The ratio of free triiodothyronine to free thyroxine is regulated differently in patients with type 2 diabetes mellitus treated and not treated with sodium glucose cotransporter 2 inhibitors |
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| Affiliation: | 1. Hoshi-Iin, 204-1 Nishizen-machi, Maebashi, Gunma, 379-2131, Japan;2. Hidaka Hospital, 886 Nakao-machi, Takasaki, Gunma, 370-0001, Japan;3. Department of Medicine, Division of Endocrinology, Albert Einstein College of Medicine, 1301 Morris Park Ave., Price 369, Bronx, NY, 10461, USA;4. Department of Orthopedic Surgery, Gunma University, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan;5. Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, 371-8511, Japan;6. Endocrinology and Metabolism, Saku Central Hospital Advanced Care Center, 28-3400 Nakagomi, Saku, Nagano, 385-0051, Japan |
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| Abstract: | Background and aimsTriiodothyronine reduces sodium glucose cotransporter 2 expression in the kidney and increased glucose excretion in urine of alloxan-induced diabetic rats. Free thyroxine is also negatively associated with islet beta-cell function in euthyroid subjects. However, the influence of sodium glucose cotransporter 2 inhibitor on thyroid function in patients with type 2 diabetes mellitus has not been established.MethodsWe investigated thyroid function in patients with type 2 diabetes mellitus in the presence or absence of sodium glucose cotransporter 2 inhibitor in a multicenter retrospective study conducted between 2019 and 2021. All participants visited the hospital monthly for type 2 diabetes mellitus treatment and plasma glucose and glycated hemoglobin level measurements. Furthermore, thyroid-stimulating hormone, free triiodothyronine, and free thyroxine levels were measured annually.ResultsFree triiodothyronine level and the free triiodothyronine:free thyroxine ratio in the group treated with sodium glucose cotransporter 2 inhibitor were significantly higher than the levels in the group not treated with sodium glucose cotransporter 2 inhibitor. Free triiodothyronine levels in the group treated with sodium glucose cotransporter 2 inhibitor were significantly higher than the levels in the group not treated with sodium glucose cotransporter 2 inhibitor (p = 0.040). Free thyroxine levels in the group treated with sodium glucose cotransporter 2 inhibitor were significantly lower than the levels in the group not treated with sodium glucose cotransporter 2 inhibitor (p = 0.002). Thyroid-stimulating hormone levels did not differ significantly between the two groups.ConclusionsOur findings show that sodium glucose cotransporter 2 inhibitor affects free triiodothyronine levels free thyroxine levels, and the free triiodothyronine:free thyroxine ratio. |
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| Keywords: | Sodium glucose cotransporter 2 inhibitor Iodothyronine deiodinase Type 2 diabetes mellitus Thyroid-stimulating hormone |
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