Revista da Sociedade Portuguesa de Endocrinologia Diabetes e Metabolismo

Online first

Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo - Online first: 2021-01-19
Original article

Lipid profile, insulin resistance and cytokines evaluation in autoimmune thyroiditis patients

Juliana Gonçalves, Celestino Neves, Francisco Pêgo, João Neves, Sofia Oliveira, Oksana Sokhatska, Miguel Pereira, Ana Oliveira, José Medina, Luís Delgado, Davide Carvalho

Abstract

Introduction: Thyroid dysfunction has been associated with cardiovascular events since it worsens atherogenesis, insulin resistance and dyslipidemia. Thyroid hormones and adipokines regulate metabolism. The impact of thyroid dysfunction on adipokines remains controversial. Objective: To evaluate interrelations between thyroid function and cardiovascular risk factors as insulin resistance, lipid profile, inflammatory markers and adipokines, in autoimmune thyroiditis patients. Methods: 60 patients with autoimmune thyroiditis were evaluated and measured thyroid function and autoimmunity, lipid profile, serum homocysteine, vitamin B12, folic acid, high sensitivity C reactive protein, adiponectin, resistin, PAI-1 (plasminogen activator inhibitor-1), VCAM-1 (vascular adhesion molecule 1), ICAM-1 (intercellular adhesion molecule 1), and insulin resistance markers comprising HOMA-IR and WBISI (Whole-Body Insulin Sensitivity Index). A 75-g OGTT was performed and blood samples were collected every 30 min for 120 min for measurements of plasma glucose, insulin, and C-peptide. Pearson’s correlations were performed for statistical analysis. Results: In our sample, median age was 51.0 (32.3-59.8) years. 40% of patients were taking levothyroxine. TSH was correlated positively with HOMA-IR (r=0.317; p=0.014) and negatively with WBISI (r=-0.311; p=0.027). Free T3 was correlated negatively with PAI-1 (r=-0.328; p=0.011). Conclusions: The association between autoimmune thyroiditis and cardiovascular risk is complex and multifactorial. We found significant interrelationships between thyroid function, insulin resistance and PAI-1.

Portuguese abstract

Introdução: A disfunção tiroideia associa-se ao aumento de eventos cardiovasculares, agravando a aterogénese, a insulinorresistência e a dislipidemia. As hormonas tiroideias e as adipocinas regulam o metabolismo, permanecendo controversa a sua inter-relação. Objetivo: Avaliar inter-relações entre a função tiroideia e fatores de risco cardiovascular: marcadores de insulinorresistência, perfil lipídico, marcadores inflamatórios e adipocinas. Métodos: Em 60 doentes diagnosticados com tiroidite autoimune, determinamos a função e autoimunidade tiroideia, perfil lipídico, homocisteína, vitamina B12, ácido fólico, proteína C reativa de alta sensibilidade, adiponectina, resistina, PAI-1 (plasminogen activator inhibitor-1), VCAM-1 (vascular cell adhesion molecule 1), ICAM-1 (intercellular adhesion molecule 1) e índices de insulinorresistência como HOMA-IR e WBISI (Whole-Body Insulin Sensitivity Index) e doseamos a glicose plasmática, insulina e peptídeo-C a cada 30 minutos durante 120 minutos na prova de tolerância à glicose oral. Calculamos correlações de Person para avaliar as associações entre os parâmetros analisados. Os resultados com p<0,05 foram considerados estatisticamente significativos. Resultados: A idade mediana da amostra foi 51,0 (32,3-59,8) anos. 40% dos doentes estavam suplementados com levotiroxina. Os níveis de TSH correlacionaram-se positivamente com o HOMA-IR (r=0,317; p=0,014) e negativamente com o WBISI (r=-0,311; p=0,027). Observamos uma correlação negativa entre a T3 livre e o PAI-1 (r=- 0,328; p=0,011). Conclusão: As inter-relações entre função tiroideia, insulinorresistência e PAI-1 poderão contribuirpara aumento de risco cardiovascular nesta população.


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