, Volume 61, Issue 1, pp 68–75 | Cite as

High-normal serum thyrotropin levels and increased glycemic variability in type 2 diabetic patients

  • Jian-Bin Su
  • Li-Hua Zhao
  • Xiu-Lin Zhang
  • Hong-Li Cai
  • Hai-Yan Huang
  • Feng Xu
  • Tong Chen
  • Xue-Qin Wang
Original Article



High-normal thyrotropin (TSH) is related to reduced insulin sensitivity and may contribute to glycemic disorders in diabetes. We investigated the relationship between normal serum TSH levels and glycemic variability in euthyroid type 2 diabetic patients.


A total of 432 newly diagnosed type 2 diabetic patients with euthyroid function and normal serum TSH levels were recruited between March 2013 and February 2017. Insulin sensitivity was evaluated by the Matsuda index (ISIMatsuda) following a 75-g oral glucose tolerance test. Multiple glycemic variability indices, including the mean amplitude of glycemic excursions (MAGE), mean of daily differences (MODD), and standard deviation of glucose (SD), were calculated from glucose data obtained with a continuous glucose monitoring system. Average glucose accessed by 24-h mean glucose (24-h MG) was also calculated.


A normal serum TSH level was positively correlated with MAGE, MODD, SD, and 24-h MG (r = 0.206, 0.178, 0.186, and 0.132, respectively, p < 0.01). After adjusting for somatometric parameters, lipid profiles, ISIMatsuda, and HbA1c via multiple linear regression analysis, mean differences [B(95% CI)] in MAGE, MODD, SD, and 24-h MG between the patients in the lowest and highest quartiles of TSH levels were 0.128(0.031, 0.226), 0.085(0.022, 0.148), 0.039(0.001, 0.078), and 0.002(−0.264, 0.267) mmol/L, respectively. High-normal TSH was independently associated with MAGE, MODD, and SD, but not 24-h MG.


High-normal serum TSH is a significant additional risk factor for increased glycemic variability in type 2 diabetic patients.


Glycemic variability Thyrotropin Type 2 diabetes 





Free triiodothyronine


Free thyroxine


Thyroperoxidase antibody


Insulin sensitivity index recommended by Matsuda


Mean amplitude of glycemic excursions


Mean of daily differences


Standard deviation of glucose

24-h MG

24-h mean glucose


Body mass index


Systolic blood pressure


Diastolic blood pressure


Total cholesterol




High-density lipoprotein cholesterol


Low-density lipoprotein cholesterol


Glycosylated hemoglobin A1c



The study was supported by the Medical Research Projects of Nantong Technology Bureau (HS2012028, MS22015065) and the Medical Research Project of Health and Family Planning Commission of Jiangsu (QNRC2016408).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study conformed to the guidelines of the Declaration of Helsinki, and the study procedures were reviewed and approved by the Medical Research Ethics Committee of Second Affiliated Hospital of Nantong University.

Informed consent

Each patient agreed to participate in the study and signed the informed consent form.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of EndocrinologyThe Second Affiliated Hospital of Nantong University, and First People’s Hospital of Nantong CityNantongChina
  2. 2.Department of Clinical LaboratoryThe Second Affiliated Hospital of Nantong University, and First People’s Hospital of Nantong CityNantongChina
  3. 3.Department of GeriatricsThe Second Affiliated Hospital of Nantong University, and First People’s Hospital of Nantong CityNantongChina

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