Co-existence of type 1 diabetes and other autoimmune ailments in subjects with autoimmune thyroid disorders

Sharma, Himanshu; Rahul, S G; Purwar, Naincy; Umesh, Garg; Saran, Sonal; Sharma, Balram; K, Mathur Sandeep

doi:10.1016/j.dsx.2022.102405

Cited by 17 publications

(14 citation statements)

References 29 publications

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“…In a separate study, it was found that out of 491 patients diagnosed with T1D, 122 tested positive for the TPO antibody, including 15 with autoimmune thyroid disease 48 . In addition, a study of 500 individuals reported that patients with autoimmune thyroid disorders were more likely to develop other autoimmune diseases 49 . Among them, researchers found T1D in 3.1% of patients with GD, con rming our nding that genetic susceptibility to GD increases the risk of developing T1D.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the causal effects between Grave’s disease and diabetes mellitus: a bidirectional Mendelian randomization study

Zhang,

2024

Preprint

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Background Graves’ disease (GD) is an autoimmune disease associated with an increased incidence of other autoimmune diseases. To investigate the causality between GD and Diabetes mellitus (DM), we designed bidirectional two-sample Mendelian randomization (MR) and multivariable MR (MVMR) studies. Methods Single-nucleotide polymorphisms (SNPs) associated with GD, thyroid peroxidase (TPO), thyroglobulin (Tg), thyroid-stimulating hormone (TSH), type 1 diabetes (T1D), and type 2 diabetes (T2D) were obtained from the IEU Open GWAS and FinnGen biobank databases. For the forward MR study, we used GD (sample size = 458,620) as the exposure and T1D (sample size = 520,580) and T2D (sample size = 211,766) as the outcomes. Next, T1D and T2D were used as exposure variables, and GD was used as the outcome variable for the reverse MR analysis. Finally, MVMR analysis was conducted to investigate the probable relationship between DM and indicators for thyroid function like TPO, Tg, and TSH. The inverse variance weighting (IVW) was used as the main method. Finally, the heterogeneity and sensitivity were assessed. Results There were 27, 88, and 55 SNPs associated with GD, T1D, and T2D, respectively. A significant causal connection between GD and T1D (odds ratio [OR] [95% confidence interval, CI] = 1.411 [1.077–1.848], P = 0.012) and T2D (OR [95% CI] = 1.059 [1.025–1.095], P = 5.53e-04) was found in the forward MR analysis. However, reverse MR suggested that there was a genetic susceptibility to T1D that increased the likelihood of developing GD (OR [95% CI] = 1.059 [1.025–1.095], P = 5.53e-04), while T2D did not (OR [95% CI] = 0.963 [0.870–1.066], P = 0.468). Furthermore, there was inadequate evidence to suggest that abnormal TSH, TPO, and Tg levels increase the risk of incident T1D or T2D in individuals with GD. MVMR revealed no causal relationship among Tg, TSH, TPO, T1D, or T2D. Conclusion Evidence of a bidirectional causative relationship between GD and T1D and a unidirectional causal relationship between GD and T2D was discovered using MR analyses. MVMR analysis showed no statistically relevant causality between TSH, TPO, or Tg and either T1D or T2D.

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Section: Discussionmentioning

confidence: 99%

Evaluating the causal effects between Grave’s disease and diabetes mellitus: a bidirectional Mendelian randomization study

Zhang,

2024

Preprint

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“…Additionally, the incidence of HT among T1DM individuals is relatively higher than that of GD[ 73 , 74 ]. Conversely, the prevalence of T1DM is also enhanced in patients with HT or GD, and the incidence of T1DM in HT individuals is relatively higher than that in GD individuals[ 75 , 76 ].…”

Section: The Concomitant Presence Of T1dm and Aitdmentioning

confidence: 99%

Association of autoimmune thyroid disease with type 1 diabetes mellitus and its ultrasonic diagnosis and management

Wang,

Wan,

Chang

et al. 2024

World J Diabetes

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As a common hyperglycemic disease, type 1 diabetes mellitus (T1DM) is a complicated disorder that requires a lifelong insulin supply due to the immune-mediated destruction of pancreatic β cells. Although it is an organ-specific autoimmune disorder, T1DM is often associated with multiple other autoimmune disorders. The most prevalent concomitant autoimmune disorder occurring in T1DM is autoimmune thyroid disease (AITD), which mainly exhibits two extremes of phenotypes: hyperthyroidism [Graves' disease (GD)] and hypo-thyroidism [Hashimoto's thyroiditis, (HT)]. However, the presence of comorbid AITD may negatively affect metabolic management in T1DM patients and thereby may increase the risk for potential diabetes-related complications. Thus, routine screening of thyroid function has been recommended when T1DM is diagnosed. Here, first, we summarize current knowledge regarding the etiology and pathogenesis mechanisms of both diseases. Subsequently, an updated review of the association between T1DM and AITD is offered. Finally, we provide a relatively detailed review focusing on the application of thyroid ultrasonography in diagnosing and managing HT and GD, suggesting its critical role in the timely and accurate diagnosis of AITD in T1DM.

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“…In this study, the duration of AITD was >5 years, and the female gender increased the association with NTAD. 19…”

Section: Epidemiologymentioning

confidence: 99%

Thyroid Eye Disease and Its Association With Diabetes Mellitus: A Major Review

Gupta,

Kalra,

Ramamurthy

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: Thyroid eye disease (TED) associated with diabetes mellitus (DM) presents unique challenges. DM is a risk factor for TED. Standard management of TED with glucocorticoids (GC), orbital radiation, or teprotumumab can cause adverse events in poor glycemic control. The authors reviewed the literature on the relationship between TED and DM and the management of co-existing diseases. Methods: The authors searched PubMed with keywords “thyroid eye disease,” “diabetes mellitus,” and similar terms from 2013 to 2022. The authors included relevant studies after screening the abstracts. Additional references to the selected studies were included where applicable. Data were extracted from the final articles according to the preplanned outline of the review. Results: The initial search yielded 279 abstracts. The final review included 93 articles. TED and DM interact at multiple levels—genetic, immunologic, cellular, nutritional, and metabolic. Both DM and thyroid dysfunction exacerbate the morbidity caused by the other. Metabolic factors also affect the inflammatory pathway for TED. Patients with DM develop TED with greater frequency and severity, necessitating interventions for vision salvage. Agents (GC, teprotumumab, or radiation) used for TED are often unsuitable for treatment with DM, especially if there is poor glycemic control or diabetic retinopathy. There were no studies on using steroid-sparing agents in TED with DM. Conclusion: TED and DM co-exist because of multiple intersections in the pathophysiology. Challenges in the treatment include increased TED severity and risk of hyperglycemia and retinopathy. Multidisciplinary teams best undertake treatment of TED with DM.

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Co-existence of type 1 diabetes and other autoimmune ailments in subjects with autoimmune thyroid disorders

Cited by 17 publications

References 29 publications

Evaluating the causal effects between Grave’s disease and diabetes mellitus: a bidirectional Mendelian randomization study

Evaluating the causal effects between Grave’s disease and diabetes mellitus: a bidirectional Mendelian randomization study

Association of autoimmune thyroid disease with type 1 diabetes mellitus and its ultrasonic diagnosis and management

Thyroid Eye Disease and Its Association With Diabetes Mellitus: A Major Review

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