Increased Risk of Type 2 Diabetes in Patients with Thyroid Cancer after Thyroidectomy: A Nationwide Cohort Study

Eun Roh, Eunjin Noh, Soon Young Hwang, Jung A. Kim, Eyun Song, Minjeong Park, Kyung Mook Choi, Sei Hyun Baik, Geum Joon Cho, Hye Jin Yoo

    Research output: Contribution to journalArticlepeer-review

    13 Citations (Scopus)

    Abstract

    Context: Abnormal thyroid function after thyroidectomy and subsequent thyroid-stimulating hormone suppression can have detrimental effects on glucose homeostasis in patients with thyroid cancer. Objective: To investigate whether thyroidectomy increases the risk of type 2 diabetes in patients with thyroid cancer and to explore the association between levothyroxine dosage and type 2 diabetes risk. Methods: A retrospective population-based cohort study using the Korean National Health Insurance database. We included 36 377 thyroid cancer patients without known diabetes who underwent thyroidectomy between 2004 and 2013. Matched subjects with nonthyroid cancer were selected using 1:1 propensity score matching. The main outcome measure was newly developed type 2 diabetes mellitus. Results: Patients with thyroid cancer who underwent thyroidectomy had a higher risk of developing type 2 diabetes mellitus than the matched controls (hazard ratio [HR] 1.43, 95% CI 1.39-1.47). Among patients with thyroid cancer, when the second quartile group (in terms of the mean levothyroxine dosage; 101-127 μg/day) was considered the reference group, the risk of type 2 diabetes mellitus increased in the first quartile (<101 μg/day; HR 1.45, 95% CI 1.36-1.54) and fourth quartile groups (≥150 μg/day; HR 1.37, 95% CI 1.29-1.45); meanwhile, the risk decreased in the third quartile group (128-149 μg/day; HR 0.91, 95% CI 0.85-0.97). Conclusion: Patients with thyroid cancer who underwent thyroidectomy were more likely to develop type 2 diabetes mellitus than the matched controls. There was a U-shaped dose-dependent relationship between the levothyroxine dosage and type 2 diabetes mellitus risk.

    Original languageEnglish
    Pages (from-to)E1047-E1056
    JournalJournal of Clinical Endocrinology and Metabolism
    Volume107
    Issue number3
    DOIs
    Publication statusPublished - 2022 Mar 1

    Bibliographical note

    Publisher Copyright:
    © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved.

    Keywords

    • thyroid cancer
    • thyroid function
    • thyroidectomy
    • type 2 diabetes

    ASJC Scopus subject areas

    • Endocrinology, Diabetes and Metabolism
    • Biochemistry
    • Endocrinology
    • Clinical Biochemistry
    • Biochemistry, medical

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