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Li W, Yang Z, Li S, Jiang S, Hu W, Wan Z, Tu P, Duan P. Free triiodothyronine predicts the risk of developing diabetic kidney disease. BMC Nephrol 2023; 24:298. [PMID: 37821807 PMCID: PMC10568907 DOI: 10.1186/s12882-023-03349-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/24/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Low levels of Free Triiodothyronine (FT3) are associated with poor survival in chronic kidney disease, and the aim of this study was to further assess the relationship between changes in FT3 levels and renal damage in patients with type 2 diabetes based on glomerular and tubular markers. METHODS We retrospectively studied 452 type 2 diabetic patients, measured glomerular damage markers (UACR, eGFR) and tubular damage markers (NAG/Cr,β2-MG), analyzed the relationship between FT3 and renal damage by logistic regression models, and plotted restrictive cubic splines. RESULTS 41.6% of subjects had diabetic kidney disease (DKD), and the prevalence of DKD decreased progressively with increasing FT3 levels in the third quartile. Spearman correlation analysis showed that FT3 was negatively associated with UACR, NAG/Cr and β2-MG, while eGFR was positively associated with FT3. Multifactorial analysis, after adjusting for relevant confounders, revealed that compared with the lowest quartile of FT3, the highest quartile reduced the risk of developing urinary albumin (OR = 0.499,95% CI:0.289-0.856), moderate to severe impairment of glomerular filtration rate (OR = 0.106,95% CI:0.032-0.354), renal tubular marker β2 -MG positive (OR = 0.516,95% CI:0.299 to 0.883) and the risk of DKD occurrence (OR = 0.450,95% CI:0.260 to 0.774). In the sample model, FT3 levels below 4.39 pmol/L were associated with an increased risk of glomerular tubule injury and DKD occurrence. CONCLUSIONS FT3 is closely associated with glomerular tubular injury and is a protective factor. As FT3 levels (< 4.39 pmol/L) decrease, the risk of developing DKD becomes higher, and FT3 can be used as an independent predictor of developing DKD.
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Affiliation(s)
- Weihong Li
- Department of Endocrinology and Metabolism, Nanchang People's Hospital (The Third Hospital of Nanchang), Jiangxi, China
| | - Zhi Yang
- Department of Endocrinology and Metabolism, Nanchang People's Hospital (The Third Hospital of Nanchang), Jiangxi, China
| | - Shengjian Li
- Department of Endocrinology and Metabolism, Nanchang People's Hospital (The Third Hospital of Nanchang), Jiangxi, China
| | - Shanshan Jiang
- Department of Endocrinology and Metabolism, Nanchang People's Hospital (The Third Hospital of Nanchang), Jiangxi, China
| | - Wan Hu
- Department of Endocrinology and Metabolism, Nanchang People's Hospital (The Third Hospital of Nanchang), Jiangxi, China
| | - Zhenying Wan
- Department of Endocrinology and Metabolism, Nanchang People's Hospital (The Third Hospital of Nanchang), Jiangxi, China
| | - Ping Tu
- Department of Endocrinology and Metabolism, Nanchang People's Hospital (The Third Hospital of Nanchang), Jiangxi, China
| | - Peng Duan
- Department of Endocrinology and Metabolism, Nanchang People's Hospital (The Third Hospital of Nanchang), Jiangxi, China.
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Wu JN, Pérez-López FR, Peng T, Xie F, Li MQ. Association of Early Pregnancy Free and Total Triiodothyronine With the Subsequent Risk of Gestational Diabetes Mellitus. Endocr Pract 2023; 29:40-47. [PMID: 36280024 DOI: 10.1016/j.eprac.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/29/2022] [Accepted: 10/17/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To estimate the association of free triiodothyronine (FT3) and total triiodothyronine (TT3) in early pregnancy and subsequent gestational diabetes mellitus (GDM) risk and define appropriate TT3 thresholds for GDM screening. METHODS This investigation is a hospital-based cohort study of pregnant women submitted to a universal thyroid function test before 24 weeks of gestation. GDM was diagnosed according to a 75-g oral glucose tolerance test. The association of maternal high FT3 and TT3 levels in early pregnancy with the risk of GDM was estimated using logistic regression. The potential nonlinear association was probed by the restricted cubic spline curve method. RESULTS A total of 27 184 pregnant women and 3073 GDM cases were included in the analysis. FT3 and TT3 were associated with an increased subsequent risk of GDM in a nonlinear fashion. The adjusted odds ratios were 1.59 (95% confidence interval, 1.50-1.68) and 2.80 (95% confidence interval, 2.46-3.18) for FT3 and TT3 continuous levels, respectively. Associations were strong in euthyroid women, showed heterogeneity in women with mild thyroid dysfunction, and lacked in patients with overt hypothyroidism and hyperthyroidism. The TT3 thresholds of 1.5 and 2.0 ng/mL between 7 and 12 weeks of gestation and 1.6 and 2.1 ng/mL for 13 to 23 weeks of gestation effectively distinguished the subsequent risk of GDM. CONCLUSION The increased FT3 and TT3 levels in early pregnancy were associated with a subsequent higher risk of GDM. These findings provide measures for early detection and potential prevention of GDM.
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Affiliation(s)
- Jiang-Nan Wu
- Department of Clinical Epidemiology, Clinical Research Unit, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China.
| | - Faustino R Pérez-López
- Aragón Health Research Institute, Zaragoza, Spain; University of Zaragoza Faculty of Medicine, Zaragoza, Spain
| | - Ting Peng
- Department of Obstetrics, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Feng Xie
- Medical Center of Diagnosis and Treatment for Cervical Disease, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Ming-Qing Li
- Department of Clinical Epidemiology, Clinical Research Unit, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
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Yang J, Ding W, Wang H, Shi Y. Association Between Sensitivity to Thyroid Hormone Indices and Diabetic Retinopathy in Euthyroid Patients with Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2023; 16:535-545. [PMID: 36874555 PMCID: PMC9984276 DOI: 10.2147/dmso.s399910] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/27/2023] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVE Normal thyroid hormone (TH) levels and their relation to microvascular complications in patients with type 2 diabetes mellitus (T2DM) have been studied. However, the relationship between TH sensitivity and diabetic retinopathy (DR) remains unclear. Thus, this study aimed to investigate the relationship between TH sensitivity and the risk of DR in euthyroid T2DM patients. METHODS This retrospective study analyzed 422 T2DM patients and calculated their sensitivity to TH indices. Multivariable logistic regression, generalized additive model, and subgroup analysis were performed to examine the association between sensitivity to TH indices and DR risk. RESULTS After adjusting for covariates, the binary logistic regression model showed no statistically significant association between the sensitivity of TH indices and the risk of DR in euthyroid T2DM patients. However, a non-linear relationship was found between sensitivity to TH indices (thyroid-stimulating hormone index, thyroid feedback quantile index [TFQI]) and the risk of DR in the crude model; TFQI and DR in the adjusted model. The inflection point of the TFQI was 0.23. The effect size (odds ratio) on the left and right of the inflection point were 3.19 (95% confidence interval [CI]: 1.24 to 8.17 p=0.02) and 0.11 (95% CI: 0.01, 0.93 p=0.04), respectively. Moreover, this relationship was maintained by men stratified by sex. In euthyroid patients with T2DM, an approximate inverted U-shaped relationship and a threshold effect were demonstrated between TH index sensitivity and DR risk with sex differences. This study provided an in-depth understanding of the relationship between thyroid function and DR, which has important clinical implications for risk stratification and individual prediction.
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Affiliation(s)
- Jie Yang
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, 061000, People’s Republic of China
- Correspondence: Jie Yang, Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, 061000, People’s Republic of China, Email
| | - Wencui Ding
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, 061000, People’s Republic of China
| | - Haiying Wang
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, 061000, People’s Republic of China
| | - Yanan Shi
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, 061000, People’s Republic of China
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Gong L, Ma A, Yin X, Liang K, Liu J. Circulating free triiodothyronine concentration is positively associated with β-cell function in euthyroid patients with obesity and type 2 diabetes. J Int Med Res 2022; 50:3000605221118511. [PMID: 35983678 PMCID: PMC9393685 DOI: 10.1177/03000605221118511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate the relationship between thyroid hormone concentrations and β-cell function in euthyroid patients with obesity and type 2 diabetes. METHODS We performed a single-center cross-sectional study of 254 patients with type 2 diabetes mellitus aged ≥40 years. The participants were allocated to an obesity group or non-obesity group on the basis of their body mass index (BMI). Their β-cell function was assessed by measuring C-peptide concentration during a 75-g oral glucose tolerance test (OGTT); and their serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone concentrations were measured. RESULTS The serum FT3 concentration and the C-peptide concentrations at five time points of the OGTT were significantly higher in the obesity group than in the non-obesity group. FT3 was positively associated with the β-cell function of the obesity group, but not that of the non-obesity group, in multiple linear regression analysis, after adjustment for potential confounding factors. Serum FT3 concentration was also significantly associated with indices of obesity (BMI, waist circumference, body fat percentage, fat mass, fat mass/height2 and visceral fat area). CONCLUSIONS Obesity-associated high serum FT3 concentrations might affect β-cell function in euthyroid patients with obesity and type 2 diabetes.
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Affiliation(s)
- Lei Gong
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.,Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.,Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Aixia Ma
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.,Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.,Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Xiaofei Yin
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.,Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.,Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Kai Liang
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.,Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.,Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Jinbo Liu
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.,Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.,Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
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Liu ZM, Li G, Wu Y, Zhang D, Zhang S, Hao YT, Chen W, Huang Q, Li S, Xie Y, Ye M, He C, Chen P, Pan W. Increased Central and Peripheral Thyroid Resistance Indices During the First Half of Gestation Were Associated With Lowered Risk of Gestational Diabetes-Analyses Based on Huizhou Birth Cohort in South China. Front Endocrinol (Lausanne) 2022; 13:806256. [PMID: 35345468 PMCID: PMC8957094 DOI: 10.3389/fendo.2022.806256] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/24/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The study aimed to explore the relationship of thyroid function and resistance indices with subsequent risk of gestational diabetes (GDM). DESIGN This was a longitudinal study embedded in the Huizhou Birth Cohort. METHODS A total of 2,927 women of singleton pregnancy were recruited from January to October of 2019. Thyroid central resistance indices were evaluated by Thyroid Feedback Quartile-Based index (TFQI), Thyrotrophy T4 Resistance Index (TT4RI), and TSH Index (TSHI) based on plasma-free thyroxine (FT4) and thyroid-stimulating hormone (TSH) levels during the first half of pregnancy. Thyroid peripheral sensitivity was assessed by free triiodothyronine (FT3) to FT4 ratio (FT3/FT4), a proxy of deiodinase activity. GDM was diagnosed between 24 and 28 weeks of gestation by a standardized 75 g oral glucose tolerance test. Multivariable linear and logistic regression was applied to examine the associations of thyroid markers with GDM risk. RESULTS FT3 and FT3/FT4 were positively associated with both fasting and post-load glucose levels, while TSH, TSHI, TT4RI, and TFQI were negatively associated with 1 and 2 h post-load glucose levels. Compared with the lowest quartile, GDM risk in the highest quartile increased by 44% [odds ratio (OR) = 1.44; 95%CI, 1.08-1.92; ptrend = 0.027] for FT3 and 81% (OR = 1.81; 95%CI, 1.33-2.46; ptrend < 0.001) for FT3/FT4, while it lowered by 37% (OR = 0.63; 95%CI, 0.47-0.86; ptrend = 0.002] for TSHI, 28% for TT4RI (OR = 0.72; 95%CI, 0.54-0.97; ptrend = 0.06), and 37% for TFQI (OR = 0.63; 95%CI, 0.46-0.85; ptrend < 0.001). CONCLUSIONS This longitudinal study indicated that higher FT3 and FT3/FT4 and lower central thyroid resistance indices were associated with increased risk of GDM.
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Affiliation(s)
- Zhao-min Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
- *Correspondence: Zhao-min Liu, ; Wenjing Pan,
| | - Guoyi Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Yi Wu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Di Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Sujuan Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Yuan-Tao Hao
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Weiqing Chen
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Qi Huang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Shuyi Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Yaojie Xie
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Mingtong Ye
- Huizhou First Mother and Child Health-Care Hospital, Huizhou, China
| | - Chun He
- Huizhou First Mother and Child Health-Care Hospital, Huizhou, China
| | - Ping Chen
- Huizhou First Mother and Child Health-Care Hospital, Huizhou, China
| | - Wenjing Pan
- Huizhou First Mother and Child Health-Care Hospital, Huizhou, China
- *Correspondence: Zhao-min Liu, ; Wenjing Pan,
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Kocatürk E, Kar E, Küskü Kiraz Z, Alataş Ö. Insulin resistance and pancreatic β cell dysfunction are associated with thyroid hormone functions: A cross-sectional hospital-based study in Turkey. Diabetes Metab Syndr 2020; 14:2147-2151. [PMID: 33395774 DOI: 10.1016/j.dsx.2020.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS The prevalence of thyroid disease in diabetic patients is significantly higher than the general population. This indicates a possible interaction between thyroid functions and insulin sensitivity. This study aimed to investigate the relationship between insulin resistance (IR), pancreatic β cell function, and thyroid function tests. METHODS This cross-sectional study was conducted with adults who applied to Eskişehir Osmangazi University Hospital for general control. Fasting insulin, glucose, TSH, fT3, and fT4 levels in the serum of 1340 adult (18-60 aged) patients without any chronic diseases were examined retrospectively. The fT3/fT4 ratio, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and HOMA-β values were calculated. The correlation between HOMA-IR and HOMA-β values with thyroid function tests and differences between hormone levels of patients with and without IR were evaluated. RESULTS There was a positive correlation between HOMA-IR and TSH, negative with fT4. Also, a positive correlation between HOMA-β and fT3, negative correlation with fT4 were observed. In the IR group, fT3 levels were found significantly higher and fT4 levels were significantly lower. TSH levels were higher in the IR group but not statistically significant. The fT3/fT4 ratio was found significantly higher in the IR group and was correlated positively with both HOMA-IR and HOMA-β. CONCLUSION Our results revealed that thyroid dysfunction prevalence is quite high in adults who have not yet been diagnosed with diabetes but have insulin resistance and the onset of pancreatic β cell dysfunction.
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Affiliation(s)
- Evin Kocatürk
- Department of Medical Biochemistry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
| | - Ezgi Kar
- Department of Medical Biochemistry, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
| | - Zeynep Küskü Kiraz
- Department of Medical Biochemistry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
| | - Özkan Alataş
- Department of Medical Biochemistry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
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da Silva LA, Wouk J, Weber VMR, de Almeida P, Martins JC, Malfatti CR, Osiecki R. Correlation Between Insulin Levels and Thyroid Hormones in Diabetic Animals After Caffeine Consumption Associated with Exercise. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401315666181211144036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Introduction:
Thyroid hormones (TH) are important determinants of glucose homeostasis,
and in contrast, insulin is the first hormone responsible for glycemic control.
Objective:
The objective of the present study was to correlate the levels of insulin and thyroid hormones
in diabetic animals after caffeine consumption associated with physical exercise.
Methods:
A total of 48 animals, 60 days old were allocated in eight experimental groups: Control,
Diabetic, Exercise, Diabetes + exercise, Caffeine, Diabetes + Caffeine, Caffeine + Exercise, and Diabetes
+ Exercise + Caffeine. Diabetes model was induced by intraperitoneal administration of 120
mg/kg of alloxan. On the test day, 6 mg/kg of caffeine was administrated 30 minutes before physical
exercise. After, animals performed a 60 minutes’ session of predominantly aerobic exercise, using an
overload of 6% of their body’s weight. Blood has been collected by a caudal puncture to future insulin,
TSH, T3, and T4 analyses.
Results:
After caffeine treatment and training, insulin values were higher for the control groups
(231%) when compared to the diabetic groups. A significant increase in plasmatic insulin concentration
was found in caffeine group (95%) and Exercise+Caffeine group (56%) when compared to Control
and Exercise groups. TSH values were increased for Diabetes, Diabetes+Caffeine and Diabetes+
Exercise+Caffeine groups (30%) compared to the other groups. A reduction in T4 values occurred
in the animals of groups Diabetes+Exercise and Diabetes +Caffeine (66%) compared to the
Control group. T3 values were significantly increased for the Diabetes+Exercise group (70%) when
compared to the Diabetes+Exercise+Caffeine group.
Conclusion:
Physical exercise and caffeine consumption were able to promote hormonal changes in
diabetic animals after 30 days of training. The study showed a reduction in the serum concentration
of thyroid hormones, but insulin levels were higher.
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Affiliation(s)
| | - Jéssica Wouk
- Post-graduation of Pharmaceutical Science, Midwest State University of Parana, Guarapuava, Parana, Brazil
| | | | - Pablo de Almeida
- Post-graduation of Pharmaceutical Science, Midwest State University of Parana, Guarapuava, Parana, Brazil
| | - Julio C.L. Martins
- Academia Militar das Agulhas Negras - AMAN, Resende, Rio de Janeiro, Brazil
| | - Carlos R.M. Malfatti
- Post-graduation of Pharmaceutical Science, Midwest State University of Parana, Guarapuava, Parana, Brazil
| | - Raul Osiecki
- Post-graduation of Physical Education, Federal University of Parana, Curitiba, Parana, Brazil
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Li Q, Lu M, Wang NJ, Chen Y, Chen YC, Han B, Li Q, Xia FZ, Jiang BR, Zhai HL, Lin DP, Lu YL. Relationship between Free Thyroxine and Islet Beta-cell Function in Euthyroid Subjects. Curr Med Sci 2020; 40:69-77. [PMID: 32166667 DOI: 10.1007/s11596-020-2148-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 12/01/2019] [Indexed: 12/29/2022]
Abstract
Thyroid hormones have a specific effect on glucose-induced insulin secretion from the pancreas. We aimed to investigate the association between euthyroid hormones and islet beta-cell function in general population and non-treated type 2 diabetes mellitus (T2DM) patients. A total of 5089 euthyroid participants (including 4601 general population and 488 non-treated T2DM patients) were identified from a cross-sectional survey on the prevalence of metabolic diseases and risk factors in East China from February 2014 to June 2016. Anthropometric indices, biochemical parameters, and thyroid hormones were measured. Compared with general population, non-treated T2DM patients exhibited higher total thyroxine (TT4) and free thyroxine (FT4) levels but lower ratio of free triiodothyronine (T3):T4 (P<0.01). HOMA-β had prominently negative correlation with FT4 and positive relationship with free T3:T4 in both groups even after adjusting for age, body mass index (BMI) and smoking. When analyzed by quartiles of FT4 or free T3:T4, there were significantly decreased trend of HOMA-β going with the higher FT4 and lower free T3:T4 in both groups. Linear regression analysis showed that FT4 but not FT3 and free T3:T4 was negatively associated with HOMA-β no matter in general population or T2DM patients, which was independent of age, BMI, smoking, hypertension and lipid profiles. FT4 is independently and negatively associated with islet beta-cell function in euthyroid subjects. Thyroid hormone even in reference range could play an important role in the function of pancreatic islets.
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Affiliation(s)
- Qing Li
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Meng Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Ning-Jian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Ying-Chao Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Bing Han
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Qin Li
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Fang-Zhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Bo-Ren Jiang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Hua-Ling Zhai
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Dong-Ping Lin
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China.
| | - Ying-Li Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China.
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Kong X, Wang J, Gao G, Tan M, Ding B, Li H, Ma J. Association between Free Thyroxine Levels and Diabetic Retinopathy in Euthyroid Patients with Type 2 Diabetes Mellitus. Endocr Res 2020; 45:111-118. [PMID: 31773995 DOI: 10.1080/07435800.2019.1690504] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background: This study aimed to evaluate the association between thyroid parameters and diabetic retinopathy (DR) in euthyroid patients with type 2 diabetes mellitus (T2DM).Materials and Methods: In this cross-sectional study, a total of 911 euthyroid patients with T2DM (539 men and 372 women; mean age, 60.81 ± 12.93 years) were enrolled. Clinical factors were assessed and free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) levels were measured. DR was diagnosed using fundus fluorescein angiography.Results: Compared with patients without DR (n = 718), patients with DR (n = 193) exhibited lower FT3 (4.40 ± 0.58 vs. 4.50 ± 0.51 pmol/L; P = .019) and FT4 (14.86 ± 2.09 vs. 15.91 ± 2.18 pmol/L; P < .001) and higher TSH (1.86 [1.22, 2.66] vs. 1.58 [1.14, 2.34] µIU/mL; P = .015) levels. After adjustment for potential DR risk factors, patients in the highest tertile of plasma FT4 levels had a 0.332-fold likelihood of developing DR compared with those in the lowest tertile of plasma FT4 levels (Ptrend < 0.001). The prevalence of DR showed a significantly decreasing trend across the three tertiles based on FT4 levels (31.35%, 19.08% and 13.16%; Ptrend < 0.001). Similar results were obtained for the presence of proliferative DR.Conclusion: These findings suggest that low-normal FT4 levels are associated with the prevalence of DR in euthyroid patients with T2DM.
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Affiliation(s)
- Xiaocen Kong
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jian Wang
- Department of intensive care unit, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Gu Gao
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Mingjuan Tan
- Department of Clinical Laboratory, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Bo Ding
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Huiqin Li
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jianhua Ma
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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10
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Adamska A, Krentowska A, Łebkowska A, Hryniewicka J, Leśniewska M, Adamski M, Kowalska I. Decreased deiodinase activity after glucose load could lead to atherosclerosis in euthyroid women with polycystic ovary syndrome. Endocrine 2019; 65:184-191. [PMID: 30945110 PMCID: PMC6606654 DOI: 10.1007/s12020-019-01913-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 03/19/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Glucose and lipid disturbances, as well as higher tendency to atherosclerosis, are observed in women with polycystic ovary syndrome (PCOS). Thyroid hormones action has long been recognized as an important determinant of glucose and lipid homeostasis. Some studies suggest that even in euthyroid subjects, thyroid function may affect atherosclerosis risk factors. The aim of this study was to evaluate the relationships between thyroid hormonal status and glucose and lipid profile before and after oral glucose tolerance test (OGTT) in PCOS women in comparison to the control group. PATIENTS AND METHODS The study group included 98 women-60 women with PCOS and 38 women matched for age and BMI as a control group. OGTT with estimation of plasma glucose and lipids, as well as serum insulin and thyroid hormones (TH) concentrations was performed. Activity of peripheral deiodinases at baseline (SPINA-GD1) and at the 120 min of OGTT (SPINA-GD2) was calculated according to the formula by Dietrich et al. as a measure of T4-T3 conversion efficiency. Delta GD was estimated as SPINA-GD1-SPINA-GD2, and delta fT3 was calculated as a difference between fT3 before and after OGTT. RESULTS We did not find differences in TH, SPINA-GDs, and plasma lipid concentrations between PCOS and control group before and after OGTT. Glucose load resulted in a decrease of level TSH, TC, TG, HDL-C, and LDL-C concentrations in women with PCOS, as well as in the control group (all p < 0.05). We found that GD (p = 0.01) and serum fT3 concentration (p = 0.0008) decreased during glucose load only in the PCOS group. We observed a positive relationship between delta fT3 and plasma TG concentration (r = 0.36, p = 0.004), delta GD and plasma TG concentration after glucose load (r = 0.34, p = 0.007), only in the PCOS group. We also found negative relationship between SPINA-GD2 and plasma TC concentration (r = -0.29, p = 0.02) after glucose load and positive relationship between delta GD and insulin at the 60 min of OGTT (r = 0.29, p = 0.02), only in the PCOS women. CONCLUSIONS These data showed insufficient conversion of fT4 to fT3, as well as a relationship of SPINA-GDs with insulin, TC and TG in PCOS women after glucose load. It may suggest that disturbances in deiodinase activity after glucose load might promote atherosclerosis in PCOS women.
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Affiliation(s)
- Agnieszka Adamska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, Białystok, Poland.
| | - Anna Krentowska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, Białystok, Poland
| | - Agnieszka Łebkowska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, Białystok, Poland
| | - Justyna Hryniewicka
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, Białystok, Poland
| | - Monika Leśniewska
- Department of Reproduction and Gynecological Endocrinology, Medical University of Białystok, Białystok, Poland
| | - Marcin Adamski
- Faculty of Computer Science, Bialystok University of Technology, Białystok, Poland
| | - Irina Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, Białystok, Poland
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11
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Biondi B, Kahaly GJ, Robertson RP. Thyroid Dysfunction and Diabetes Mellitus: Two Closely Associated Disorders. Endocr Rev 2019; 40:789-824. [PMID: 30649221 PMCID: PMC6507635 DOI: 10.1210/er.2018-00163] [Citation(s) in RCA: 226] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 10/15/2018] [Indexed: 12/13/2022]
Abstract
Thyroid dysfunction and diabetes mellitus are closely linked. Several studies have documented the increased prevalence of thyroid disorders in patients with diabetes mellitus and vice versa. This review critically discusses the different underlying mechanisms linking type 1 and 2 diabetes and thyroid dysfunction to demonstrate that the association of these two common disorders is unlikely a simple coincidence. We assess the current state of knowledge on the central and peripheral control of thyroid hormone on food intake and glucose and lipid metabolism in target tissues (such as liver, white and brown adipose tissue, pancreatic β cells, and skeletal muscle) to explain the mechanism linking overt and subclinical hypothyroidism to type 2 diabetes and metabolic syndrome. We also elucidate the common susceptibility genes and the pathogenetic mechanisms contributing to the autoimmune mechanism involved in the onset of type 1 diabetes mellitus and autoimmune thyroid disorders. An untreated thyroid dysfunction can impair the metabolic control of diabetic patients, and this association can have important repercussions on the outcome of both of these disorders. Therefore, we offer recommendations for the diagnosis, management, and screening of thyroid disorders in patients with diabetes mellitus, including the treatment of diabetic patients planning a pregnancy. We also discuss the major causes of failure to achieve an optimal management of thyroid dysfunction in diabetic patients and provide recommendations for assessing and treating these disorders during therapy with antidiabetic drugs. An algorithm for a correct approach of these disorders when linked is also provided.
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Affiliation(s)
- Bernadette Biondi
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - George J Kahaly
- Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - R Paul Robertson
- Department of Medicine, Division of Endocrinology and Metabolism, University of Washington School of Medicine, Seattle, Washington.,Department of Pharmacology, University of Washington, Seattle, Washington
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12
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Han Q, Zhang J, Wang Y, Li H, Zhang R, Guo R, Li L, Teng G, Wang J, Wang T, Liu F. Thyroid hormones and diabetic nephropathy: An essential relationship to recognize. Nephrology (Carlton) 2019; 24:160-169. [PMID: 29660205 DOI: 10.1111/nep.13388] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Qianqian Han
- Division of Nephrology; West China Hospital of Sichuan University; Chengdu China
| | - Junlin Zhang
- Division of Nephrology; West China Hospital of Sichuan University; Chengdu China
| | - Yiting Wang
- Division of Nephrology; West China Hospital of Sichuan University; Chengdu China
| | - Hanyu Li
- Division of Nephrology; West China Hospital of Sichuan University; Chengdu China
| | - Rui Zhang
- Division of Nephrology; West China Hospital of Sichuan University; Chengdu China
| | - Ruikun Guo
- Division of Nephrology; West China Hospital of Sichuan University; Chengdu China
| | - Li Li
- Division of Nephrology; West China Hospital of Sichuan University; Chengdu China
| | - Geer Teng
- The Faculty of Social Development and Western China Development Studies; Sichuan University; Chengdu China
| | - Jiali Wang
- Division of Nephrology; West China Hospital of Sichuan University; Chengdu China
| | - Tingli Wang
- Division of Nephrology; West China Hospital of Sichuan University; Chengdu China
| | - Fang Liu
- Division of Nephrology; West China Hospital of Sichuan University; Chengdu China
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13
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Wang J, Li H, Tan M, Gao G, Zhang Y, Ding B, Su X, Kong X, Ma J. Association between thyroid function and diabetic nephropathy in euthyroid subjects with type 2 diabetes mellitus: a cross-sectional study in China. Oncotarget 2019; 10:88-97. [PMID: 30719205 PMCID: PMC6349442 DOI: 10.18632/oncotarget.26265] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 02/28/2018] [Indexed: 12/19/2022] Open
Abstract
Previous studies have suggested that even in euthyroid subjects, thyroid function may affect the risk factors of diabetic nephropathy (DN). Thus, we investigated the association between thyroid parameters and DN in euthyroid subjects with type 2 diabetes mellitus (T2DM). This was a cross-sectional study of 1,071 euthyroid subjects with T2DM (mean age of 61.90 ± 12.74 years; 622 men). Clinical factors, including levels of free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), thyroid autoantibodies, albumin excretion rate were measured. DN was present in 400 (37.35%) individuals. Patients with DN exhibited higher serum TSH and lower serum FT3 and FT4 levels than those without DN (P<0.05). After adjusting traditional risk factors of DN, the levels of both FT3 (per-SD increase, odds ratio [OR] 0.606 [95% confidence interval (CI), 0.481-0.762], P<0.001) and FT4 (per-SD increase, OR 0.944 [0.894-0.998], P = 0.040) were inversely correlated with DN. Meanwhile, we found that serum TSH levels were positively correlated with DN (per-SD increase, OR1.179 [1.033-1.346], P = 0.015). Low-to-normal thyroid hormones (THs) were also associated with the presence of macroalbuminuria. In conclusion, the relatively low levels of THs were significantly associated with DN in euthyroid subjects with T2DM.
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Affiliation(s)
- Jian Wang
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210012, China
| | - Huiqin Li
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210012, China
| | - Mingjuan Tan
- Department of Clinical Laboratory, Nanjing First Hospital, Nanjing Medical University, Nanjing 210012, China
| | - Gu Gao
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210012, China
| | - Ying Zhang
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210012, China
| | - Bo Ding
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210012, China
| | - Xiaofei Su
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210012, China
| | - Xiaocen Kong
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210012, China
| | - Jianhua Ma
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210012, China
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14
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Jayanthi R, Srinivasan AR, Maran AL. Clinical sensitivity and specificity of serum total bilirubin - A study on thyroid status in clinically euthyroid non-obese, overweight, and obese type 2 diabetics. Int J Health Sci (Qassim) 2019; 13:22-28. [PMID: 31341452 PMCID: PMC6619454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate the sensitivity and specificity of total bilirubin (serum) in determining thyroid status in clinically euthyroid non-obese, overweight, and obese type 2 diabetics. SUBJECTS AND METHODS Three anthropometry specific groups of clinically euthyroid type 2 diabetics were enabled, following enrolment: 153 non-obese (body mass index [BMI] = 18.5-24.99), 291 overweight (BMI = 25-29.99), and 126 obese type 2 diabetes mellitus (BMI ≥30). Total bilirubin (serum), glycemic status, insulin resistance (IR), and thyroid hormones, besides routine biochemistry, were estimated, as per International Federation of Clinical Chemistry approved procedures. RESULTS Receiver operating characteristic curves for non-obese, overweight, and obese were plotted to assess the role of total bilirubin (serum) in determining thyroid status in clinically euthyroid type 2 diabetics. In overweight, the area under curve (AUC) for FT3 and postprandial sugar showed 0.621 and 0.531 with cutoff values of 2.02 pg/ml and 147.5 mg/dl, respectively, whereas for aspartate aminotransferase/alanine aminotransferase (De Ritis ratio), the AUC was 0.583. As regards, obese diabetics and the AUC for insulin and homeostatic model assessment IR were 0.657 and 0.709, respectively, with cutoff values of 16.06 mIU/L and 7.274, respectively, and for postprandial sugar 0.727, in the same group (obese) with cutoff value of 208.5 mg/dl. CONCLUSION Total bilirubin could predict thyroid status and IR in anthropometry specific clinically euthyroid type 2 diabetics.
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Affiliation(s)
- Rajendran Jayanthi
- Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute (A Constituent College of Sri Balaji Vidyapeeth), Pondicherry, India
| | - Abu Raghavan Srinivasan
- Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute (A Constituent College of Sri Balaji Vidyapeeth), Pondicherry, India,Address for correspondence: Dr. Abu Raghavan Srinivasan, Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute (A Constituent College of Sri Balaji Vidyapeeth), Pillaiyarkuppam, Pondy-Cuddalore Main Road, Pondicherry – 607 402, India. Phone: +91-9994455627. Fax.: +91-413-2615457. E-mail:
| | - Anandraj Lokesh Maran
- Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute (A Constituent College of Sri Balaji Vidyapeeth), Pondicherry, India
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15
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Rawal S, Tsai MY, Hinkle SN, Zhu Y, Bao W, Lin Y, Panuganti P, Albert PS, Ma RCW, Zhang C. A Longitudinal Study of Thyroid Markers Across Pregnancy and the Risk of Gestational Diabetes. J Clin Endocrinol Metab 2018; 103:2447-2456. [PMID: 29889229 PMCID: PMC6276672 DOI: 10.1210/jc.2017-02442] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 04/25/2018] [Indexed: 12/20/2022]
Abstract
CONTEXT T3 is the biologically active thyroid hormone involved in glucose metabolism. The free T3 (fT3)/free T4 (fT4) ratio, a marker indicating conversion of fT4 to fT3, is also implicated in glucose homeostasis. OBJECTIVE To examine associations of fT3 and the fT3/fT4 ratio with gestational diabetes mellitus (GDM). DESIGN In a case-control study, thyroid markers (fT3, fT4, TSH) were measured and the fT3/fT4 ratio was derived across four visits in pregnancy, including first (gestational weeks 10 to 14) and second (weeks 15 to 26) trimester. Conditional logistic regression adjusting for thyroid autoimmunity status and major GDM risk factors estimated trimester-specific associations of thyroid markers with subsequent GDM risk. SETTING Twelve US clinical centers. PARTICIPANTS One hundred seven GDM cases and 214 non-GDM controls from a multiracial pregnancy cohort of 2802 women. MAIN OUTCOME MEASURES GDM diagnosis ascertained from medical records. RESULTS Both fT3 and the fT3/fT4 ratio were positively associated with GDM: adjusted OR (95% CI) comparing the highest vs lowest fT3 quartile was 4.25 (1.67, 10.80) at the first trimester and 3.89 (1.50, 10.10) at the second trimester. Similarly, the corresponding risk estimates for the fT3/fT4 ratio were 8.63 (2.87, 26.00) and 13.60 (3.97, 46.30) at the first and second trimester, respectively. Neither TSH nor fT4 was significantly associated with GDM. CONCLUSIONS Higher fT3 levels, potentially resulting from de novo synthesis or increased fT4 to fT3 conversion, may be an indicator of GDM risk starting early in pregnancy.
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Affiliation(s)
- Shristi Rawal
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
- Department of Nutritional Sciences, School of Health Professions, Rutgers University, Newark, New Jersey
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Stefanie N Hinkle
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Yuan Lin
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Pranati Panuganti
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Paul S Albert
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Ronald C W Ma
- Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
- Correspondence and Reprint Requests: Cuilin Zhang, MD, PhD, Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, MSC 7004, Bethesda, Maryland 20817. E-mail:
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16
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Lyu J, Imachi H, Yoshimoto T, Fukunaga K, Sato S, Ibata T, Kobayashi T, Dong T, Yonezaki K, Yamaji N, Kikuchi F, Iwama H, Ishikawa R, Haba R, Sugiyama Y, Zhang H, Murao K. Thyroid stimulating hormone stimulates the expression of glucose transporter 2 via its receptor in pancreatic β cell line, INS-1 cells. Sci Rep 2018; 8:1986. [PMID: 29386586 PMCID: PMC5792451 DOI: 10.1038/s41598-018-20449-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 01/17/2018] [Indexed: 12/30/2022] Open
Abstract
Thyroid stimulating hormone (TSH) stimulates the secretion of thyroid hormones by binding the TSH receptor (TSHR). TSHR is well-known to be expressed in thyroid tissue, excepting it, TSHR has also been expressed in many other tissues. In this study, we have examined the expression of TSHR in rat pancreatic islets and evaluated the role of TSH in regulating pancreas-specific gene expression. TSHR was confirmed to be expressed in rodent pancreatic islets and its cell line, INS-1 cells. TSH directly affected the glucose uptake in INS cells by up-regulating the expression of GLUT2, and furthermore this process was blocked by SB203580, the specific inhibitor of the p38 MAPK signaling pathway. Similarly, TSH stimulated GLUT2 promoter activity, while both a dominant-negative p38MAPK α isoform (p38MAPK α-DN) and the specific inhibitor for p38MAPK α abolished the stimulatory effect of TSH on GLUT2 promoter activity. Finally, INS-1 cells treated with TSH showed increased protein level of glucokinase and enhanced glucose-stimulated insulin secretion. Together, these results confirm that TSHR is expressed in INS-1 cells and rat pancreatic islets, and suggest that activation of the p38MAPK α might be required for TSH-induced GLUT2 gene transcription in pancreatic β cells.
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Affiliation(s)
- Jingya Lyu
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.,Department of Cell Biology, Medical College of Soochow University, Jiangsu Key Laboratory of Stem Cell Research, Ren Ai Road 199, Suzhou Industrial Park, Suzhou, 215123, China
| | - Hitomi Imachi
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Takuo Yoshimoto
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Kensaku Fukunaga
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Seisuke Sato
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Tomohiro Ibata
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Toshihiro Kobayashi
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Tao Dong
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Kazuko Yonezaki
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Nao Yamaji
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Fumi Kikuchi
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Hisakazu Iwama
- Life Science Research Center, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Ryou Ishikawa
- Department of Diagnostic Pathology, Kagawa University Hospital, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Reiji Haba
- Department of Diagnostic Pathology, Kagawa University Hospital, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Yasunori Sugiyama
- Department of Life Sciences, Faculty of Agriculture, Kagawa University, 2393, Miki-cho, Kita-gun, Kagawa, 761-0795, Japan
| | - Huanxiang Zhang
- Department of Cell Biology, Medical College of Soochow University, Jiangsu Key Laboratory of Stem Cell Research, Ren Ai Road 199, Suzhou Industrial Park, Suzhou, 215123, China.
| | - Koji Murao
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.
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Benites-Zapata VA, Urrunaga-Pastor D, Torres-Mallma C, Prado-Bravo C, Guarnizo-Poma M, Lázaro-Alcántara H. Is free triiodothyronine important in the development of insulin resistance in healthy people? Diabetes Metab Syndr 2017; 11 Suppl 2:S663-S667. [PMID: 28487105 DOI: 10.1016/j.dsx.2017.04.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 04/27/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To determine the association between thyroid hormones and insulin resistance in a population of healthy individuals. MATERIALS AND METHODS We conducted an analytical cross-sectional study in adults who attended a private clinic from 2012 to 2014. We excluded those participants with fasting glucose values compatible with diabetes mellitus, abnormal thyroid hormone values, chronic use of corticosteroids, and incomplete medical records. Participants were divided into tertiles (low, intermediate and high) according to their free triiodothyronine and free thyroxine values. We defined Insulin resistance as a Homeostasis Model Assessment (HOMA-IR) value greater than 3.8. We conducted a univariate and multivariate Poisson regression model to assess the association between thyroid hormones and insulin resistance. The association measure reported was the prevalence ratio (PR) with their confidence interval (CI) at 95%. RESULTS We evaluated 600 participants. The mean age was 36.8±14.2years and 33% were male. The frequency of insulin resistance was 29.5%. In the univariate regression, we found association between free triiodothyronine tertiles and insulin resistance. In the multivariate regression adjusted for age, sex, body mass index and thyroid stimulating hormone, the association between free triiodothyronine tertiles and insulin resistance remained; intermediate tertile (PR=1.54; CI95%: 1.10-2.15) and high tertile (PR=1.70; CI95%: 1.21-2.39). We found no association between T4 and insulin resistance. CONCLUSIONS High levels of free triiodothyronine are associated with insulin resistance. The use of free trioodothyronine to assess insulin resistance in healthy patients should be considered.
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Affiliation(s)
- Vicente A Benites-Zapata
- Centre for Public Health Research, Research Institute, Faculty of Medicine, Universidad de San Martín de Porres, Lima, Peru.
| | - Diego Urrunaga-Pastor
- Scientific Society of Medical Students at the University of San Martin de Porres, Universidad de San Martín de Porres, Lima, Peru
| | - Cristina Torres-Mallma
- Scientific Society of Medical Students at the University of San Martin de Porres, Universidad de San Martín de Porres, Lima, Peru
| | - Christian Prado-Bravo
- Scientific Society of Medical Students at the University of San Martin de Porres, Universidad de San Martín de Porres, Lima, Peru
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Brown PJ, Badreddine D, Roose SP, Rutherford B, Ayonayon HN, Yaffe K, Simonsick EM, Goodpaster B. Muscle fatigability and depressive symptoms in later life. Int J Geriatr Psychiatry 2017; 32:e166-e172. [PMID: 28198046 DOI: 10.1002/gps.4678] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 01/11/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Fatigability is the degree to which performance decreases during a specific activity of a given intensity and duration. Depression is known to heighten subjective fatigue, but whether its association with physical fatigability is unknown. Further, whether fatigability is a precursor or risk factor for the development of subsequent depressive symptoms is also unclear. METHODS Data are from the Health Aging and Body Composition Study with fatigability assessed using isokinetic dynamometry of the knee extensors at year 3, and depressive symptoms ascertained longitudinally using the Center for Epidemiologic Studies Depression (CES-D) scale. The relationship between fatigability and depressive symptoms was evaluated using linear and Cox regression models. RESULTS There was a significant cross-sectional association between fatigability and depressive symptomatology (β = -0.06, p = 0.02), after adjusting for demographic variables, medical comorbidities, cognition, gait speed, and physical activity levels. Greater fatigability was associated with greater adjusted scores on the 10-item CES-D (F2, 1695 = 38.65, p < 0.001), with individuals with greater fatigability on average reporting an adjusted CES-D score 0.5 point greater than those individuals with higher levels of resistance to fatigability (mean of 70% or better; p < 0.001). Fatigability however was not associated with the development of depression at follow-up (p = 0.828). CONCLUSIONS This study found an association between skeletal muscle fatigability and higher depressive symptoms in older adults, but no longitudinal association was identified. These findings suggest that age-related changes in energy capacity may affect the phenomenology of late life depression. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Patrick J Brown
- Division of Geriatric Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA
| | | | - Steven P Roose
- Division of Geriatric Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA
| | - Bret Rutherford
- Division of Geriatric Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA
| | - Hilsa N Ayonayon
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Kristine Yaffe
- Neurology, Psychiatry, Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Eleanor M Simonsick
- Intramural Research Program, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Bret Goodpaster
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital and Sanford Burnham Presbys Medical Discovery Institute, Orlando, FL, USA
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- Translational Research Institute for Metabolism and Diabetes, Florida Hospital and Sanford Burnham Presbys Medical Discovery Institute, Orlando, FL, USA
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Martinez B, Ortiz RM. Thyroid Hormone Regulation and Insulin Resistance: Insights From Animals Naturally Adapted to Fasting. Physiology (Bethesda) 2017; 32:141-151. [PMID: 28202624 DOI: 10.1152/physiol.00018.2016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The contribution of thyroidal status in insulin signaling and glucose homeostasis has been implicated as a potential pathophysiological factor in humans, but the specific mechanisms remain largely elusive. Fasting induces changes in both thyroid hormone secretion and insulin signaling. Here, we explore how mammals that undergo natural, prolonged bouts of fasting provide unique insight into evolved physiological adaptations that allow them to tolerate such conditions despite intermittent states of reversible insulin resistance. Such insights from nature may provide clues to better understand the basis of thyroidal involvement in insulin dysregulation in humans.
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Affiliation(s)
- Bridget Martinez
- Department of Molecular & Cellular Biology, University of California, Merced, California
| | - Rudy M Ortiz
- Department of Molecular & Cellular Biology, University of California, Merced, California
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Jun JE, Kim TH, Lee SE, Lee YB, Jee JH, Bae JC, Jin SM, Hur KY, Kim JH, Kim SW, Chung JH, Min YK, Lee MK. Hormetic effect of triiodothyronine in metabolically healthy obese persons. Endocrine 2017; 57:418-427. [PMID: 28726184 DOI: 10.1007/s12020-017-1363-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 06/26/2017] [Indexed: 02/05/2023]
Abstract
PURPOSE Metabolically healthy obese is the designation for a subgroup of obese individuals with normal metabolic features. However, metabolically healthy obese individuals are prone to developing metabolic syndrome. Serum triiodothyronine (T3) levels are associated with various metabolic risk factors including obesity. Therefore, this longitudinal study aimed to explore the possible correlation between serum T3 concentration and the onset of MetS in metabolically healthy obese persons. METHODS A retrospective analysis of 992 euthyroid metabolically healthy obese subjects who underwent yearly health checkups over 6 years was performed. The risk of developing MetS was analyzed according to baseline T3 concentration, as both tertiles and continuous values, using Cox regression analysis. Serum T3 concentration at the end of the study was further analyzed according to the final metabolic phenotype. RESULTS The incidence of MetS was 464 cases (46.8%) during a median 3.3 years of follow-up (3168.2 person-years). The hazard ratio for incident MetS enhanced with increasing T3 concentration in both the crude and adjusted models. Higher baseline serum T3 levels were associated with unfavorable metabolic parameters. However, over the course of the study, serum T3 concentration significantly increased in subjects who sustained metabolically healthy phenotypes compared to baseline value, while it significantly decreased in the subjects who developed MetS. CONCLUSIONS Serum T3 concentrations exhibit distinct associations with development of metabolic syndrome in euthyroid metabolically healthy obese persons, but its increment during follow-up maintained metabolically healthy state. These findings suggest that serum T3 modulation might be an adaptive process to protect against metabolic deterioration.
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Affiliation(s)
- Ji Eun Jun
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea.
| | - Seung-Eun Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea
| | - Jae Hwan Jee
- Department of Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Cheol Bae
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea
| | - Yong-Ki Min
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea
| | - Moon-Kyu Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea
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Shpakov AO. [Pharmacological approaches for correction of thyroid dysfunctions in diabetes mellitus]. BIOMEDIT︠S︡INSKAI︠A︡ KHIMII︠A︡ 2017; 63:219-231. [PMID: 28781255 DOI: 10.18097/pbmc20176303219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Thyroid diseases are closely associated with the development of types 1 and 2 diabetes mellitus (DM), and as a consequence, the development of effective approaches for their treatment is one of the urgent problems of endocrinology. Traditionally, thyroid hormones (TH) are used to correct functions of the thyroid system. However, they are characterized by many side effects, such as their negative effect on the cardiovascular system as well as the ability of TH to enhance insulin resistance and to disturb insulin-producing function of pancreas, exacerbating thereby diabetic pathology. Therefore, the analogues of TH, selective for certain types of TH receptors, that do not have these side effects, are being developed. The peptide and low-molecular weight regulators of thyroid-stimulating hormone receptor, which regulate the activity of the thyroid axis at the stage of TH synthesis and secretion in thyrocytes, are being created. Systemic and intranasal administration of insulin, metformin therapy and drugs with antioxidant activity are effective for the treatment of thyroid pathology in types 1 and 2 DM. In the review, the literature data and the results of own investigations on pharmacological approaches for the treatment and prevention of thyroid diseases in patients with types 1 and 2 DM are summarized and analyzed.
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Affiliation(s)
- A O Shpakov
- I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences
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22
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Kim HJ, Bae JC, Park HK, Byun DW, Suh K, Yoo MH, Jae Hwan J, Kim JH, Min YK, Kim SW, Chung JH. Association of triiodothyronine levels with future development of metabolic syndrome in euthyroid middle-aged subjects: a 6-year retrospective longitudinal study. Eur J Endocrinol 2017; 176:443-452. [PMID: 28100631 DOI: 10.1530/eje-16-0734] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/20/2016] [Accepted: 01/17/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Several cross-sectional studies have reported that thyroid hormone levels are associated with cardiovascular risk markers and metabolic syndrome (MetS) even in euthyroid subjects. However, the prognostic role of serum thyroid hormone levels in the risk of incident MetS has not been elucidated. AIM We aimed to investigate the associations of baseline serum thyroid hormone levels with the development of MetS in healthy subjects. METHODS This 6-year, cross-sectional, longitudinal and follow-up study was conducted in 12 037 euthyroid middle-aged subjects without MetS subjected to comprehensive health examinations. Subjects were grouped according to total triiodothyronine (T3) quartiles. The hazard ratio (HR) for the development of MetS according to T3 quartiles was estimated using Cox proportional hazards model. RESULTS During the 6-year period, 3544 incident cases of MetS (29%) were identified. The proportion of subjects with incident MetS increased across the T3 quartiles (P for trend <0.001). The HR and 95% confidence interval (CI) for the development of MetS were significantly higher in the highest T3 quartile compared with the lowest T3 quartile even after adjusting for confounding variables including gender, age and smoking (HR: 1.238, 95% CI: 1.128-1.358, P < 0.001). CONCLUSION In euthyroid middle-aged subjects, serum T3 levels are associated with increased risk for future development of MetS.
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Affiliation(s)
- Hye Jeong Kim
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Ji Cheol Bae
- Division of Endocrinology and MetabolismDepartment of Medicine, Changwon Samsung Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Hyeong Kyu Park
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Dong Won Byun
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Kyoil Suh
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Myung Hi Yoo
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jee Jae Hwan
- Department of Health Promotion CenterSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and MetabolismDepartment of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong-Ki Min
- Division of Endocrinology and MetabolismDepartment of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology and MetabolismDepartment of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology and MetabolismDepartment of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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THE PECULARITIES OF CORRELATION BETWEEN INSULIN RESISTANCE, CARBOHYDRATE AND LIPID METABOLISM INDICES IN PATIENTS WITH GRAVES’DISEASE. EUREKA: HEALTH SCIENCES 2017. [DOI: 10.21303/2504-5679.2017.00272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim. The number of patients with endocrine disorders in the world, in particular, Graves’ disease is continuously increasing. Recent studies have determined the fact of insulin resistance in thyroid disorders. On the one hand, numerous researches prove correlation of hypothyroidism with arterial hypertension, ischaemic heart disease and lipid metabolism disorder, on the other – carbohydrate metabolism disorder and hyper-sympathicotonia are closely associated with hyperthyroidism. The subject of the research was to study the correlation of insulin resistance, lipid and carbohydrate metabolism indices in patients with Graves’disease.
Material and Methods. During the study 53 (37 female and 16 male) patients with Graves’ disease with noticed IR have been examined. At the beginning, after 3– and 6-months thyreostatic therapy with insulin sensitizers (metformin or pioglitazone) the following investigations have been performed: assessing thyroid-stimulating hormone levels, free thyroxine and triiodothyronine; assessing glycated haemoglobin, glucose, C-peptide and fasting insulin as primary IR markers; calculating НОМА-IR index for analysing tissue sensitivity to insulin; calculating НОМА-β index for evaluating the functional capacity of β-cells of islets of Langerhans; measuring Caro indices to monitor hyperinsulinemia, measuring total cholesterol level, low-density lipoproteins, very-low-density lipoproteins, high-density lipoproteins , triglycerides, for analysing IR in relation to lipid metabolism.
Results. The research results found out that free thyroid hormones and thyroid-stimulating hormone are closely related to lipid metabolism. Thus, thyroid-stimulating hormone was characterized as having direct correlation with low-density lipoproteins, while the free thyroxine inversely correlated with total cholesterol, low-density lipoproteins, and high-density lipoproteins. The free triiodothyronine negatively correlated with high-density lipoproteins. The research has also determined the direct correlation between insulin and free thyroxine, as well as free triiodothyronine in patients with diffuse toxic goitre.
Conclusions. The study proves the presence of insulin resistance in patients with Graves’ disease that generates interest to further study of the changes in insulin sensitivity, relation of insulin resistance to thyroid-stimulating hormone, thyroid hormones and looking for the ways to correct these disorders.
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Meng Z, Liu M, Zhang Q, Liu L, Song K, Tan J, Jia Q, Zhang G, Wang R, He Y, Ren X, Zhu M, He Q, Wang S, Li X, Hu T, Liu N, Upadhyaya A, Zhou P, Zhang J. Gender and Age Impacts on the Association Between Thyroid Function and Metabolic Syndrome in Chinese. Medicine (Baltimore) 2015; 94:e2193. [PMID: 26683929 PMCID: PMC5058901 DOI: 10.1097/md.0000000000002193] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The relationship between thyroid dysfunction and metabolic syndrome (MS) is complex. We aimed to explore the impact of gender and age on their association in a large Chinese cohort. This cross-sectional study enrolled 13,855 participants (8532 male, 5323 female), who self-reported as healthy without any known previous diseases. Clinical data including anthropometric measurements, thyroid function, and serum metabolic parameters were collected. The associations between thyroid function and MS of both genders were analyzed separately after dividing thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and age into subgroups. MS risks were calculated by binary logistic regression models. Young males had significantly higher MS prevalence than females, yet after menopause, females had higher prevalence than males. Females had higher incidence of thyroid dysfunction than males. By using TSH quartiles as the categorical variables and the lowest quartile as reference, significantly increased MS risk was demonstrated in quartile 4 for males, yet quartiles 3 and 4 for females. By using FT3 quartiles as the categorical variables, significantly increased MS risk was demonstrated in quartile 2 to 4 for females only. By using age subgroups as the categorical variables, significantly increased MS risk was shown in both genders, with females (4.408-58.455) higher than males (2.588-4.943). Gender and age had substantial influence on thyroid function and MS. Females with high TSH and high FT3 had higher MS risks than males. Aging was a risk for MS, especially for females. Urgent need is necessary to initiate interventional programs.
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Affiliation(s)
- Zhaowei Meng
- From the Department of Nuclear Medicine (ZM, JT, QJ, GZ, RW, YH, SW, XL, TH, NL, AU, PZ, JZ), Department of Endocrinology and Metabolism (ML, XR, MZ, QH), and Department of Health Management, Tianjin Medical University General Hospital, Tianjin, P.R. China (QZ, LL, KS)
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Aras Ş, Üstünsoy S, Armutçu F. Indices of Central and Peripheral Obesity; Anthropometric Measurements and Laboratory Parameters of Metabolic Syndrome and Thyroid Function. Balkan Med J 2015; 32:414-20. [PMID: 26740903 DOI: 10.5152/balkanmedj.2015.151218] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/27/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) and obesity are serious health problems in the World, including Turkey. Contemporary studies have suggested a meaningful association between insulin resistance (IR), MetS parameters, and thyroid function tests. AIMS We aimed to elucidate the impact of fat distribution on the anthropometric and laboratory parameters, especially indices of MetS, IR and thyroid function, in obese women. STUDY DESIGN Cross-sectional study. METHODS Anthropometric measurements of all participants and biochemical tests in their serum samples were performed. RESULTS Weight, waist circumference (WC), body mass index (BMI), and other parameters of fat distribution were significantly increased in all obese compared to control subjects; but there was no significant difference between central and peripheral obese groups. The central obese group had significantly higher insulin levels, components of MetS, the ratio free triiodothyronine (fT3) to free thyroxin fT4, and fT4 than those of peripheral obese and control groups. CONCLUSION Elevated triglyceride, glucose and insulin levels may be associated with increased IR, which in turn is related to MetS. Body fat composition may affect thyroid tests in the obese; the changes in fT3/fT4 could be the consequence of fat distribution.
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Affiliation(s)
- Şükrü Aras
- Department of Nutrition and Dietetics, Şifa University Faculty of Medicine, İzmir, Turkey
| | - Seyfettin Üstünsoy
- Department of Biochemistry, Fatih University Faculty of Medicine, İstanbul, Turkey
| | - Ferah Armutçu
- Department of Biochemistry, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
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Rodríguez-Castelán J, Nicolás L, Morimoto S, Cuevas E. The Langerhans islet cells of female rabbits are differentially affected by hypothyroidism depending on the islet size. Endocrine 2015; 48:811-7. [PMID: 25213470 DOI: 10.1007/s12020-014-0418-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 09/01/2014] [Indexed: 12/31/2022]
Abstract
Effects of hypothyroidism on the glucose and insulin levels are controversial, and its impact on the Langerhans islet morphology of adult subjects has been poorly addressed. In spite of hypothyroidism and diabetes mellitus are more frequent in females than in males, most studies using animal models have been done in males. The effect of hypothyroidism on the immunolabeling of thyroid hormone receptors (TRs) and thyrotropin receptor (TSHR) of islet cells is unknown. The aim of this study was to determine the effect of hypothyroidism on the glucose and insulin concentrations, morphometry of islets, and immunostaining of TRs α1-2 and β1 and TSHR of islet cells in female rabbits. Control and hypothyroid (0.02% of methimazole for 30 days) animals were used to quantify blood levels of glucose and insulin, density of islets, cross-sectional area (CSA) of islets, number of cells per islet, cell proliferation, and the immunolabeling of TRs α1-2, TRβ1, and TSHR. Student's t or Mann-Whitney-U tests, two-way ANOVAs, and Fischer's tests were applied. Concentrations of glucose and insulin, as well as the insulin resistance were similar between groups. Hypothyroidism did not affect the density or the CSA of islets. The analysis of islets by size showed that hypothyroidism reduced the cell number in large and medium islets, but not in small ones. In small islets, cell proliferation was increased. The immunoreactivity of TRα1-2, TRβ1, and TSHR was increased by hypothyroidism in all islet sizes. Our results show that hypothyroidism affects differentially the islet cells depending on the size of islets.
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Affiliation(s)
- J Rodríguez-Castelán
- Maestría en Ciencias Biológicas, Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico
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Karschin J, Lagerpusch M, Enderle J, Eggeling B, Müller MJ, Bosy-Westphal A. Endocrine determinants of changes in insulin sensitivity and insulin secretion during a weight cycle in healthy men. PLoS One 2015; 10:e0117865. [PMID: 25723719 PMCID: PMC4344201 DOI: 10.1371/journal.pone.0117865] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 01/02/2015] [Indexed: 12/15/2022] Open
Abstract
Objective Changes in insulin sensitivity (IS) and insulin secretion occur with perturbations in energy balance and glycemic load (GL) of the diet that may precede the development of insulin resistance and hyperinsulinemia. Determinants of changes in IS and insulin secretion with weight cycling in non-obese healthy subjects remain unclear. Methods In a 6wk controlled 2-stage randomized dietary intervention 32 healthy men (26±4y, BMI: 24±2kg/m2) followed 1wk of overfeeding (OF), 3wks of caloric restriction (CR) containing either 50% or 65% carbohydrate (CHO) and 2wks of refeeding (RF) with the same amount of CHO but either low or high glycaemic index at ±50% energy requirement. Measures of IS (basal: HOMA-index, postprandial: Matsuda-ISI), insulin secretion (early: Stumvoll-index, total: tAUC-insulin/tAUC-glucose) and potential endocrine determinants (ghrelin, leptin, adiponectin, thyroid hormone levels, 24h-urinary catecholamine excretion) were assessed. Results IS improved and insulin secretion decreased due to CR and normalized upon RF. Weight loss-induced improvements in basal and postprandial IS were associated with decreases in leptin and increases in ghrelin levels, respectively (r = 0.36 and r = 0.62, p<0.05). Weight regain-induced decrease in postprandial IS correlated with increases in adiponectin, fT3, TSH, GL of the diet and a decrease in ghrelin levels (r-values between -0.40 and 0.83, p<0.05) whereas increases in early and total insulin secretion were associated with a decrease in leptin/adiponectin-ratio (r = -0.52 and r = -0.46, p<0.05) and a decrease in fT4 (r = -0.38, p<0.05 for total insulin secretion only). After controlling for GL associations between RF-induced decrease in postprandial IS and increases in fT3 and TSH levels were no longer significant. Conclusion Weight cycling induced changes in IS and insulin secretion were associated with changes in all measured hormones, except for catecholamine excretion. While leptin, adiponectin and ghrelin seem to be the major endocrine determinants of IS, leptin/adiponectin-ratio and fT4 levels may impact changes in insulin secretion with weight cycling. Trial Registration ClinicalTrials.gov NCT01737034
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Affiliation(s)
- Judith Karschin
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Merit Lagerpusch
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Janna Enderle
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Ben Eggeling
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Manfred J. Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Anja Bosy-Westphal
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
- * E-mail:
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Oda T, Taneichi H, Takahashi K, Togashi H, Hangai M, Nakagawa R, Ono M, Matsui M, Sasai T, Nagasawa K, Honma H, Kajiwara T, Takahashi Y, Takebe N, Ishigaki Y, Satoh J. Positive association of free triiodothyronine with pancreatic β-cell function in people with prediabetes. Diabet Med 2015; 32:213-9. [PMID: 25255697 DOI: 10.1111/dme.12589] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/19/2014] [Indexed: 12/12/2022]
Abstract
AIM To analyse the effects of thyroid hormones on β-cell function and glucose metabolism in people with prediabetes who are euthyroid. METHODS A total of 111 people who were euthyroid underwent 75-g oral glucose tolerance tests, of whom 52 were assigned to the normal glucose tolerance and 59 to the prediabetes groups. Homeostatic model assessment of β-cell function, insulinogenic index and areas under the curve for insulin and glucose were evaluated as indices of pancreatic β-cell function. RESULTS In both groups, BMI, fasting insulin, homeostasis model assessment ratio and HDL cholesterol correlated significantly with all indices of pancreatic β-cell function. Free triiodothyronine correlated positively with all insulin secretion indices in the prediabetes group. Multiple linear regression analysis showed that free triiodothyronine was an independent variable that had a positive correlation with all indices of β-cell function in the prediabetes group. By contrast, no such correlation was found in the normal glucose tolerance group. CONCLUSIONS Free triiodothyronine is associated with both basal and glucose-stimulated insulin secretion in people with prediabetes who are euthyroid; therefore, the regulation of insulin secretion by thyroid hormones is a potentially novel therapeutic target for the treatment of diabetes.
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Affiliation(s)
- T Oda
- Division of Diabetes and Metabolism, Department of Internal Medicine, Iwate Medical University, Morioka, Japan
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Wu J, Li X, Tao Y, Wang Y, Peng Y. Free Triiodothyronine Levels Are Associated with Diabetic Nephropathy in Euthyroid Patients with Type 2 Diabetes. Int J Endocrinol 2015; 2015:204893. [PMID: 26697065 PMCID: PMC4677198 DOI: 10.1155/2015/204893] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 11/05/2015] [Accepted: 11/12/2015] [Indexed: 12/20/2022] Open
Abstract
Objective. To investigate the association of thyroid function and diabetic nephropathy (DN) in euthyroid patients with type 2 diabetes. Methods. A total of 421 patients were included in this cross-sectional study. The following parameters were assessed: anthropometric measurements, fast plasma glucose, serum creatinine, lipid profile, HbA1c, free triiodothyronine (FT3), free thyroxine, thyroid-stimulating hormone levels, and urinary albumin-to-creatinine ratio (UACR). Patients with UACR of ≥30 mg/g were defined as those suffering from DN. Results. Of the 421 patients, 203 (48.2%) suffered from DN, and no difference was found between males and females. The patients with DN yielded significantly lower FT3 levels than those without DN (P < 0.01). The prevalence of DN showed a significantly decreasing trend across the three tertiles based on FT3 levels (59.6%, 46.4%, and 38.6%, P < 0.01). After adjustment for gender and age, FT3 levels were found to correlate positively with estimated glomerular filtration rate (P = 0.03) and negatively with UACR (P < 0.01). Multiple linear regression analysis showed that FT3 level was independently associated with UACR (β = -0.18, t = -3.70, and P < 0.01). Conclusion. Serum FT3 levels are inversely associated with DN in euthyroid patients with type 2 diabetes, independent of traditional risk factors.
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Affiliation(s)
- Jingcheng Wu
- Department of Endocrinology and Metabolism, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China
- School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, China
| | - Xiaohua Li
- Department of Endocrinology and Metabolism, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Yang Tao
- Department of Clinical Laboratory, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu 212002, China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Yongde Peng
- Department of Endocrinology and Metabolism, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China
- *Yongde Peng:
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Rodríguez-Castelán J, Martínez-Gómez M, Castelán F, Cuevas E. Hypothyroidism Affects Vascularization and Promotes Immune Cells Infiltration into Pancreatic Islets of Female Rabbits. Int J Endocrinol 2015; 2015:917806. [PMID: 26175757 PMCID: PMC4484561 DOI: 10.1155/2015/917806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 05/07/2015] [Accepted: 05/26/2015] [Indexed: 02/07/2023] Open
Abstract
Thyroidectomy induces pancreatic edema and immune cells infiltration similarly to that observed in pancreatitis. In spite of the controverted effects of hypothyroidism on serum glucose and insulin concentrations, the number and proliferation of Langerhans islet cells as well as the presence of extracellular matrix are affected depending on the islet size. In this study, we evaluated the effect of methimazole-induced hypothyroidism on the vascularization and immune cells infiltration into islets. A general observation of pancreas was also done. Twelve Chinchilla-breed female adult rabbits were divided into control (n = 6) and hypothyroid groups (n = 6, methimazole, 0.02% in drinking water for 30 days). After the treatment, rabbits were sacrificed and their pancreas was excised, histologically processed, and stained with Periodic Acid-Schiff (PAS) or Masson's Trichrome techniques. Islets were arbitrarily classified into large, medium, and small ones. The external and internal portions of each islet were also identified. Student-t-test and Mann-Whitney-U test or two-way ANOVAs were used to compare variables between groups. In comparison with control rabbits, hypothyroidism induced a strong infiltration of immune cells and a major presence of collagen and proteoglycans in the interlobular septa. Large islets showed a high vascularization and immune cells infiltration. The present results show that hypothyroidism induces pancreatitis and insulitis.
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Affiliation(s)
- Julia Rodríguez-Castelán
- Doctorado en Ciencias Biológicas, Universidad Autónoma de Tlaxcala, 90070 Tlaxcala, TLAX, Mexico
| | - Margarita Martínez-Gómez
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, 90070 Tlaxcala, TLAX, Mexico
- Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Unidad Periférica, 90070 Tlaxcala, TLAX, Mexico
| | - Francisco Castelán
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, 90070 Tlaxcala, TLAX, Mexico
| | - Estela Cuevas
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, 90070 Tlaxcala, TLAX, Mexico
- *Estela Cuevas:
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Liu G, Zheng X, Guan L, Jiang Z, Lin H, Jiang Q, Zhang N, Zhang Y, Zhang X, Yu C, Guan Q. Free triiodothyronine levels are positively associated with non-alcoholic fatty liver disease in euthyroid middle-aged subjects. Endocr Res 2015; 40:188-93. [PMID: 25531861 DOI: 10.3109/07435800.2014.987399] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Studies on the relationship between thyroid function and non-alcoholic fatty liver disease (NAFLD) among euthyroid subjects have produced conflicting results. OBJECTIVES The aim of this study was to investigate the association between thyroid function and the presence of NAFLD in a large-sample middle-aged euthyroid subjects. METHODS A total of 2576 euthyroid subjects who underwent health check-up were included. NAFLD was diagnosed by hepatic ultrasonography. Conventional risk factors for NAFLD were assessed as well as serum levels of TSH, FT3 and FT4. RESULTS Levels of FT3 were significantly higher in NAFLD group (5.12 ± 0.58 versus 4.84 ± 0.58 pmol/L, adjusted p = 0.000) than non-NAFLD group, while levels of TSH and FT4 were comparable between NAFLD and non-NAFLD groups (TSH: 2.13 ± 0.90 versus 2.20 ± 0.93 mIU/L, adjusted p = 0.190; FT4: 16.41 ± 2.04 versus 16.18 ± 2.06 pmol/L, adjusted p = 0.146, respectively). Levels of FT3 were positively correlated with components of metabolic syndrome. Multivariate logistic regression analysis revealed that high level of FT3 was an independent predictor for NAFLD (odds ratio: 1.253, p = 0.040). The relationship between FT4 and NAFLD in women was different according to menopausal status, with negative association in pre-menopausal women (OR: 0.777, 95% CI: 0.617-0.979, p = 0.032) and null association in post-menopausal women (OR: 1.037, 95% CI: 0.841-1.277, p = 0.736). CONCLUSIONS Our findings suggested that high levels of FT3 were significantly associated with NAFLD among middle-aged euthyroid subjects independently of known metabolic risk factors. A negative correlation of serum FT4 level with NAFLD was only observed in pre-menopausal women.
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Affiliation(s)
- Guoli Liu
- a Department of Endocrinology , Shandong Provincial Hospital Affiliated to Shandong University , Jinan , People's Republic of China
- b First Department of Geriatrics Taian City Central Hospital , Taian , People's Republic of China
| | - Xiao Zheng
- c Department of General Surgery , Taian City Central Hospital , Taian , People's Republic of China , and
| | - Liying Guan
- d Center of Health Management, Shandong Provincial Hospital Affiliated to Shandong University , Jinan , People's Republic of China
| | - Zhi Jiang
- b First Department of Geriatrics Taian City Central Hospital , Taian , People's Republic of China
| | - Haiyan Lin
- d Center of Health Management, Shandong Provincial Hospital Affiliated to Shandong University , Jinan , People's Republic of China
| | - Qiang Jiang
- a Department of Endocrinology , Shandong Provincial Hospital Affiliated to Shandong University , Jinan , People's Republic of China
| | - Nan Zhang
- a Department of Endocrinology , Shandong Provincial Hospital Affiliated to Shandong University , Jinan , People's Republic of China
| | - Yikun Zhang
- a Department of Endocrinology , Shandong Provincial Hospital Affiliated to Shandong University , Jinan , People's Republic of China
| | - Xu Zhang
- a Department of Endocrinology , Shandong Provincial Hospital Affiliated to Shandong University , Jinan , People's Republic of China
| | - Chunxiao Yu
- a Department of Endocrinology , Shandong Provincial Hospital Affiliated to Shandong University , Jinan , People's Republic of China
| | - Qingbo Guan
- a Department of Endocrinology , Shandong Provincial Hospital Affiliated to Shandong University , Jinan , People's Republic of China
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Mazaheri T, Sharifi F, Kamali K. Insulin resistance in hypothyroid patients under Levothyroxine therapy: a comparison between those with and without thyroid autoimmunity. J Diabetes Metab Disord 2014; 13:103. [PMID: 25364704 PMCID: PMC4216656 DOI: 10.1186/s40200-014-0103-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 10/21/2014] [Indexed: 01/21/2023]
Abstract
Background A chronic inflammation resulting from an imbalance between pro-inflammatory and anti-inflammatory cytokines in Hashimoto’s thyroiditis (HT) might be responsible for IR in hypothyroidism. This study was performed to investigate a probable association between autoimmune background of hypothyroidism and IR. Methods In this clinical study, 63 subjects with Hashimoto’s thyroiditis and 49 subjects with post-ablation hypothyroidism were enrolled. All the participants were euthyroid for more than one year through Levothyroxine therapy. Serum concentrations of Thyroid-stimulating Hormone (TSH), Free Thyroxin (FT4, FT3), Anti-Thyroid Peroxidase Antibodies (Anti-TPO Abs), Total Cholesterol (TC), HDL-Cholesterol (HDL-C), Triglyceride (TG), Fasting Blood Glucose (FBG), and insulin levels were measured and Oral Glucose Tolerance Test (OGTT) was performed for all of the subjects. Participants with anti TPO levels more than 1000 IU /ml were classified as having highly positive antibodies. Results No significant differences regarding to plasma insulin, glucose and lipid concentration, were detected between subjects with and without Hashimoto’s thyroiditis. However, subjects with highly positive Anti TPO Abs had higher prevalence of elevated fasting insulin level than those with lower titers of Anti TPO Abs and subjects without autoimmune background (94.1% vs. 62.8% and 71.4% respectively, P = 0.05). Subjects with highly positive titers of Abs also had a lower serum HDL-c levels than the rest of the subjects (40.6 ± 2.1 vs. 47.2 ± 1.7 and 47.4 ± 1.4, P = 0.04). Conclusions There is no obvious association between thyroid autoimmunity and metabolic indexes of hypothyroid patients. Only patients with Ani TPO antibody levels more than 1000 IU/ml may experience higher insulin level and less HDL-c with the same BMI.
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Affiliation(s)
| | - Faranak Sharifi
- Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Koorosh Kamali
- Department of public health, Zanjan University of Medical Sciences, Zanjan, Iran
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Akiyama S, Ogiwara T, Aoki T, Tsunekawa K, Araki O, Murakami M. Glucagon-like peptide-1 stimulates type 3 iodothyronine deiodinase expression in a mouse insulinoma cell line. Life Sci 2014; 115:22-8. [PMID: 25241124 DOI: 10.1016/j.lfs.2014.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 08/14/2014] [Accepted: 09/08/2014] [Indexed: 12/25/2022]
Abstract
AIMS The pathophysiological roles of thyroid hormones in glucose metabolism remain uncertain. Type 3 iodothyronine deiodinase (D3) converts thyroxine (T4) and 3,5,3'-triiodothyronine (T3) to 3,3',5'-triiodothyronine (rT3) and 3,3'-diiodothyronine (T2), respectively, inactivating thyroid hormones in a cell-specific fashion. In the present study, we identified D3 expression in MIN6 cells derived from a mouse insulinoma cell line and examined the mechanisms regulating D3 expression in these cells. MAIN METHODS We characterized D3 activity using HPLC analysis, and examined the effect of GLP-1 or exendin-4 on D3 expression and cAMP accumulation in MIN6 cells. We also measured insulin secretion from MIN6 cells exposed to GLP-1 and T3. KEY FINDINGS We identified enzyme activity that catalyzes the conversion of T3 to T2 in MIN6 cells, which showed characteristics compatible with those for D3. D3 mRNA was identified in these cells using RT-PCR analysis. Forskolin rapidly stimulated D3 mRNA and D3 activity. Glucagon-like peptide-1 (GLP-1) increased D3 expression in a dose-dependent manner, and this effect was inhibited by the protein kinase A (PKA) inhibitor H-89. Exendin-4, a GLP-1 receptor agonist, also stimulated D3 expression in MIN6 cells. These results suggest that a cAMP-PKA-mediated pathway participates in GLP-1-stimulated D3 expression in MIN6 cells. Furthermore, GLP-1 stimulated insulin secretion was suppressed by the addition of T3 in MIN6 cells. SIGNIFICANCE Our findings indicate that GLP-1 regulates intracellular T3 concentration in pancreatic β cells via a cAMP-PKA-D3-mediated pathway that may also regulate β-cell function.
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Affiliation(s)
- Shigeo Akiyama
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Takayuki Ogiwara
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Tomoyuki Aoki
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Katsuhiko Tsunekawa
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Osamu Araki
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Masami Murakami
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan.
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Jing S, Xiaoying D, Ying X, Rui L, Mingyu G, Yuting C, Yanhua Y, Yufan W, Haiyan S, Yongde P. Different levels of thyroid hormones between impaired fasting glucose and impaired glucose tolerance: free T3 affects the prevalence of impaired fasting glucose and impaired glucose tolerance in opposite ways. Clin Endocrinol (Oxf) 2014; 80:890-8. [PMID: 24330392 DOI: 10.1111/cen.12384] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 11/11/2013] [Accepted: 12/03/2013] [Indexed: 02/02/2023]
Abstract
CONTEXT There is an association between thyroid disorders and diabetes mellitus. OBJECTIVE To investigate thyroid hormone levels in different glucose metabolic statuses, analyse relationships between thyroid hormone levels and different categories of prediabetes and metabolic parameters within a large euthyroid nondiabetic population. METHODS A total of 3328 subjects without diabetes or thyroid dysfunction were included in this cross-sectional study. Subjects were divided in to four groups [normal glucose tolerance (NGR), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and combined glucose intolerance (CGI)] according to the results of oral glucose tolerance test. Participants were then divided into four groups according to the quartile of free T3 (FT3) in their blood. RESULTS Subjects with IFG had higher levels of FT3 and ratio of FT3 to FT4 (FT3/FT4), but lower level of free T4 (FT4) than subjects with IGT. FT3/FT4 was negatively associated with postprandial plasma glucose (PPG) [standardized β (β) = -0·087; P < 0·001]. The prevalence of IFG and CGI was increased with the level of FT3, while the prevalence of IGT was decreased with the level of FT3 (P for trend: <0·001, 0·003 and <0·001, respectively). FT3 was negatively associated with the risk of IGT (OR = 0·409, 95% CI 0·179-0·935), whereas FT4 was positively associated with the risk of IGT (OR = 1·296, 95% CI 1·004-1·673). CONCLUSIONS Free thyroid hormone levels were different between subjects with IFG and IGT. FT3 affects the prevalence of IFG and IGT in opposite ways. The difference in thyroid hormone levels may play an important role in the different pathological mechanisms of IFG and IGT.
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Affiliation(s)
- Su Jing
- Department of Endocrinology and Metabolism, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Roef GL, Rietzschel ER, Van Daele CM, Taes YE, De Buyzere ML, Gillebert TC, Kaufman JM. Triiodothyronine and free thyroxine levels are differentially associated with metabolic profile and adiposity-related cardiovascular risk markers in euthyroid middle-aged subjects. Thyroid 2014; 24:223-31. [PMID: 24032604 PMCID: PMC3926145 DOI: 10.1089/thy.2013.0314] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND We have previously shown that in healthy young men, a less favorable body composition is associated with higher free triiodothyronine (fT3) levels within the euthyroid range. Besides, a higher free-triiodothyronine-to-free-thyroxin (fT3-to-fT4) ratio has been related to a less favorable metabolic phenotype and more placental growth in pregnant women. In the present study, we therefore investigated whether serum thyrotropin (TSH), thyroid hormone levels, and the fT3-to-fT4 ratio are associated with metabolic and adiposity-related cardiovascular risk markers in a healthy population of middle-aged euthyroid men and women. METHODS Thyroid parameters were measured in 2524 generally healthy subjects from the Asklepios Study (35-55 years, mean age 46 years). Analyses were restricted to 2315 subjects (1138 women and 1177 men), not using thyroid medication, not having anti-TPO levels above clinical cutoff values or TSH levels outside the reference range (0.27-4.2 mU/L). Twenty-seven percent of the women and 47.5% of the men were overweight, while 13% of women and 17% of men were obese. Twenty percent of the subjects were active smokers. Serum thyroid function parameters were determined by electrochemiluminescence. RESULTS fT3 and the fT3-to-fT4 ratio were positively related to body mass index (BMI), waist circumference, and components of metabolic syndrome, that is, triglycerides, systolic and diastolic blood pressure, and fasting plasma glucose, and negatively with HDL-cholesterol levels, whereas fT4 was negatively associated with BMI, waist circumference, and triglycerides (p<0.001). TSH related positively with total cholesterol levels (p<0.01), triglycerides, and systolic and diastolic blood pressure (p<0.001). The fT3-to-fT4 ratio was further positively associated with the adiposity-related inflammation markers interleukin-6 and high-sensitivity C-reactive protein and to pulse wave velocity. All associations were adjusted for sex, age, height, and smoking, and most associations persisted after additional adjustment for weight or waist circumference. CONCLUSION In healthy euthyroid middle-aged men and women, higher fT3 levels, lower fT4 levels, and thus a higher fT3-to-fT4 ratio are consistently associated with various markers of unfavorable metabolic profile and cardiovascular risk.
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Affiliation(s)
- Greet L. Roef
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Ernst R. Rietzschel
- Department of Cardiovascular Diseases, Ghent University Hospital, Ghent, Belgium
| | | | - Youri E. Taes
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | | | - Thierry C. Gillebert
- Department of Cardiovascular Diseases, Ghent University Hospital, Ghent, Belgium
| | - Jean-Marc Kaufman
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
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Boggio A, Muzio F, Fiscella M, Sommariva D, Branchi A. Is thyroid-stimulating hormone within the normal reference range a risk factor for atherosclerosis in women? Intern Emerg Med 2014; 9:51-7. [PMID: 22203234 DOI: 10.1007/s11739-011-0743-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 11/28/2011] [Indexed: 11/26/2022]
Abstract
The relationship between overt hypothyroidism and cardiovascular risk has been well documented and some data also suggest an association between cardiovascular risk and subclinical hypothyroidism. The aim of our study was to investigate, in a large cohort of euthyroid women, the association of thyroid stimulating hormone (TSH) within the normal reference range with cardiovascular risk factors. The study was carried out on 744 women with normal thyroid function (TSH 0.3-4.9 μU/mL). Women with TSH above the median (≥2.1 μU/mL) were more obese, had greater waist girth, were more hypertensive and had higher levels of total cholesterol (TC), serum triglycerides (TG), blood sugar (BG) and lower levels of HDL-cholesterol (HDL-C) than women with TSH below the median. TSH was significantly correlated with body mass index (BMI), waist circumference, BG, TG, TC, HDL-C and hypertension. Multiple backward stepwise regression analysis with age, waist circumference and TSH as independent variables confirmed the strong association of TSH with BG, TG, HDL-C and hypertension. A total of 205 patients (28%) fulfilled the definition criteria of the metabolic syndrome and the prevalence of metabolic syndrome was significantly greater in patients with TSH above than in patients with TSH below the median. Results of logistic analysis, including age and TSH as predictor variables, confirmed the association of TSH with metabolic syndrome.The results of this study suggest that TSH in the upper limits of the reference range (above 2.1 μU/ml) is associated with a less favourable cardiometabolic profile and consequently with a higher risk of developing cardiovascular diseases.
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Affiliation(s)
- Anna Boggio
- Dietetic and Clinical Nutrition Unit, "Luigi Sacco" University Hospital, Milan, Italy,
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Mourouzis I, Giagourta I, Galanopoulos G, Mantzouratou P, Kostakou E, Kokkinos AD, Tentolouris N, Pantos C. Thyroid hormone improves the mechanical performance of the post-infarcted diabetic myocardium: a response associated with up-regulation of Akt/mTOR and AMPK activation. Metabolism 2013; 62:1387-93. [PMID: 23773982 DOI: 10.1016/j.metabol.2013.05.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/09/2013] [Accepted: 05/11/2013] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Thyroid hormone (TH) is shown to be protective against cardiac and pancreatic injury. Thus, this study explored the potential effects of TH treatment on the functional status of the postinfarcted diabetic myocardium. Diabetic patients have worse prognosis after acute myocardial infarction (AMI). MATERIALS/METHODS AMI was induced by left coronary ligation in rats previously treated with 35 mg/kg streptozotocin (STZ), (DM-AMI). TH treatment was initiated at 2 weeks after AMI and continued for 6 weeks (DM-AMI+TH), while sham-operated animals served as control (DM-SHAM). RESULTS TH treatment increased cardiac mass, improved wall stress and favorably changed cardiac geometry. TH significantly increased echocardiographic left ventricular ejection fraction (LVEF%): [54.2 (6.5) for DM-AMI+TH vs 37 (2.0) for DM-AMI, p<0.05]. TH treatment resulted in significantly increased insulin and decreased glucose levels in serum. The ratios of phosphorylated (p)-Akt/total Akt and p-mTOR/total mTOR were increased 2.0 fold and 2.7 fold in DM-AMI+TH vs DM-AMI respectively, p<0.05. Furthermore, the ratio of p-AMPK/total AMPK was found to be increased 1.6 fold in DM-AMI+TH vs DM-AMI, p<0.05. CONCLUSION TH treatment improved the mechanical performance of the post-infarcted myocardium in rats with STZ-induced diabetes, an effect which was associated with Akt/mTOR and AMPK activation.
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Affiliation(s)
- Iordanis Mourouzis
- Department of Pharmacology, University of Athens, 75 Mikras Asias Ave., 11527 Goudi, Athens, Greece
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Roef G, Lapauw B, Goemaere S, Zmierczak HG, Toye K, Kaufman JM, Taes Y. Body composition and metabolic parameters are associated with variation in thyroid hormone levels among euthyroid young men. Eur J Endocrinol 2012; 167:719-26. [PMID: 22956557 DOI: 10.1530/eje-12-0447] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Thyroid disorders affect metabolism and body composition. Existing literature has been conflicting on whether this is also the case for thyroid hormone levels within the euthyroid range. Therefore, we have investigated the relationship between thyroid hormone concentrations and body composition together with metabolic parameters in a population of healthy euthyroid men. METHODS Healthy male siblings (n=941, 25-45 years, median BMI 24.6) were recruited in a cross-sectional, population-based study; a history or treatment of thyroid disease and thyroid autoimmunity were exclusion criteria. Body composition and muscle cross-sectional area were assessed by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography. Total (triiodothyronine (T(3); TT(3)) thyroxine and (T(4); TT(4))) and free thyroid hormones (FT(3) and FT(4)), TSH, and reverse T(3) (rT(3)) and thyroid-binding globulin (TBG) were determined using immunoassays. RESULTS BMI was positively associated with (F)T(3) (P<0.0001). Whole body fat mass displayed positive associations with TT(3) and with (F)T(4) and TBG (P≤0.0006). Positive associations were further observed between leptin and (F)T(3), TT(4), and TBG (P≤0.0002). Inverse associations between lean mass and muscle cross-sectional area and (F)T(3), (F)T(4), and TBG were observed (P≤0.0003). Higher levels of (F)T(3) and TBG were associated with lower insulin sensitivity, assessed by homeostatic model assessment of insulin resistance (IR; P≤0.0001). No associations between TSH and body composition or metabolic parameters were seen. CONCLUSION We show that a less favorable body composition (with higher fat and lower muscle mass and accompanying higher leptin concentrations) and IR are associated with higher thyroid hormone levels in healthy young men with well characterized euthyroidism.
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Affiliation(s)
- Greet Roef
- Department of Endocrinology and Metabolic Bone Diseases, Ghent University Hospital, Belgium.
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Farasat T, Cheema AM, Khan MN. Hyperinsulinemia and insulin resistance is associated with low T₃/T₄ ratio in pre diabetic euthyroid Pakistani subjects. J Diabetes Complications 2012; 26:522-5. [PMID: 22795338 DOI: 10.1016/j.jdiacomp.2012.05.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 05/21/2012] [Accepted: 05/23/2012] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the relationship of thyroid hormones in glucose homeostasis in impaired glucose-tolerant subjects with normal thyroid functions. METHODS Cross-sectional analysis was carried out in (n=260) impaired glucose-tolerant (IGT) and normal glucose-tolerant (NGT) subjects. Thyrotropin (TSH), total triiodothyronine (TT₃), total thyroxin (TT₄) free T₃ (fT₃), free T₄ (fT₄), and insulin were assessed by enzyme-linked immunoassays (ELISA). Fasting plasma glucose (FPG) and HbA1c were measured by glucose oxidase and low-pressure cation exchange chromatography. Homeostasis model of assessment (HOMA-IR) was employed to assess the level of insulin resistance; fT₃/fT₄ ratio was calculated. Anthropometric measurement and habits were recorded. RESULTS Marked hyperinsulinemia and insulin resistance were observed in IGT subjects. Serum TT₃ and fT₃ levels were significantly low in the IGT as compared to normal glucose-tolerant (NGT) controls. TT₄ and TSH were higher in IGT subjects as compared to control subjects. There was a significant positive correlation of TSH with BMI only in the control group (r=0.351; P<0.05). Correlation of insulin with TT₃, fT₃,and TSH was significant (P<0.05) in IGT subjects. A significant low fT₃/fT₄ ratio was observed in IGT subjects as compared to NGT subjects (P<0.01). In multiple regression analysis, TSH, TT₄ and fT₃ contributed significantly to the variance of fasting insulin and insulin resistance in IGT subjects. CONCLUSION Hyperinsulinemia and insulin resistance are associated with low T₃/T₄ ratio in pre-diabetic euthyroid Pakistani subjects.
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Affiliation(s)
- Tasnim Farasat
- Department of Zoology, Lahore College for Women University, Lahore, Pakistan.
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Goswami B, Singh B. Role of surrogate markers in assessment of insulin resistance in females with thyroid disorders. Diabetes Metab Syndr 2012; 6:163-166. [PMID: 23158981 DOI: 10.1016/j.dsx.2012.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Thyroid status is known to affect insulin sensitivity although conflicting data have been reported regarding hypothyroid and hyperthyroid states. Assessment of insulin resistance is difficult, therefore we compared homeostasis model assessment (HOMA), glucose to insulin (G:I) ratio, glucose to C-peptide (G:C) ratio and ferritin of hypothyroid and hyperthyroid subjects with euthyroid, euglycemic subjects. METHODS The study group comprised of 40 hypothyroid, 25 hyperthyroid female subjects and 40 euthyroid controls. Serum samples of all the patients were assayed for thyroid profile, glucose, Insulin, C-peptide and ferritin. Homeostasis model of assessment (HOMA-IR), (G:I), (G:C) and ferritin were employed as surrogate measures to assess the level of insulin resistance. The area under the curves for the surrogate markers was determined from the receiver operating characteristics (ROC) curves for the hypothyroid and hyperthyroid patients. RESULTS Patients with hypothyroidism demonstrated insulin resistance as observed by the higher HOMA-IR and G:I ratio as compared to the controls whereas insulin resistance was not detected in the hyperthyroid patients in our study. CONCLUSION Thyroid dysfunction attributes to deranged glucose metabolism. Assessment of the surrogate markers might prove to be beneficial in detecting insulin resistance at the incipient stages and subsequent management.
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Affiliation(s)
- Binita Goswami
- Department of Biochemistry, Lady Hardinge Medical College, New Delhi 110001, India.
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Goulart-Silva F, Teixeira SDS, Luchessi AD, Dos Santos LRB, Rebelato E, Carpinelli AR, Nunes MT. Potential contribution of translational factors to triiodo-L-thyronine-induced insulin synthesis by pancreatic beta cells. Thyroid 2012; 22:637-42. [PMID: 22667453 DOI: 10.1089/thy.2011.0252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Thyroid hormones (THs) are known to regulate protein synthesis by acting at the transcriptional level and inducing the expression of many genes. However, little is known about their role in protein expression at the post-transcriptional level, even though studies have shown enhancement of protein synthesis associated with mTOR/p70S6K activation after triiodo-L-thyronine (T3) administration. On the other hand, the effects of TH on translation initiation and polypeptidic chain elongation factors, being essential for activating protein synthesis, have been poorly explored. Therefore, considering that preliminary studies from our laboratory have demonstrated an increase in insulin content in INS-1E cells in response to T3 treatment, the aim of the present study was to investigate if proteins of translational nature might be involved in this effect. METHODS INS-1E cells were maintained in the presence or absence of T3 (10(-6) or 10(-8) M) for 12 hours. Thereafter, insulin concentration in the culture medium was determined by radioimmunoassay, and the cells were processed for Western blot detection of insulin, eukaryotic initiation factor 2 (eIF2), p-eIF2, eIF5A, EF1A, eIF4E binding protein (4E-BP), p-4E-BP, p70S6K, and p-p70S6K. RESULTS It was found that, in parallel with increased insulin generation, T3 induced p70S6K phosphorylation and the expression of the translational factors eIF2, eIF5A, and eukaryotic elongation factor 1 alpha (eEF1A). In contrast, total and phosphorylated 4E-BP, as well as total p70S6K and p-eIF2 content, remained unchanged after T3 treatment. CONCLUSIONS Considering that (i) p70S6K induces S6 phosphorylation of the 40S ribosomal subunit, an essential condition for protein synthesis; (ii) eIF2 is essential for the initiation of messenger RNA translation process; and (iii) eIF5A and eEF1A play a central role in the elongation of the polypeptidic chain during the transcripts decoding, the data presented here lead us to suppose that a part of T3-induced insulin expression in INS-1E cells depends on the protein synthesis activation at the post-transcriptional level, as these proteins of the translational machinery were shown to be regulated by T3.
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Affiliation(s)
- Francemilson Goulart-Silva
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, SP, Brazil
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Abstract
OBJECTIVE To elucidate the link between TSH and obesity, the relationship between TSH and adipocytokines were previously studied. Animal studies demonstrated a possible relationship between vaspin levels and thyroid functions. In this study, we aimed to investigate vaspin levels in hypothyroid states and its relationship with insulin resistance parameters in humans. DESIGN Prospective observational study. METHODS We enrolled 27 overt hypothyroid, 33 subclinical hypothyroid and 41 euthyroid patients. We measured the body mass index (BMI), fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance index (HOMA-IR), lipid profile, TSH, free triiodothyronine, free thyroxine and vaspin levels. The change in vaspin levels in 12 overt hypothyroid patients after establishment of euthyroidism was analysed. RESULTS All groups were age-matched. Overt hypothyroid group had higher BMI values (P<0.05) than other groups. No significant difference was observed in insulin levels and HOMA-IR among the groups (P>0.05). Adjusted vaspin levels for BMI and age were similar among the groups. Mean vaspin levels in overt, subclinical and euthyroid patients were 1.20 ± 1.17, 1.48 ± 0.93 and 0.95 ± 0.75 ng/ml respectively (P>0.05). There was no significant association between vaspin levels and BMI, fasting glucose, insulin and HOMA-IR (P>0.05). Establishing euthyroidism in hypothyroid patients did not result in a significant change in vaspin levels (before and after treatment, 1.35 ± 1.06 and 1.25 ± 0.68 ng/ml, respectively; P>0.05). CONCLUSION We herein present novel data indicating vaspin levels are neither altered in overt and subclinical hypothyroidism nor have a relationship with features of insulin resistance in hypothyroid patients.
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Affiliation(s)
- Neşe Cinar
- Department of Endocrinology and Metabolism, Hacettepe University Medical School, Sihhiye, Ankara, Turkey
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Lin Y, Sun Z. Thyroid hormone potentiates insulin signaling and attenuates hyperglycemia and insulin resistance in a mouse model of type 2 diabetes. Br J Pharmacol 2011; 162:597-610. [PMID: 20883475 DOI: 10.1111/j.1476-5381.2010.01056.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND PURPOSE The thyroid hormone, triiodothyronine (T3) has many metabolic functions. Unexpectedly, exogenous T3 lowered blood glucose in db/db mice, a model of type 2 diabetes. Here, we have explored this finding and its possible mechanisms further. EXPERIMENTAL APPROACH db/db and lean mice were treated with T3, the phosphoinositide 3- kinase (PI3-kinase) inhibitor, LY294002, plus T3, or vehicles. Blood glucose, insulin sensitivity, levels and synthesis were measured. Effects of T3 on intracellular insulin signaling were analyzed in 3T3-L1 pre-adipocytes with Western blotting. Knock-down of the thyroid hormone receptor α1 (TRα1) in 3T3-L1 cells was achieved with an appropriate silencing RNA (siRNA). KEY RESULTS Single injections of T3 (7 ng·g⁻¹ i.p.) rapidly and markedly attenuated hyperglycemia. Treatment with T3 (14 ng·g⁻¹·day⁻¹, 18 days) dose-dependently attenuated blood glucose and increased insulin sensitivity in db/db mice. Higher doses of T3 (28 ng·g⁻¹·day⁻¹) reversed insulin resistance in db/db mice. T3 also increased insulin levels in plasma and the neurogenic differentiation factor (an insulin synthesis transcription factor) and insulin storage in pancreatic islets in db/db mice. These anti-diabetic effects of T3 were abolished by the PI3-kinase inhibitor (LY294002). In 3T3-L1 preadipocytes, T3 enhanced insulin-induced tyrosine phosphorylation of insulin receptor substrate (IRS)-1 and activation of PI3-kinase, effects blocked by siRNA for TRα1. CONCLUSIONS AND IMPLICATIONS T3 potentiated insulin signaling, improved insulin sensitivity, and increased insulin synthesis, which may contribute to its anti-diabetic effects. These findings may provide new approaches to the treatment of type 2 diabetes.
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Affiliation(s)
- Yi Lin
- Department of Physiology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Verga Falzacappa C, Mangialardo C, Madaro L, Ranieri D, Lupoi L, Stigliano A, Torrisi MR, Bouchè M, Toscano V, Misiti S. Thyroid hormone T3 counteracts STZ induced diabetes in mouse. PLoS One 2011; 6:e19839. [PMID: 21637761 PMCID: PMC3103518 DOI: 10.1371/journal.pone.0019839] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Accepted: 04/18/2011] [Indexed: 12/14/2022] Open
Abstract
This study intended to demonstrate that the thyroid hormone T3 counteracts the onset of a Streptozotocin (STZ) induced diabetes in wild type mice. To test our hypothesis diabetes has been induced in Balb/c male mice by multiple low dose Streptozotocin injection; and a group of mice was contemporaneously injected with T3. After 48 h mice were tested for glucose tolerance test, insulin serum levels and then sacrified. Whole pancreata were utilized for morphological and biochemical analyses, while protein extracts and RNA were utilized for expression analyses of specific molecules. The results showed that islets from T3 treated mice were comparable to age- and sex-matched control, untreated mice in number, shape, dimension, consistency, ultrastructure, insulin and glucagon levels, Tunel positivity and caspases activation, while all the cited parameters and molecules were altered by STZ alone. The T3-induced pro survival effect was associated with a strong increase in phosphorylated Akt. Moreover, T3 administration prevented the STZ-dependent alterations in glucose blood level, both during fasting and after glucose challenge, as well as in insulin serum level. In conclusion we demonstrated that T3 could act as a protective factor against STZ induced diabetes.
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Affiliation(s)
- Cecilia Verga Falzacappa
- Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Roma, Italy
- DEM, Fondazione per lo studio del Diabete, l'Endocrinologia ed il Metabolismo, Roma, Italy
| | - Claudia Mangialardo
- Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Roma, Italy
| | - Luca Madaro
- Dipartimento di Istologia ed Embriologia Medica, Sapienza Università di Roma, Roma, Italy
| | - Danilo Ranieri
- Dipartimento di Medicina Molecolare, Sapienza Università di Roma, Roma, Italy
| | - Lorenzo Lupoi
- Stabilimento di Utilizzazione di animali da laboratorio, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Antonio Stigliano
- Dipartimento di Medicina Molecolare, Sapienza Università di Roma, Roma, Italy
| | | | - Marina Bouchè
- Dipartimento di Istologia ed Embriologia Medica, Sapienza Università di Roma, Roma, Italy
| | - Vincenzo Toscano
- DEM, Fondazione per lo studio del Diabete, l'Endocrinologia ed il Metabolismo, Roma, Italy
- Dipartimento di Medicina Molecolare, Sapienza Università di Roma, Roma, Italy
| | - Silvia Misiti
- Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Roma, Italy
- * E-mail:
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Lambadiari V, Mitrou P, Maratou E, Raptis AE, Tountas N, Raptis SA, Dimitriadis G. Thyroid hormones are positively associated with insulin resistance early in the development of type 2 diabetes. Endocrine 2011; 39:28-32. [PMID: 21072691 DOI: 10.1007/s12020-010-9408-3] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Accepted: 10/06/2010] [Indexed: 12/13/2022]
Abstract
Thyroid hormones have generally been found normal in diabetic patients. The question of whether variation within the euthyroid range influences insulin sensitivity in type 2 diabetes remains to be established. To investigate this, a meal was given to four groups: 17 healthy volunteers (controls), 22 first-degree relatives of type 2 diabetic subjects (relatives), 15 subjects with impaired glucose tolerance (IGT), and 24 subjects with overt type 2 diabetes (DM). Blood was drawn for 360 min for measurements of glucose and insulin. Plasma-free-T4(FT4) and plasma-free-T3(FT3) levels were measured. Fasting and postprandial insulin resistance was assessed by HOMA-IR and ISI indices, respectively. FT4 levels were found to be lower in controls (13.73 ± 0.48 pmol/l) than relatives, IGT, and DM (15.33 ± 0.52, 16.13 ± 0.65, and 17.7 ± 0.85 pmol/l, respectively, P = 0.007). FT3 levels were lower in controls (3.68 ± 0.09 pmol/l) than in relatives, IGT, and DM (4.35 ± 0.1, 4.8 ± 0.067, and 4.87 ± 0.11 pmol/l, respectively, P = 0.001). HOMA-IR was positively associated with FT4 and FT3 levels (β-co-efficient = 1.876 ± 0.476, P = 0.001; and 0.406 ± 0.090, P = 0.001, respectively). ISI was negatively associated with FT4 and FT3 levels (β-co-efficient = -0.051 ± 0.009, P = 0.001 and -0.009 ± 0.002, P = 0.001, respectively). In conclusion, increases of thyroid hormone levels within the normal range associate positively with insulin resistance. These data suggest that thyroid hormones may be part of the pathogenetic mechanism to explain metabolic derangement early in the development of type 2 diabetes.
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Affiliation(s)
- Vaia Lambadiari
- 2nd Department of Internal Medicine, Research Institute and Diabetes Center, Athens University Medical School, Athens, Greece
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Alexander NB, Taffet GE, Horne FM, Eldadah BA, Ferrucci L, Nayfield S, Studenski S. Bedside-to-Bench conference: research agenda for idiopathic fatigue and aging. J Am Geriatr Soc 2010; 58:967-75. [PMID: 20722821 DOI: 10.1111/j.1532-5415.2010.02811.x] [Citation(s) in RCA: 119] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The American Geriatrics Society, with support from the National Institute on Aging and the John A. Hartford Foundation, held its fifth Bedside-to-Bench research conference, "Idiopathic Fatigue and Aging," to provide participants with opportunities to learn about cutting-edge research developments, draft recommendations for future research, and network with colleagues and leaders in the field. Fatigue is a symptom that older persons, especially by those with chronic diseases, frequently experience. Definitions and prevalence of fatigue may vary across studies, across diseases, and even between investigators and patients. The focus of this review is on physical fatigue, recognizing that there are other related domains of fatigue (such as cognitive fatigue). Many definitions of fatigue involve a sensation of "low" energy, suggesting that fatigue could be a disorder of energy balance. Poor energy utilization efficiency has not been considered in previous studies but is likely to be one of the most important determinants of fatigue in older individuals. Relationships between activity level, capacity for activity, a tolerable rate of activity, and a tolerable fatigue threshold or ceiling underlie a notion of fatiguability. Mechanisms probably contributing to fatigue in older adults include decline in mitochondrial function, alterations in brain neurotransmitters, oxidative stress, and inflammation. The relationships between muscle function and fatigue are complex. A number of diseases (such as cancer) are known to cause fatigue and may serve as models for how underlying impaired physiological processes contribute to fatigue, particularly those in which energy utilization may be an important factor. A further understanding of fatigue will require two key strategies: to develop and refine fatigue definitions and measurement tools and to explore underlying mechanisms using animal and human models.
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Affiliation(s)
- Neil B Alexander
- Mobility Research Center, Geriatrics Center and Division of Geriatric Medicine, University of Michigan Hospitals and Veterans Affairs Ann Arbor Health Care System Geriatric Research Education and Clinical Center, Ann Arbor, Michigan 48105, USA.
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Abstract
It has long been recognised that thyroid hormones have marked effects on glucose homeostasis. Glucose intolerance is associated with hyperthyroidism and most recently it was shown that hypothyroidism is characterised by insulin resistance. Although autoimmune thyroid disease is more prevalent in type 1 diabetes as a result of their common origin, in patients with type 2 diabetes the prevalence of hypothyroidism and hyperthyroidism is similar to that of the general population. However, in type 2 diabetic patients, the presence of the highly frequent sub-clinical forms of hyperthyroidism and hypothyroidism should be ruled out since they may be associated with higher cardiovascular risk. While there are no doubts about the therapeutic impact of normalising hypothyroidism and hyperthyroidism, the information available about the benefit of treating subclinical thyroid disease in diabetes remains insufficient.
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Affiliation(s)
- Gabriela Brenta
- Department of Endocrinology and Metabolism, Cesar Milstein Hospital, Buenos Aires, Argentina,
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Kim KK, Park KS, Song SB, Kim KE. Insulin represses transcription of the thyroid stimulating hormone beta-subunit gene through increased recruitment of nuclear factor I. J Biol Chem 2010; 285:32003-11. [PMID: 20685655 DOI: 10.1074/jbc.m110.107573] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Although the regulation of thyroid stimulating hormone β-subunit gene (TSHβ) has been intensively studied, the functions of transcription factors involved are not fully understood. The authors found that the -615/-516 promoter region of the TSHβ interacts specifically with nuclear proteins derived from pituitary tissue or from cultured thyrotroph cells. The actual binding site at the nucleotide level, as revealed by DNase I protection assay, includes the consensus sequence for nuclear factor I (NFI). RT-PCR analysis indicated that NFI-B expression is restricted to thyrotroph cells in the anterior pituitary. EMSA and ChIP analysis showed that NFI-B binds most efficiently to the -588/-560 region of TSHβ promoter. The forced expressions of NFI-B markedly reduced TSHβ promoter activity and its mRNA expression. Furthermore, it was also shown that the -588/-560 region is involved in the insulin-mediated repression of the TSHβ. It was of particular interest to observe that NFI-B was recruited to the -588/-560 region of the TSHβ promoter in an insulin-dependent manner. Taken together, this study provides new insights of the delicate regulations of energy metabolism and hormonal homeostasis.
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Affiliation(s)
- Kee Kwang Kim
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon 305-764, Republic of Korea
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Ruhla S, Weickert MO, Arafat AM, Osterhoff M, Isken F, Spranger J, Schöfl C, Pfeiffer AFH, Möhlig M. A high normal TSH is associated with the metabolic syndrome. Clin Endocrinol (Oxf) 2010; 72:696-701. [PMID: 20447068 DOI: 10.1111/j.1365-2265.2009.03698.x] [Citation(s) in RCA: 131] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Obesity and insulin resistance are key features of the metabolic syndrome. In euthyroidism, the relationships between TSH and insulin resistance or the metabolic syndrome are less clear. We investigated the associations between TSH and the features and prevalence of the metabolic syndrome in euthyroid German subjects. METHODS In a cross-sectional study, glucose metabolism was defined by an oral glucose tolerance test (oGTT) (except for those with evident diabetes) in 1333 subjects with TSH values between 0.3 and 4.5 mU/l who did not take any thyroid medication. Lipid parameters were measured, blood pressure and anthromopmetric parameters were taken, and insulin resistance was quantified as HOMA%S. RESULTS TSH was weakly correlated with BMI (R = 0.061, P = 0.025). This association remained significant after adjustment for sex, age, and impaired glucose metabolism (P = 0.002). Subjects with a TSH in the upper normal range (2.5-4.5 mU/l, n = 119) had a significantly higher BMI (30.47 +/- 0.57 vs. 28.74 +/- 0.18 kg/m(2), P = 0.001) and higher fasting triglycerides (1.583 +/- 0.082 vs. 1.422 +/- 0.024 mmol/l, P = 0.023), and their likeliness for fulfilling the ATP III criteria of the metabolic syndrome was 1.7-fold increased (95% CI: 1.11- 2.60). CONCLUSION In euthyroidism, subjects with a TSH in the upper normal range (2.5-4.5 mU/l) were more obese, had higher triglycerides, and had an increased likeliness for the metabolic syndrome. Therefore, a TSH below 2.5 mU/l is associated with a favourable metabolic profile. Whether lowering TSH to levels below 2.5 mU/l improves metabolism needs to be investigated in intervention trials.
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Affiliation(s)
- Stephan Ruhla
- Department of Endocrinology, Diabetes and Nutrition, Charité-University Medicine Berlin, Berlin, Germany
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Rozing MP, Westendorp RGJ, de Craen AJM, Frölich M, Heijmans BT, Beekman M, Wijsman C, Mooijaart SP, Blauw GJ, Slagboom PE, van Heemst D. Low serum free triiodothyronine levels mark familial longevity: the Leiden Longevity Study. J Gerontol A Biol Sci Med Sci 2009; 65:365-8. [PMID: 20018826 DOI: 10.1093/gerona/glp200] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The hypothalamo-pituitary-thyroid axis has been widely implicated in modulating the aging process. Life extension effects associated with low thyroid hormone levels have been reported in multiple animal models. In human populations, an association was observed between low thyroid function and longevity at old age, but the beneficial effects of low thyroid hormone metabolism at middle age remain elusive. METHODS We have compared serum thyroid hormone function parameters in a group of middle-aged offspring of long-living nonagenarian siblings and a control group of their partners, all participants of the Leiden Longevity Study. RESULTS When compared with their partners, the group of offspring of nonagenarian siblings showed a trend toward higher serum thyrotropin levels (1.65 vs157 mU/L, p = .11) in conjunction with lower free thyroxine levels (15.0 vs 15.2 pmol/L, p = .045) and lower free triiodothyronine levels (4.08 vs 4.14 pmol/L, p = .024). CONCLUSIONS Compared with their partners, the group of offspring of nonagenarian siblings show a lower thyroidal sensitivity to thyrotropin. These findings suggest that the favorable role of low thyroid hormone metabolism on health and longevity in model organism is applicable to humans as well.
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Affiliation(s)
- Maarten P Rozing
- Department of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
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