity and Obesity-Related Thyroid Dysfunction: Any Potential Role for the Very Low-Calorie Ketogenic Diet (VLCKD)?
    Sebastián Pablo Chapela, Alison Simancas-Racines, Florencia Ceriani, Andrés Luciano Nicolas Martinuzzi, María Paula Russo, Ana Karina Zambrano, Daniel Simancas-Racines, Ludovica Verde, Giovanna Muscogiuri, Christos S. Katsanos, Evelyn Frias-Toral, Luigi B
    Current Nutrition Reports.2024; 13(2): 194.     CrossRef
  • View on Metformin: Antidiabetic and Pleiotropic Effects, Pharmacokinetics, Side Effects, and Sex-Related Differences
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    Pharmaceuticals.2024; 17(4): 478.     CrossRef
  • Thyroid Hormones and Diabetes in Euthyroid Hispanic/Latino Adults of Diverse Backgrounds: HCHS/SOL
    Victoria Persky, Chibuzor Abasilim, Konstantina Tsintsifas, Tessa Day, Robert M Sargis, Martha Daviglus, Jianwen Cai, Sally Freels, Robert Kaplan, Carmen R Isasi, Amber Pirzada, Michelle L Meyer, Gregory A Talavera, Bharat Thyagarajan, Shivani Agarwal, No
    Journal of the Endocrine Society.2024;[Epub]     CrossRef
  • Managing Adults With Hypoglycemia
    Christopher James Watson, Jonathan A. Edlow
    Annals of Emergency Medicine.2023; 82(6): 705.     CrossRef
  • Relationship of Glucose, C-peptide, Leptin, and BDNF in Maternal and Umbilical Vein Blood in Type-1 Diabetes
    Josip Delmis, Slavko Oreskovic, Vesna Elvedji Gasparovic, Mirta Starcevic, Mislav Herman, Nada Dessardo, Vito Starcevic, Marina Ivanisevic
    Nutrients.2023; 15(3): 600.     CrossRef
  • Isolated Maternal Hypothyroxinemia May be Associated with Insulin Requirement in Gestational Diabetes Mellitus
    Ömercan Topaloğlu, Mehmet Uzun, Seda Nur Topaloğlu, Ibrahim Sahin
    Hormone and Metabolic Research.2023; 55(04): 245.     CrossRef
  • Association of urinary iodine concentration with prediabetes/diabetes in adults: Analysis of the NHANES 2005–2016
    Jingmin Chen, Huanzhu Liang, Yuxuan Tan, Lin Wen, Ziang Guo, Jiyu Nie, Xiaoxiao Lin, Feng Huang, Jie Wang, Puyi Xing, Lihong Nie, Lihong Wang, Chunxia Jing
    Journal of Trace Elements in Medicine and Biology.2023; 77: 127144.     CrossRef
  • Central sensitivity to thyroid hormones is reduced in youths with overweight or obesity and impaired glucose tolerance
    Procolo Di Bonito, Domenico Corica, Maria Rosaria Licenziati, Anna Di Sessa, Emanuele Miraglia del Giudice, Maria Felicia Faienza, Valeria Calcaterra, Francesca Franco, Giulio Maltoni, Giuliana Valerio, Malgorzata Wasniewska
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Association of thyroid stimulating hormone and time in range with risk of diabetic retinopathy in euthyroid type 2 diabetes
    Yaxin Wang, Jingyi Lu, Jiaying Ni, Ming Wang, Yun Shen, Wei Lu, Wei Zhu, Yuqian Bao, Jian Zhou
    Diabetes/Metabolism Research and Reviews.2023;[Epub]     CrossRef
  • The circadian rhythm: an influential soundtrack in the diabetes story
    Amirali Hariri, Mina Mirian, Ali Zarrabi, Mohammad Kohandel, Maryam Amini-Pozveh, Amir Reza Aref, Aliye Tabatabaee, Pranav Kumar Prabhakar, Ponnurengam Malliappan Sivakumar
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Folate deficiency may increase the risk for elevated TSH in patients with type 2 diabetes mellitus
    Lin Lin, Yushan Du, Guanyu Niu, Shuangbo Xia, Jufen Liu
    BMC Endocrine Disorders.2023;[Epub]     CrossRef
  • L- Thyroxine ameliorates renal function in thyroidectomized diabetic nephropathy rats through downregulation of TGF- β1, Ang II and ET-1 expression
    Zeinab H. El-Said, Sherihan I. Gouda, Hebatallah A. Mahgoub, S El_desouky, Neven A. Ebrahim
    Egyptian Journal of Basic and Applied Sciences.2023; 10(1): 632.     CrossRef
  • Thyroid dysfunction in children and adolescents affected by undernourished and overnourished eating disorders
    Valeria Calcaterra, Vittoria Carlotta Magenes, Francesca Siccardo, Chiara Hruby, Martina Basso, Veronica Conte, Giulia Maggioni, Valentina Fabiano, Susanna Russo, Pierangelo Veggiotti, Gianvincenzo Zuccotti
    Frontiers in Nutrition.2023;[Epub]     CrossRef
  • Preventive Effect of Molecular Iodine in Pancreatic Disorders from Hypothyroid Rabbits
    Julia Rodríguez-Castelán, Evangelina Delgado-González, Esteban Rodríguez-Benítez, Francisco Castelán, Estela Cuevas-Romero, Brenda Anguiano, Michael C. Jeziorski, Carmen Aceves
    International Journal of Molecular Sciences.2023; 24(19): 14903.     CrossRef
  • Hypothyroidism increases angiotensinogen gene expression associated with vascular smooth muscle cells cholesterol metabolism dysfunction and aorta remodeling in Psammomys obesus
    Samia Neggazi, Nadjiba Hamlat, Sihem Berdja, Saliha Boumaza, Leila Smail, Michel Beylot, Souhila Aouichat-Bouguerra
    Scientific Reports.2023;[Epub]     CrossRef
  • The Correlation Between Thyroid Parameters and the Ratios of Neutrophil/Lymphocyte and Platelet/Lymphocyte in Euthyroid Type 2 Diabetic Patients
    Hui Chen, Jun-Qiang Ju, Xiao-Wu Qian, Zheng-Tai Zhu, Chun-Zhi Zhao, Zhe Liu
    Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 3763.     CrossRef
  • Effects of high-intensity interval training program on pituartry function in basketball players: a randomized controlled trial
    Recep Soslu, Abdullah Uysal, Meltem Devrilmez, İsmail Can Çuvalcıoğlu, Ali Ahmet Doğan, Sülbiye Karaburgu, Murat Taş
    Frontiers in Physiology.2023;[Epub]     CrossRef
  • Selenium and Selenoproteins at the Intersection of Type 2 Diabetes and Thyroid Pathophysiology
    Francesca Gorini, Cristina Vassalle
    Antioxidants.2022; 11(6): 1188.     CrossRef
  • TSH levels within the normal range and risk of cardiovascular and all-cause mortality among individuals with diabetes
    Ping Zhu, Guojuan Lao, Chuping Chen, Lihui Luo, Jing Gu, Jianmin Ran
    Cardiovascular Diabetology.2022;[Epub]     CrossRef
  • Metabolite Changes during the Transition from Hyperthyroidism to Euthyroidism in Patients with Graves’ Disease
    Ho Yeop Lee, Byeong Chang Sim, Ha Thi Nga, Ji Sun Moon, Jingwen Tian, Nguyen Thi Linh, Sang Hyeon Ju, Dong Wook Choi, Daiki Setoyama, Hyon-Seung Yi
    Endocrinology and Metabolism.2022; 37(6): 891.     CrossRef
Original Article
Obesity and Metabolic Syndrome
The Relationship between Thyroid Function and Different Obesity Phenotypes in Korean Euthyroid Adults
Jeong Mi Kim, Bo Hyun Kim, Hyungi Lee, Eun Heui Kim, Mijin Kim, Jong Ho Kim, Yun Kyung Jeon, Sang Soo Kim, In Joo Kim, Yong Ki Kim
Diabetes Metab J. 2019;43(6):867-878.   Published online April 3, 2019
  • 6,153 View
  • 71 Download
  • 17 Web of Science
  • 16 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   

Thyroid disease and metabolic syndrome are both associated with cardiovascular disease. The aim of this study was to investigate the correlation between thyroid hormones and obesity sub-phenotypes using nationwide data from Korea, a country known to be iodine replete.


This study was based on data obtained from the sixth Korea National Health and Nutrition Examination Survey, administered from 2013 to 2015. A total of 13,873 participants aged ≥19 years were included, and classified into four groups: metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO), and metabolically unhealthy obesity (MUO) by body fat on the basis of body mass index and metabolic health.


At baseline, serum free thyroxine (fT4) values were significantly higher in the MHNO phenotype (MHNO, 1.27±0.01 ng/dL; MHO, 1.25±0.01 ng/dL; MUNO, 1.24±0.01 ng/dL; MUO, 1.24±0.01 ng/dL, P<0.001) in total study population. However, this significant association no longer remained after adjustment for age, urine iodine concentration, and smoking (P=0.085). After adjustment for confounders, statistically significant association was observed between lower thyroid stimulating hormone (TSH) and MHNO phenotype (P=0.044). In men participants (not women), higher fT4 values were significantly associated with MHNO phenotype (P<0.001). However, no significant association was observed between thyroid function (TSH or fT4) and obesity phenotypes in groups classified by age (cutoff age of 55 years).


Although there was a difference by age and sex, we found that the decrease of TSH and the increase of fT4 values were associated with MHNO.


Citations to this article as recorded by  
  • Causal association between obesity and hypothyroidism: a two-sample bidirectional Mendelian randomization study
    Yingkun Qiu, Qinyu Liu, Yinghua Luo, Jiadi Chen, Qingzhu Zheng, Yuping Xie, Yingping Cao
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Association between thyroid function and obesity phenotypes in healthy euthyroid individuals: an investigation based on Tehran Thyroid Study
    Behnaz Abiri, Amirhossein Ramezani Ahmadi, Maryam Mahdavi, Atieh Amouzegar, Majid Valizadeh
    European Journal of Medical Research.2023;[Epub]     CrossRef
  • Characteristics of the metabolically unhealthy phenotype in menopausal resistance training practitioners
    Ana Carla Leocadio de Magalhaes, Vilma Fernandes Carvalho, Sabrina Pereira da Cruz, Andréa Ramalho
    Nutrición Hospitalaria.2023;[Epub]     CrossRef
  • A systematic review and meta-analysis investigating the relationship between metabolic syndrome and the incidence of thyroid diseases
    Heba Alwan, Valerie Aponte Ribero, Orestis Efthimiou, Cinzia Del Giovane, Nicolas Rodondi, Leonidas Duntas
    Endocrine.2023; 84(2): 320.     CrossRef
  • Higher Sensitivity to Thyroid Hormones May Be Linked to Maintaining the Healthy Metabolic Condition in People with Obesity: New Insight from NHANES
    Ying-shan Liu, Xiao-cong Liu, Jian Kuang, Hai-xia Guan
    Obesity Facts.2023; 16(5): 497.     CrossRef
  • Is there a link between obesity phenotype and thyroid diseases? A mini-review of current concepts
    Ewa Malwina Milewska-Kobos, Ewelina Szczepanek-Parulska, Marek Ruchala
    Postępy Higieny i Medycyny Doświadczalnej.2023; 77(1): 107.     CrossRef
  • Sex-specific Association of Subclinical Hypothyroidism With Incident Metabolic Syndrome: A Population-based Cohort Study
    Zhiyuan Wu, Yue Jiang, Di Zhou, Shuo Chen, Yu Zhao, Haiping Zhang, Yue Liu, Xia Li, Wei Wang, Jingbo Zhang, Xiaoping Kang, Lixin Tao, Bo Gao, Xiuhua Guo
    The Journal of Clinical Endocrinology & Metabolism.2022; 107(6): e2365.     CrossRef
  • Determination of age and sex specific TSH and FT4 reference limits in overweight and obese individuals in an iodine-replete region: Tehran Thyroid Study (TTS)
    Hengameh Abdi, Bita Faam, Safoora Gharibzadeh, Ladan Mehran, Maryam Tohidi, Fereidoun Azizi, Atieh Amouzegar
    Endocrine Research.2021; 46(1): 37.     CrossRef
  • Association of Metabolic Obesity Phenotypes and Total Testosterone in Chinese Male Population
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  • Insulin Resistance in Association with Thyroid Function, Psychoemotional State, and Cardiovascular Risk Factors
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  • Causal Association Between Serum Thyrotropin and Obesity: A Bidirectional, Mendelian Randomization Study
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    The Journal of Clinical Endocrinology & Metabolism.2021; 106(10): e4251.     CrossRef
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  • Interaction effect of obesity and thyroid autoimmunity on the prevalence of hyperthyrotropinaemia
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  • Characteristics of Serum Thyroid Hormones in Different Metabolic Phenotypes of Obesity
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