We would like to announce the new LATS Position Statement now recommending Case Finding of Hypothyroidism in both Metabolic Syndrome and Type 2 Diabetes patients.
This document was previously approved by LATS Leadership and Staff and has been recently published in the journal Endocrine Practice (Endocr Pract. 2019 Jan;25(1):101-105. doi: 10.4158/EP-2018-0317)
The position statement is meant to update the list of case finding of hypothyroidism reported in our former 2013 Guidelines of Hypothyroidism (Arq Bras Endocrinol Metabol. 2013 Jun;57(4):265-91) and it acknowledges new evidence published on this topic.
See the abstract of the document:
Case finding for hypothyroidism should include type 2 diabetes and metabolic syndrome patients: a Latin American Thyroid Society (LATS) position statement.Brenta Gabriela, Sosa Caballero Alejandro, Nunes Maria Teresa
Abstract
OBJECTIVE:
Latin American Thyroid Society (LATS) Hypothyroidism Clinical Practice Guidelines recommend case finding of hypothyroid patients in multiple and different situations that agree with other Society guidelines. However, the detection of hypothyroidism in type 2 diabetes mellitus (T2DM) or metabolic syndrome (MetS) patients is not mentioned in particular. In the recent years, several basic and epidemiologic studies have appeared showing that a lower thyroid function and MetS/T2DM are associated. Hence, the aim of this review is to manifest the LATS position on the diagnosis of hypothyroidism in both MetS and T2DM patients.
METHODS:
A search was made in PubMed using the following terms: “hypothyroidism” AND “diabetes” OR “metabolic syndrome.” The most relevant studies describing the prevalence and complications due to hypothyroidism in both MetS and T2DM patients were selected.
RESULTS:
The current document reviews new information from studies that have shown that the prevalence of hypothyroidism is higher in T2DM patients (odds ratio [OR], 3.45; 95% confidence interval [CI], 2.5 to 4.7) and that diabetic complications are more prevalent in subclinical hypothyroidism (ScH). The incidence of T2DM is 1.09-fold higher with each doubling of thyroid-stimulating hormone (TSH) mIU/L (95% CI, 1.06 to 1.12), and the incidence of prediabetes increases 15% (hazard ratio, 1.15; 95% CI, 1.04 to 1.26) in patients with TSH >5 mIU/L. Similarly, MetS is more prevalent in ScH compared to euthyroid individuals (OR, 1.31; 95% CI, 1.08 to 1.60).
CONCLUSION:
Thyroid function is affected in MetS and T2DM, and hypothyroidism is more common in these patients. Diabetic complications are more frequent in ScH patients. Therefore, LATS now recommends aggressive case finding of hypothyroidism in both MetS and T2DM patients.
ABBREVIATIONS:
CI = confidence interval; GLUT4 = glucose transporter 4; HOMA-IR = homeostatic model assessment for insulin resistance; HR = hazard ratio; LATS = Latin American Thyroid Society; MetS = metabolic syndrome; OR = odds ratio; ScH = subclinical hypothyroidism; T2DM = type 2 diabetes mellitus; T3 = triiodothyronine; T4 = thyroxine; TSH = thyroid-stimulating hormone. PMID: 30742573.
Best Regards,
LATS Board.
