Subclinical Hypothyroidism is Associated with Insulin Resistance in Rheumatoid Arthritis

Dessein, Patrick H; Joffe, B. I.; Stanwix, Anne E.

doi:10.1089/105072504323150750

Cited by 79 publications

(60 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The lower fasting insulin sensitivity assessed using the HOMA index was also found lower in a number of other studies in patients with SHO [4,10,33]. Yet, the results of other studies indicate a normal insulin sensitivity in that group of patients [34,35].…”

Section: Hypothyroidismmentioning

confidence: 71%

See 1 more Smart Citation

Insulinooporność a choroby tarczycy

Gierach¹,

Gierach²,

Junik³

2014

Endokrynologia Polska

View full text Add to dashboard Cite

Insulin resistance is defined as a glucose homeostasis disorder involving a decreased sensitivity of muscles, adipose tissue, liver and other body tissues to insulin, despite its normal or increased concentration in blood. Insulin resistance may be asymptomatic or occur presenting a variety of disorders, such as: glucose tolerance impairment, type 2 diabetes, as well as hypercholesterolaemia, hypertriglyceridaemia, obesity, and arterial hypertension. Insulin acts via specific receptors present on the surface of most cells of the body. The greatest number of these receptors is found on adipocytes, hepatocytes and striated muscle cells. There are three mechanisms of insulin resistance: pre-receptor, receptor and post-receptor. Multiple methods of assessing insulin resistance are based on the concurrent measurements of glucose and insulin levels in blood serum. The glucose and insulin measurements are conducted in baseline conditions or after intravenous administration of a specific quantity of glucose or insulin. The methods of assessing insulin resistance are divided into direct and indirect. The current 'gold standard' in the assessment of insulin sensitivity is the determination of tissue glucose utilisation using the metabolic clamp technique. The presence of disorders of carbohydrate metabolism has been demonstrated in thyroid disease involving either overt hyperthyroidism or overt hypothyroidism. The severity of the disease is proportional to the severity of these disorders. The possible influence of subclinical forms of both hyperthyroidism and hypothyroidism on carbohydrate disorders is still under discussion. Thyroid hormones have a significant effect on glucose metabolism and the development of insulin resistance. In hyperthyroidism, impaired glucose tolerance may be the result of mainly hepatic insulin resistance, whereas in hypothyroidism the available data suggests that the insulin resistance of peripheral tissues prevails. StreszczenieInsulinooporność definiuje się jako zaburzenie homeostazy glukozy polegające na zmniejszonej wrażliwości mięśni, tkanki tłuszczowej, wątroby oraz innych tkanek na insulinę pomimo jej prawidłowego lub podwyższonego stężenia we krwi. Insulinooporność może przebiegać bezobjawowo lub towarzyszyć różnorodnym chorobom i zaburzeniom, takim jak upośledzona tolerancja glukozy, cukrzyca typu 2, hipercholesterolemia, hipertriglicerydemia, otyłość i nadciśnienie tętnicze. Insulina działa za pośrednictwem swoistych receptorów obecnych na powierzchni większości komórek organizmu. Najwięcej tych receptorów stwierdza się na komórkach tłuszczowych, hepatocytach i komórkach mięśni poprzecznie prążkowanych. Wyróżnia się trzy rodzaje insulinooporności: przedreceptorową, receptorową i poreceptorową. Metody rozpoznawania insulinooporności oparte są na jednoczesnym oznaczaniu stężenia glukozy i insuliny w surowicy krwi. Pomiary stężenia glukozy i insuliny wykonywane są albo w warunkach podstawowych, albo po dożylnym podaniu określonej ilości glukozy lub insuliny. Metody oceny insulin...

show abstract

Section: Hypothyroidismmentioning

confidence: 71%

“…However, it should be noted that in some of these studies in which insulin resistance was not found in patients with SHO, fasting hyperinsulinaemia was reported [33,36]. These observations may be interpreted as an early sign of impairment of glucose metabolism.…”

Section: Hypothyroidismmentioning

confidence: 90%

Insulinooporność a choroby tarczycy

Gierach¹,

Gierach²,

Junik³

2014

Endokrynologia Polska

View full text Add to dashboard Cite

show abstract

“…Some studies demonstrated that subclinical hypothyroidis leads to insulin resistance [31,32], but other studies did not observe this effect [33,34]. The reason for the differences in the obtained results may be due to different durations and degrees of subclinical hypothyroidism.…”

Section: Prace Oryginalnementioning

confidence: 92%

Powiązania między zespołem metabolicznym, subkliniczną niedoczynnością i autoimmunologicznym zapaleniem tarczycy u kobiet po menopauzie oraz rola interleukiny-6

Siemińśka

Wojciechowska

Walczak

et al. 2015

Endokrynologia Polska

View full text Add to dashboard Cite

Introduction: The prevalence of metabolic syndrome increases after menopause; however, the role of concomitant subclinical hypothyroidism has not been completely elucidated. The aim of the study was to identify associations between thyrotropin, immune status, inflammation, and metabolic syndrome in postmenopausal women. The specific goals were: to assess thyrotropin (TSH) and interleukin-6 (IL-6) concentrations in the serum of subclinical hypothyroid postmenopausal women with and without metabolic syndrome and compare them with euthyroid controls; to test whether immune status is related to metabolic syndrome in postmenopausal women and determine the role of IL-6; to examine the relationships between TSH and different features of metabolic syndrome: insulin resistance, waist circumferences, waist-to-hip ratio (WHR), BMI, metabolic parameters (triglycerides, total cholesterol and high-density lipoprotein cholesterol), and inflammatory cytokines (IL-6). Material and methods: Three hundred and seventy-two postmenopausal women were included in the study: 114 women had subclinical hypothyroidism (10.0 uIU/mL > TSH ≥ 4.5 uIU/mL, normal fT4), and 258 women were in euthyreosis (TSH 0.35-4.5 uIU/mL, normal fT4); both groups were matched by age. Anthropometric measurements were conducted (BMI, waist circumference, WHR) and blood pressure was measured. In all subjects the following were assessed in serum: lipid profile, glucose, insulin, TSH, fT4, thyroid antibodies (T-Abs) -TPO-Abs, TG-Abs, and IL-6 concentrations. Results: The prevalence of metabolic syndrome was 49.12% in subclinical hypothyroid women and 46.89% in euthyroid women. However, the proportion of subjects with one or two abnormalities was significantly higher in the subclinical hypothyroid group (45.61%) than in the euthyroid group (32.17%). When we compared subclinical hypothyroid women with and without metabolic syndrome, subjects with metabolic syndrome had higher BMI, abdominal circumferences, WHR, and HOMA-I. They presented higher systolic and diastolic blood pressure. Serum concentrations of cholesterol, triglycerides, fasting glucose, IL-6, TSH, T-Abs were also higher and serum cHDL was lower. There were no significant differences in fT4 concentrations. A similar comparison was made for euthyroid women with and without metabolic syndrome. Higher BMI, waist circumference, WHR, HOMA-I, and systolic blood pressure were observed in subjects with metabolic syndrome. Serum concentrations of TSH, triglycerides, glucose, and IL-6 were also higher, but the concentration of cHDL was significantly lower. There were no significant differences in fT4, T-Abs, cholesterol levels, and diastolic pressure. When we compared euthyroid women T-Abs (+) and T-Abs (-), the prevalence of metabolic syndrome was similar (48.68% vs. 46.15%). There were no differences in BMI, waist circumference, WHR, lipid profile, glucose, and HOMA-I, fT4. However, thyroid autoimmunity was associated with elevated TSH and IL-6 levels. When we analysed subclinical hypothyroid women with ...

show abstract

“…4,5 Only treatment of diabetes will not be that effective to resolve insulin resistance completely. Along with diabetes treatment, if we check and treat hypothyroidism even in subclinical stage then it will take care of its contribution to total insulin resistance.…”

Section: Introductionmentioning

confidence: 99%

Study of insulin levels in hypothyroidism patients

et al. 2015

View full text Add to dashboard Cite

INTRODUCTIONHypothyroidism is a clinical syndrome due to deficiency of thyroid hormones which results in a generalized slowing down of metabolic 1 process. It is a common disorder that occurs in mild to severe forms in 2% to 15% of the population. Women are affected more often than men and both sexes are affected more frequently with increasing age. Clinical symptoms can range from the obvious and easy to recognise lethargy, fatigue and cold intolerance to more subtle, subclinical disease with general symptoms that escape detection. Prevalence of subclinical hypothyroidism is 6-8% in women and 3% in men. Myxoedema is a severe form of hypothyroidism in which there is accumulation of mucopolysaccharides in skin and other tissues, leading to thickening of facial features and a doughy induration of skin. On the basis of severity of clinical signs and symptoms, hypothyroidism is classified into 1 overt hypothyroidism (OH) patient has high TSH but low T3 and low T4 levels in serum as compared to normal reference levels & distinct signs and symptoms of hypothyroidism. 2 Subclinical hypothyroidism patient has high TSH but normal T3 and T4 levels as compared to normal reference levels. These patients have very few or no clinical signs and symptoms. ABSTRACT Background:Overt hypothyroidism is an established risk factor for insulin resistance. In this study we find out whether this association exists between insulin resistance and subclinical hypothyroidism. Methods: Serum Insulin, Fasting blood sugar, Cholesterol were estimated in 60 clinically diagnosed patients of hypothyroidism these patients were divided in to two groups as group I, 30 overt hypothyroidism and group II, 30 subclinical hypothyroidism. Results were compared with a group of 30 normal subjects. To measure the level of insulin resistance using HOMA IR software. Results: In our study total cholesterol were significantly high in both overt hypothyroidism and sub clinical hypothyroidism as compared to euthyroid control group and serum TSH and serum insulin levels were positively correlated with total cholesterol levels in hypothyroidism patients. We also found that TSH levels were positively correlated with insulin and HOMA IR in patients with subclinical hypothyroidism. Conclusions: Hence it will be good practice to screen people for presence of subclinical hypothyroidism and insulin resistance for early detection and prolong the appearance of various fatal complications associated with insulin resistance in hypothyroidism.

show abstract

Subclinical Hypothyroidism is Associated with Insulin Resistance in Rheumatoid Arthritis

Cited by 79 publications

References 14 publications

Insulinooporność a choroby tarczycy

Insulinooporność a choroby tarczycy

Powiązania między zespołem metabolicznym, subkliniczną niedoczynnością i autoimmunologicznym zapaleniem tarczycy u kobiet po menopauzie oraz rola interleukiny-6

Study of insulin levels in hypothyroidism patients

Contact Info

Product

Resources

About