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ORIGINAL RESEARCH article

Front. Endocrinol.

Sec. Thyroid Endocrinology

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1591108

Impaired sensitivity to thyroid hormones is associated with high lipoprotein(a) level in euthyroid patients with type 2 diabetes mellitus

Provisionally accepted
Luojing  ZhongLuojing Zhong1Ruiyu  LinRuiyu Lin1Baozhen  CaoBaozhen Cao1Wenying  ZhongWenying Zhong2Mei  TuMei Tu1,3*Wen  WeiWen Wei1,3*
  • 1Department of Endocrinology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
  • 2Department of Physical Examination, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
  • 3The School of Clinical Medicine, Fujian Medical University, Fuzhou, China

The final, formatted version of the article will be published soon.

Background:The relationship between thyroid hormone sensitivity and lipoprotein(a) (Lp(a)) is unclear.The purpose of this study is to illuminate the correlation between thyroid hormone sensitivity and Lp(a) in euthyroid patients with type 2 diabetes mellitus (T2DM).Method:A cross-sectional study was conducted on 1097 patients with T2DM.The thyroid hormone sensitivity indices, the thyroid feedback quantile-based index (TFQI), the thyroid-stimulating hormone index (TSHI), the thyrotrophic T4 resistance index (TT4RI), and the free triiodothyronine(FT3)/free thyroxine (FT4) ratio were calculated. Linear and binary logistic regression analysis were performed to assess the relationship between thyroid hormone sensitivity indices and Lp(a). Restricted cubic splines were also used to evaluate the association between thyroid hormone sensitivity indices and Lp(a).Result:Among the 1097 participants, the percentage of Lp(a)≥30 mg/dL was 20.3%. Linear regression analysis revealed that TFQI displayed a positive correlation with Lp(a) levels, whereas the FT3/ FT4 ratio exhibited a negative correlation.The adjusted odds ratio (aOR)(95% confidence interval(CI)) for high Lp(a) level was increased with rising TFQI quartiles(Q3: aOR 1.49,95% CI 1.09-2.06; Q4: aOR 1.74, 95% CI 1.36-2.23) (P<0.05) ,with Q1 as the reference. By contrast,the aOR(95% CI) for high Lp(a) level was decreased with rising FT3/FT4 ratio quartiles (P<0.05).The robustness of these findings was further confirmed by restricted cubic spline analysis.In euthyroid T2DM patients, decreased sensitivity to thyroid hormones was found to be linked with high Lp(a) level. Screening for thyroid hormone insensitivity and serum Lp(a) levels should be emphasized in euthyroid T2DM patients for early intervention and improved outcomes.

Keywords: Lipoprotein(a), sensitivity to thyroid hormones, type 2 diabetes mellitus, thyroid feedback quantile-based Index, Free triiodothyronine/free thyroxine ratio

Received: 10 Mar 2025; Accepted: 02 Jun 2025.

Copyright: © 2025 Zhong, Lin, Cao, Zhong, Tu and Wei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Mei Tu, The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
Wen Wei, The School of Clinical Medicine, Fujian Medical University, Fuzhou, China

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