ArticleCardiovascular diabetology2022
TSH levels within the normal range and risk of cardiovascular and all-cause mortality among individuals with diabetes.
Article in Cardiovascular diabetology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 27 citations in OpenAlex.
- Association between thyroid function and 10-year cardiovascular disease risk of patients with diabetes: a cross-sectional study using KNHANES 2013-2014.Journal of Yeungnam medical science · 2026Article
- Thyroid hormone sensitivity, insulin resistance and visceral fat area as determinants of prevalent coronary heart disease in euthyroid patients with type 2 diabetes.Frontiers in endocrinology · 2026Article
- Free Triiodothyronine as a Biomarker for Ventricular Arrhythmia Following Myocardial Infarction: A Multicenter Prospective Cohort Study.Clinical interventions in aging · 2026Article
- Association of thyroid function and thyroid hormone sensitivity with all-cause and cardiovascular mortality in euthyroid patients with MASLD.Clinical and experimental hepatology · 2025Article
- Prognostic Role of TSH Within Euthyroid T2DM Patients with Retinopathy: A 3-Year Cohort Study.Diseases (Basel, Switzerland) · 2025Article
- Association of serum parathyroid hormone within normal range with the prevalence and prognosis among adults with diabetes and prediabetes: insight from NHANES 2003-2006 data.Therapeutic advances in endocrinology and metabolism · 2025Article
- A Narrative Review of the Role of Blood Biomarkers in the Risk Prediction of Cardiovascular Diseases.Cureus · 2024Review
- Impaired sensitivity to thyroid hormone correlates to all-cause mortality in euthyroid individuals with chronic kidney disease.BMC public health · 2024Article
- Association of neutrophil-lymphocyte ratio with all-cause and cardiovascular mortality in US adults with diabetes and prediabetes: a prospective cohort study.BMC endocrine disorders · 2024Article
- Association between serum TSH levels and all-cause mortality in critically ill patients.Heliyon · 2024Article
- Associations between cardiovascular health and low thyroid function among US adults: a population-based study.Frontiers in endocrinology · 2024Article
- Laparoscopic Sleeve Gastrectomy: Impact on Body Mass Index and Thyroid Hormones in Euthyroid Obese Patients.Medical science monitor : international medical journal of experimental and clinical research · 2023Article
- Replacing of sedentary behavior with physical activity and the risk of mortality in people with prediabetes and diabetes: a prospective cohort study.The international journal of behavioral nutrition and physical activity · 2023Article
- Normal thyroid stimulating hormone is associated with all-cause mortality in patients with acute myocardial infarction after percutaneous coronary intervention.European journal of medical research · 2023Article
- Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature.Frontiers in endocrinology · 2023Review
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEvidence regarding thyroid-stimulating hormone (TSH) levels within the normal range and mortality in adults with diabetes is scarce. This study aimed to identify the association between TSH levels and cardiovascular disease (CVD) and all-cause mortality among euthyroid patients with diabetes.
methodsThis prospective cohort study included 1830 adults with diabetes from the Third National Health and Nutrition Examination Survey III. Mortality outcomes were ascertained by linkage to National Death Index records through December 31, 2019. Participants were categorized by tertiles of TSH levels (low-normal, 0.39-1.30 mIU/L; medium-normal, 1.30-2.09 mIU/L; high-normal, 2.09-4.60 mIU/L). Multivariable Cox proportional hazards models were used to explore the association between TSH levels within the normal range and overall and CVD mortality. Furthermore, restricted cubic spline analyses were used to determine the nonlinear relationship between TSH levels and mortality.
resultsDuring a median follow-up of 17.1 years, 1324 all-cause deaths occurred, including 525 deaths from CVD. After multivariate adjustment, a U-shaped relationship was observed between TSH levels in euthyroid status and all-cause or CVD mortality among patients with diabetes (both P < 0.05 for nonlinearity). Compared with participants with medium-normal TSH levels, those with high-normal TSH levels had a significantly higher risk of all-cause (hazard ratio, 1.31; 95% confidence interval, 1.07-1.61) and CVD (1.52; 1.08-2.12) mortality. Similarly, low-normal TSH levels also increased all-cause (1.39; 1.12-1.73) and CVD (1.69; 1.17-2.44) mortality risk. In stratum-specific analyses, we found that high-normal TSH levels were associated with higher mortality risk in younger (< 60 years) patients with diabetes but not in older (≥ 60 years) participants.
conclusionLow- and high-normal serum TSH levels were associated with increased all-cause and CVD mortality in euthyroid adults with diabetes. Further studies are needed to confirm the present observation in a wider population.
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