Increased FT3/FT4 ratio in a certain range is associated with decreased glycemic variability in patients with type 2 diabetes

Abstract Thyroid hormone (TH) plays a crucial role in regulating glucose metabolism. However, the potential impact of the FT3/FT4 ratio, which reflects peripheral sensitivity to thyroid hormones, on glycemic variability in patients with type 2 diabetes (T2DM), has not been previously reported. To in...

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Main Authors: Ying Li, Tianrong Pan, Lingyu Wang, Yue Wang, Yu Gong, Guojuan Wang, Qianqian Zhang
Format: Article
Language:English
Published: Nature Portfolio 2024-11-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-76074-w
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author Ying Li
Tianrong Pan
Lingyu Wang
Yue Wang
Yu Gong
Guojuan Wang
Qianqian Zhang
author_facet Ying Li
Tianrong Pan
Lingyu Wang
Yue Wang
Yu Gong
Guojuan Wang
Qianqian Zhang
author_sort Ying Li
collection DOAJ
description Abstract Thyroid hormone (TH) plays a crucial role in regulating glucose metabolism. However, the potential impact of the FT3/FT4 ratio, which reflects peripheral sensitivity to thyroid hormones, on glycemic variability in patients with type 2 diabetes (T2DM), has not been previously reported. To investigate the correlation between the FT3/FT4 ratio and glycemic variability in individuals with T2DM. In this retrospective analysis, a total of 468 inpatients with T2DM underwent continuous glucose monitoring (CGM) systems for a period of 6–14 days. Baseline clinical characteristics, laboratory tests, and CGM parameters were documented to investigate the correlation between FT3/FT4 ratio and CGM parameters. The levels of HBA, MG, SD, CV, LAGE, MODD and TAR2Scale were all higher in FT3/FT4Q1 compared with FT3/FT4Q2, FT3/FT4Q3 and FT3/FT4Q4 (all P < 0.01). Additionally, TIR was lower in FT3/FT4Q1 compared with the other quartiles (P < 0.01). Smooth curve fitting and saturation effect analysis revealed that there are curve-like relationships between the FT3/FT4 ratio and SD, MAGE, MODD and TAR2Scale. The inflection points of the fitted curves were found to be at FT3/FT4 = 0.279, 0.237, 0.253 and 0.282 respectively (all P < 0.05). Prior to the inflection point, the FT3/FT4 ratio was negatively related to SD, MAGE, MODD and TAR2Scale (all P < 0.05). Furthermore, The FT3/FT4 ratio exhibits a negative linear correlation with HBA and MG, while demonstrating a positive linear relationship with TIR (all P < 0.05). Binary logistic regression demonstrated that the FT3/FT4 ratio was independently related to HBA (P = 0.001), MG (P = 0.01), TAR2Scale (P = 0.003), LAGE (P = 0.014) and MAGE (P < 0.001). The increased FT3/FT4 ratio within a certain range (FT3/FT4 ≤ 0.282) is associated with decreased blood glucose variability and increased TIR. The FT3/FT4 ratio may act as a potential independent protective factor for glycemic fluctuation and glycemic control in patients with T2DM when it increases within a specific range.
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spelling doaj-art-56e4f88f92854cf7be77136c633536952025-08-20T02:13:27ZengNature PortfolioScientific Reports2045-23222024-11-0114111510.1038/s41598-024-76074-wIncreased FT3/FT4 ratio in a certain range is associated with decreased glycemic variability in patients with type 2 diabetesYing Li0Tianrong Pan1Lingyu Wang2Yue Wang3Yu Gong4Guojuan Wang5Qianqian Zhang6Department of Endocrinology and Metabolism, Second Affiliated Hospital of Anhui Medical UniversityDepartment of Endocrinology and Metabolism, Second Affiliated Hospital of Anhui Medical UniversityDepartment of Oncology, The First Affiliated Hospital of USTC: Anhui Provincial HospitalDepartment of Endocrinology and Metabolism, Second Affiliated Hospital of Anhui Medical UniversityHefei City First People’s Hospital, Anhui Medical UniversityDepartment of Endocrinology and Metabolism, Hefei City First People’s HospitalDepartment of Endocrinology and Metabolism, Hefei City First People’s HospitalAbstract Thyroid hormone (TH) plays a crucial role in regulating glucose metabolism. However, the potential impact of the FT3/FT4 ratio, which reflects peripheral sensitivity to thyroid hormones, on glycemic variability in patients with type 2 diabetes (T2DM), has not been previously reported. To investigate the correlation between the FT3/FT4 ratio and glycemic variability in individuals with T2DM. In this retrospective analysis, a total of 468 inpatients with T2DM underwent continuous glucose monitoring (CGM) systems for a period of 6–14 days. Baseline clinical characteristics, laboratory tests, and CGM parameters were documented to investigate the correlation between FT3/FT4 ratio and CGM parameters. The levels of HBA, MG, SD, CV, LAGE, MODD and TAR2Scale were all higher in FT3/FT4Q1 compared with FT3/FT4Q2, FT3/FT4Q3 and FT3/FT4Q4 (all P < 0.01). Additionally, TIR was lower in FT3/FT4Q1 compared with the other quartiles (P < 0.01). Smooth curve fitting and saturation effect analysis revealed that there are curve-like relationships between the FT3/FT4 ratio and SD, MAGE, MODD and TAR2Scale. The inflection points of the fitted curves were found to be at FT3/FT4 = 0.279, 0.237, 0.253 and 0.282 respectively (all P < 0.05). Prior to the inflection point, the FT3/FT4 ratio was negatively related to SD, MAGE, MODD and TAR2Scale (all P < 0.05). Furthermore, The FT3/FT4 ratio exhibits a negative linear correlation with HBA and MG, while demonstrating a positive linear relationship with TIR (all P < 0.05). Binary logistic regression demonstrated that the FT3/FT4 ratio was independently related to HBA (P = 0.001), MG (P = 0.01), TAR2Scale (P = 0.003), LAGE (P = 0.014) and MAGE (P < 0.001). The increased FT3/FT4 ratio within a certain range (FT3/FT4 ≤ 0.282) is associated with decreased blood glucose variability and increased TIR. The FT3/FT4 ratio may act as a potential independent protective factor for glycemic fluctuation and glycemic control in patients with T2DM when it increases within a specific range.https://doi.org/10.1038/s41598-024-76074-wFree triiodothyronine to free thyroxine (FT3/FT4) ratioGlycemic variabilityType 2 diabetesContinuous glucose monitoring
spellingShingle Ying Li
Tianrong Pan
Lingyu Wang
Yue Wang
Yu Gong
Guojuan Wang
Qianqian Zhang
Increased FT3/FT4 ratio in a certain range is associated with decreased glycemic variability in patients with type 2 diabetes
Scientific Reports
Free triiodothyronine to free thyroxine (FT3/FT4) ratio
Glycemic variability
Type 2 diabetes
Continuous glucose monitoring
title Increased FT3/FT4 ratio in a certain range is associated with decreased glycemic variability in patients with type 2 diabetes
title_full Increased FT3/FT4 ratio in a certain range is associated with decreased glycemic variability in patients with type 2 diabetes
title_fullStr Increased FT3/FT4 ratio in a certain range is associated with decreased glycemic variability in patients with type 2 diabetes
title_full_unstemmed Increased FT3/FT4 ratio in a certain range is associated with decreased glycemic variability in patients with type 2 diabetes
title_short Increased FT3/FT4 ratio in a certain range is associated with decreased glycemic variability in patients with type 2 diabetes
title_sort increased ft3 ft4 ratio in a certain range is associated with decreased glycemic variability in patients with type 2 diabetes
topic Free triiodothyronine to free thyroxine (FT3/FT4) ratio
Glycemic variability
Type 2 diabetes
Continuous glucose monitoring
url https://doi.org/10.1038/s41598-024-76074-w
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