{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:47:22Z","timestamp":1793141242668,"version":"4.5.0"},"reference-count":22,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Vibrant America LLC","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,12,6]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association between thyroid disease and diabetes markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted in a diagnostic setting where the primary care providers recommended the patients to test for thyroid and diabetes panels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The thyroid and diabetes markers were tested in 32\u2009787 subjects with suspected thyroid and related conditions who visited Vibrant America Clinical Laboratory between January 2015 and June 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our general prevalence results showed that homeostatic model assessment-insulin resistance (HOMA-IR) was elevated in overt hypothyroid subjects (43.7%) and overt hyperthyroid subjects (42.2%). Glycated hemoglobin (HbA1C) was elevated in subclinical hypothyroid subjects (19.2%), overt hypothyroid subjects (22.3%) and overt hyperthyroid subjects (21.2%). Glucose was significantly elevated in subclinical hypothyroid subjects (24.2%) and overt hyperthyroid subjects (31.0%). Insulin was significantly elevated in overt hypothyroid subjects (15.1%). Interestingly, we found that 70.3% of subjects who had their HOMA-IR score escalated from negative (HOMA-IR&lt;2.7) to positive (HOMA-IR&gt;2.7) during their multiple visits had anti-thyroid peroxidase (anti-TPO) 369 (\u00b1242) days prior to the onset of this change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings showed that anti-TPO levels are elevated before the onset of insulin resistance, indicating its potential use as a predictive marker.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-076397","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T20:40:29Z","timestamp":1736196029000},"page":"e076397","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Association between thyroid dysfunction and insulin resistance: a retrospective cohort study"],"prefix":"10.1136","volume":"15","author":[{"given":"Hari","family":"Krishnamurthy","sequence":"first","affiliation":[{"name":"Vibrant Sciences LLC, Santa Clara, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7832-8423","authenticated-orcid":false,"given":"Chithra","family":"Suresh","sequence":"additional","affiliation":[{"name":"Biological, Vibrant America, San Carlos, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9059-1059","authenticated-orcid":false,"given":"Thushani","family":"Siriwardhane","sequence":"additional","affiliation":[{"name":"Vibrant Sciences LLC, Santa Clara, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik","family":"Krishna","sequence":"additional","affiliation":[{"name":"Vibrant Sciences LLC, Santa Clara, California, 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Endocrine diseases and diabetes. In: Pickup J , Williams G , eds. Textbook of diabetes. 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