Hypothyroidism in Type-2 Diabetics in Texas
Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and energy levels of the body. Type-2 diabetes is a chronic disease in which the body does not respond properly to insulin, a hormone that controls blood sugar levels. Both hypothyroidism and type-2 diabetes are common endocrine disorders that can affect the health and quality of life of millions of people.
In this blog post, we will explore the relationship between hypothyroidism and type-2 diabetes in the ethnic population of Texas, USA. We will also discuss the potential health problems associated with the co-occurrence of these two disorders, and the possible ways to prevent and manage them.
Prevalence of Hypothyroidism and Type-2 Diabetes in Texas
According to the Texas Department of State Health Services (2020), the population of Texas was estimated to be 29.4 million, of which 39.7% were Hispanic or Latino, mostly of Mexican origin. The prevalence of diagnosed diabetes among adults aged 18 years and older was 11.2%, and the prevalence of prediabetes was 12.6%. Diabetes was the seventh leading cause of death in Texas in 2019, accounting for 6,164 deaths.
The prevalence of hypothyroidism in Texas is not well documented, but a nationwide study by Hollowell et al. (2002) estimated that 4.6% of the US population aged 12 years and older had hypothyroidism, defined as a serum TSH level greater than 4.5 mIU/L. The prevalence was higher among women (7.5%) than men (2.8%), and increased with age. The study also found that 9.5% of the population had subclinical hypothyroidism, defined as a serum TSH level between 4.5 and 10 mIU/L with normal free T4 levels.
There is evidence that hypothyroidism and type-2 diabetes are associated with each other, and that both disorders may share some genetic and environmental risk factors. A meta-analysis by Rong et al. (2021) found that high baseline TSH levels were related to a 17% higher risk of type-2 diabetes, compared with normal TSH levels. Low free T3 and low free T4 levels were also significantly associated with an increased risk of type-2 diabetes. The study suggested that there was a J-shaped relationship between TSH and type-2 diabetes risk, and an inverted-J-shaped relationship between free T3 or free T4 and type-2 diabetes risk.
A study by Samollow et al. (2004) investigated the genetic variation of thyroid function genes in different racial and ethnic groups in Texas, including Mexican Americans, who are the main Hispanic residents. The study found that some single nucleotide polymorphisms (SNPs) near the genes encoding for TSH receptor and iodothyronine deiodinase (DIO1), which are involved in thyroid hormone synthesis and metabolism, were significantly associated with thyroid hormone levels in Mexican Americans.
Another study by Lehman et al. (2007) examined the genetic variation of genes related to insulin-dependent glucose and lipid homeostasis in different racial and ethnic groups in Texas, including Mexican Americans. The study found that some SNPs near the gene encoding for hepatocyte nuclear factor 4 alpha (HNF4A), which is a transcription factor that regulates glucose and lipid metabolism in the liver, were significantly associated with type-2 diabetes risk in Mexican Americans.
These studies suggest that there may be some genetic factors that influence both thyroid function and glucose metabolism in Mexican Americans, and that these factors may contribute to the high prevalence of hypothyroidism and type-2 diabetes in this ethnic group.
Health Problems Associated with Hypothyroidism and Type-2 Diabetes
Hypothyroidism and type-2 diabetes can have negative effects on various aspects of health, such as cardiovascular health, lipid metabolism, weight management, mental health, reproductive health, and bone health.
Hypothyroidism can cause elevated levels of low-density lipoprotein (LDL) cholesterol, triglycerides, homocysteine, and C-reactive protein, which are risk factors for cardiovascular disease (CVD). Hypothyroidism can also impair endothelial function, increase blood pressure, reduce cardiac output, and cause diastolic dysfunction, which can lead to heart failure or ischemic heart disease.
Type-2 diabetes can cause hyperglycemia, which can damage the blood vessels and nerves that supply the heart, brain, kidneys, eyes, nerves, skin, feet, and other organs. Type-2 diabetes can also cause dyslipidemia,
