No abstract

Background and Objective: Thyroid hormones play an important role in intermediate metabolism, and abnormal glucose tolerance is often observed in patients with hyperthyroidism. Several pathogenic mechanisms have been proposed as contributors. However, there is no conclusive evidence in the existing literature regarding the predominant underlying pathophysiology. Our objective was to determine the changes in insulin resistance parameters and beta-cell function in patients with Graves’ disease following restoration of a euthyroid state. Methodology: This was an observational study with a before-after study design. Forty-five treatment-naïve adults with Graves’ diseases were included and 36 completed the study. An oral glucose tolerance test was performed at baseline and after 3 months of achieving a stable euthyroid state to assess glucose tolerance, insulin sensitivity, and beta-cell function. All patients were treated with antithyroid medication. The outcome measures studied were the Homeostasis Model Assessment-2 Insulin Resistance (HOMA2-IR), Matsuda index, and Insulin Secretion-Sensitivity Index (ISSI)-2. Results: Two-thirds of the patients had abnormal glucose tolerance at baseline. Among those with abnormal glucose tolerance at baseline, 34.7% had persistent abnormality during follow-up. During follow-up, no significant change was noted in the indices of insulin resistance. Patients with abnormal glucose tolerance had a significantly lower ISSI-2 index at baseline and it improved after achieving a euthyroid state. Conclusions: Abnormal glucose tolerance is a significant metabolic consequence in patients with Graves’ disease. Decreased beta-cell function was observed among those with abnormal glucose tolerance and it improved during follow-up. In a proportion of patients, abnormal glucose tolerance persisted after 3 months, emphasizing the need for continued follow-up.

No abstract

Osteoporosis is characterised by low bone mineral density (BMD) and is a significant public health problem in India. This cross-sectional study was done to assess the relationship between various anthropometric measures and BMD in 308 rural dwelling South Indian postmenopausal women. Anthropometric variables such as weight, body mass index (BMI), waist circumference (WC), hip circumference (HC) and neck circumference (NC) were measured. BMD was assessed by dual-energy X-ray absorptiometry (DXA) scan at the lumbar spine (LS) and femoral neck (NOF). The mean age ± SD of study participants was 60.7 ± 7.8 years. All anthropometric variables showed positive correlation with BMD at NOF and LS ( P < 0.05). Weight showed the best correlation (r = 0.482 for NOF and 0.412 for LS; P < 0.001). On multivariate logistic regression, age and weight remained significant for predicting femoral neck osteoporosis while weight and WC were the best predictors for LS osteoporosis. These anthropometric measures may serve as surrogate markers for osteoporosis and thus be used to screen postmenopausal women for referral to a centre with fewer limited resources.

No abstract