Adolescent Thyroid disorders and Risk for Type 2 Diabetes in Young Adulthood.

CONTEXT Thyroid hormones play a key role in systemic metabolism, yet the relationship between thyroid dysfunction and risk for type 2 diabetes is unclear. OBJECTIVE To assess type 2 diabetes risk in adulthood among adolescents with thyroid disorders. DESIGN AND SETTING A nationwide, population-based study of Israeli adolescents who were examined before military recruitment during 1988-2007, and were followed until December 31, 2016. PARTICIPANTS 1,382,560 adolescents (mean age 17.3 years). INTERVENTIONS The diagnosis of thyroid disorders was based on recent thyroid function tests. Data were linked to the Israeli National Diabetes Registry. Cox proportional hazard models were applied. MAIN OUTCOME MEASURES Type 2 diabetes incidence. RESULTS During a mean follow-up of 18.5 years, 1.12% (69 of 6,152) of adolescents with thyroid disorders were diagnosed with type 2 diabetes vs. 0.77% of adolescents without thyroid disorders. The HR for type 2 diabetes was 2.3 (95%CI, 1.8-2.9) among those with thyroid disorders, after adjustment for sex, birth-year, BMI and sociodemographic confounders. The increased diabetes risk was observed in both men and women, presence or absence of obesity, in the absence of other health conditions, and was associated with different types of thyroid disorders. It was also similar when the outcome was defined as type 2 diabetes diagnosed at or before the age of 30 years (HR 2.3; 95%CI, 1.5-3.5). CONCLUSIONS Thyroid disorders diagnosed in adolescence are a risk factor for early-onset type 2 diabetes in both men and women.

[1]  Inbar Zucker,et al.  Adolescent Hypertension and Risk for Early-Onset Type 2 Diabetes: A Nationwide Study of 1.9 Million Israeli Adolescents. , 2020, Diabetes Care.

[2]  Inbar Zucker,et al.  Adolescent Nonalcoholic Fatty Liver Disease and Type 2 Diabetes in Young Adulthood. , 2020, The Journal of clinical endocrinology and metabolism.

[3]  D. Behar,et al.  Adolescent BMI and early-onset type 2 diabetes among Ethiopian immigrants and their descendants: a nationwide study , 2020, Cardiovascular Diabetology.

[4]  Inbar Zucker,et al.  Adolescent Obesity and Early-Onset Type 2 Diabetes , 2020, Diabetes Care.

[5]  Inbar Zucker,et al.  Childhood Pancreatitis and Risk for Incident Diabetes in Adulthood , 2019, Diabetes Care.

[6]  Y. Shim,et al.  Association of Thyroid-Stimulating Hormone and Thyroid Hormones with Cardiometabolic Risk Factors in Euthyroid Children and Adolescents Aged 10–18 Years: A Population-Based Study , 2019, Scientific Reports.

[7]  D. Behar,et al.  Impact of Immigration on Body Mass Index and Blood Pressure among Adolescent Males and Females: A Nationwide Study. , 2019, Hypertension.

[8]  R. P. Robertson,et al.  Thyroid Dysfunction and Diabetes Mellitus: Two Closely Associated Disorders. , 2019, Endocrine reviews.

[9]  N. Sattar,et al.  Age at Diagnosis of Type 2 Diabetes Mellitus and Associations With Cardiovascular and Mortality Risks: Findings From the Swedish National Diabetes Registry , 2019, Circulation.

[10]  Po-Len Liu,et al.  Thyroid diseases increased the risk of type 2 diabetes mellitus , 2019, Medicine.

[11]  Tyler J. VanderWeele,et al.  Using the E-Value to Assess the Potential Effect of Unmeasured Confounding in Observational Studies , 2019, JAMA.

[12]  H. Gerstein,et al.  Cognitive function in adolescence and the risk for premature diabetes and cardiovascular mortality in adulthood , 2018, Cardiovascular Diabetology.

[13]  H. Pattison,et al.  Type 2 diabetes in adolescents and young adults. , 2018, The lancet. Diabetes & endocrinology.

[14]  A. Tirosh,et al.  Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlife , 2018, Cardiovascular Diabetology.

[15]  Tyler J. VanderWeele,et al.  Sensitivity Analysis in Observational Research: Introducing the E-Value , 2017, Annals of Internal Medicine.

[16]  R. Ortiz,et al.  Thyroid Hormone Regulation and Insulin Resistance: Insights From Animals Naturally Adapted to Fasting. , 2017, Physiology.

[17]  G. Meng,et al.  The Relationship Between Thyroid Function and the Prevalence of Type 2 Diabetes Mellitus in Euthyroid Subjects , 2016, The Journal of clinical endocrinology and metabolism.

[18]  Å. Lernmark,et al.  Thyroid and Islet Autoantibodies Predict Autoimmune Thyroid Disease at Type 1 Diabetes Diagnosis , 2016, The Journal of clinical endocrinology and metabolism.

[19]  Patrick C Hanley,et al.  Thyroid Disorders in Children and Adolescents: A Review. , 2016, JAMA pediatrics.

[20]  O. Franco,et al.  Thyroid function and risk of type 2 diabetes: a population-based prospective cohort study , 2016, BMC Medicine.

[21]  G. Twig,et al.  Body-Mass Index in 2.3 Million Adolescents and Cardiovascular Death in Adulthood. , 2016, The New England journal of medicine.

[22]  David R Webb,et al.  Pathophysiology of type 1 and type 2 diabetes mellitus: a 90-year perspective , 2015, Postgraduate Medical Journal.

[23]  N. Gronich,et al.  Hypothyroidism Is a Risk Factor for New-Onset Diabetes: A Cohort Study , 2015, Diabetes Care.

[24]  M. Zimmermann,et al.  Iodine deficiency and thyroid disorders. , 2015, The lancet. Diabetes & endocrinology.

[25]  H. Mendieta-Zerón,et al.  Thyroid function is associated with insulin resistance markers in healthy adolescents with risk factors to develop diabetes , 2015, Diabetology & Metabolic Syndrome.

[26]  N. Tandon,et al.  Type 2 diabetes in the child and adolescent , 2014 .

[27]  G. Brent,et al.  Thyroid hormone regulation of metabolism. , 2014, Physiological reviews.

[28]  L. Hegedüs,et al.  Type and Extent of Somatic Morbidity before and after the Diagnosis of Hypothyroidism. A Nationwide Register Study , 2013, PloS one.

[29]  L. Hegedüs,et al.  Morbidity before and after the Diagnosis of Hyperthyroidism: A Nationwide Register-Based Study , 2013, PloS one.

[30]  S. Azar,et al.  Thyroid Disorders and Diabetes Mellitus , 2011, Journal of thyroid research.

[31]  M. Cappa,et al.  Autoimmune Thyroid Diseases in Children , 2010, Journal of thyroid research.

[32]  A. Weaver,et al.  Relationships between thyroid function and lipid status or insulin resistance in a pediatric population. , 2010, Thyroid : official journal of the American Thyroid Association.

[33]  S. Lafranchi,et al.  Congenital hypothyroidism , 2010, Orphanet journal of rare diseases.

[34]  Y. Tomer,et al.  Autoimmune thyroiditis and diabetes: dissecting the joint genetic susceptibility in a large cohort of multiplex families. , 2009, The Journal of clinical endocrinology and metabolism.

[35]  M. Phillip,et al.  Chronic autoimmune thyroiditis in children and adolescents: at presentation and during long-term follow-up , 2008, Archives of Disease in Childhood.

[36]  S. Wiegand,et al.  β-cell autoantibodies in children with type 2 diabetes mellitus: subgroup or misclassification? , 2006, Archives of Disease in Childhood.

[37]  S. Bonner-Weir,et al.  Five stages of evolving beta-cell dysfunction during progression to diabetes. , 2004, Diabetes.

[38]  Y. Tomer,et al.  The etiology of autoimmune diabetes and thyroiditis: evidence for common genetic susceptibility. , 2003, Autoimmunity reviews.

[39]  M. Bettendorf.  Thyroid disorders in children from birth to adolescence , 2002, European Journal of Nuclear Medicine and Molecular Imaging.

[40]  M. Banerji,et al.  Autoantibodies in children with type 2 diabetes mellitus. , 2002, Journal of pediatric endocrinology & metabolism : JPEM.

[41]  J. Sack,et al.  Comparison of body weight and height of Israeli schoolchildren with the Tanner and Centers for Disease Control and Prevention growth charts. , 2001, Pediatrics.

[42]  A. Laor,et al.  Cigarette smoking and educational level among young Israelis upon release from military service in 1988--a public health challenge. , 1992, Israel journal of medical sciences.