The Impact of Hypothyroidism on Diabetes Mellitus and Its Complications: A Comprehensive Review

Vemula, Shree Laya; Aramadaka, Saikumar; Mannam, Raam; Narayanan, Rajagopal Sankara; Bansal, Ankit; Yanamaladoddi, Vishnu R; Sarvepalli, Sai Suseel

doi:10.7759/cureus.40447

Cited by 3 publications

(2 citation statements)

References 42 publications

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“…Кроме того, гипотиреоз нередко сочетается с ожирением и нарушениями углеводного обмена [8,9], которые также предрасполагают к ССО, но не входят в mSCORE. В то же время ожирение и эпизоды гипергликемии являются компонентами другого инструмента для оценки прогноза в последующие 10 лет жизни -шкалы FINDRISC (Finnish Type 2 Diabetes Risk Score), позволяющей выделить подгруппы пациентов с высоким риском сахарного диабета 2-го типа (СД 2) [10].…”

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The effect of hypothyroidism on cardiovascular events and type 2 diabetes mellitus developing in rheumatoid arthritis

Kondratyeva,

Popkova,

Nasonov

2024

Terapevticheskii arkhiv

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Aim. To compare the frequency of cardiovascular events (CVE), to assess the risk of cardiovascular death using the mSCORE and the development of type 2 diabetes mellitus (DM) using the FINDRISC in patients with rheumatoid arthritis (RA) with and without hypothyroidism. Materials and methods. The study included 149 patients (125 women, 24 men) with RA (median age – 57 [52; 61] years). In all patients, traditional factors of cardiovascular risk and glucose metabolism disorders (age, smoking status, total blood cholesterol, blood pressure, overweight, abdominal obesity – AO, heredity burdened by diabetes, insufficient physical activity, the lack of the necessary amount of berries, fruits and vegetables in the daily diet, history of hyperglycemia episodes), the 10-year risk of death from cardiovascular causes according to the mSCORE and the risk of developing type 2 DM according to the FINDRISС were assessed, a history of CVE (myocardial infarctions, and its revascularization, stroke) was recorded. Results. Hypothyroidism was diagnosed in 17.4% of RA patients. Patients with hypothyroidism (group 1) were more likely to have AO and less likely to consume unsufficient dietary fiber than patients with euthyroidism (group 2). Moderate, high and very high risk of development according to the mSCORE and FINDRISC was detected in 61.5% of hypothyroid patients and 48.8% euthyroid patients, according to mSCORE alone – in 30.8 and 44.7%, according to FINDRISC – in 0 and 2.4%, respectively (p0.05 in all cases); 11.5% of patients in group 1 and 6.5% in group 2 suffered from CVE (OR 1.875, 95% CI 0.462–7.607; p=0.63). Conclusion. It is necessary to evaluate the thyroid gland function, especially in patients with AO due to the high frequency of hypothyroidism in RA. Hypothyroidism did not have an independent effect on the severe CVЕ rates, as well as risk assessment according to the score and FINDRISC in RA patients. Theses, with and without hypothyroidism, were predominantly in the moderate, high, very high risk groups according to both scales.

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The effect of hypothyroidism on cardiovascular events and type 2 diabetes mellitus developing in rheumatoid arthritis

Kondratyeva,

Popkova,

Nasonov

2024

Terapevticheskii arkhiv

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“…Several lines of evidence demonstrate that hypothyroidism increases the risk for microvascular diseases, 1 – 5 yet the mechanism by which thyroid hormone impacts the pathogenesis of diabetic retinopathy has not been determined. Diabetic retinopathy, a complication of diabetes, is characterized by dysfunction of both vascular and neuronal cells.…”

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Diabetes Modulates Iodothyronine Deiodinase 2 Expression in the Mouse Retina: A Role for Thyroid Hormone in the Pathogenesis of Diabetic Retinopathy

Bapputty,

Sapa,

Masaru

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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Purpose Clinical investigations associate hypothyroidism with an increased risk for microvascular complications, yet the mechanism by which thyroid hormone regulates the development of diabetic retinopathy is not clearly understood. We investigated the role of iodothyronine deiodinase 2 (DIO2) in the pathogenesis of diabetic retinopathy. Methods Retinas from streptozotocin-induced diabetic and nondiabetic mice were evaluated by RNA sequencing, RT-PCR, and immunostaining. Media and cell lysates from mouse retinal microvascular endothelial cells and retinal astrocytes exposed to physiologic (5 mM) and high glucose (25 mM) containing media were assessed by liquid chromatography-tandem mass spectrometry to measure tetraiodothyronine (T4) and tri-iodothyronine (T3) concentrations and by Western blot analysis to determine the relationship of T4/T3 to oxidative stress and inflammatory mediators. Cell death was determined by Trypan Blue exclusion assay. Results At 12 weeks of diabetes duration, retinas from diabetic mice compared with nondiabetic mice demonstrated a significant decrease in Dio2 transcripts and Dio2 gene and protein ( P < 0.05) expression. When cultured in the presence of high glucose, both mouse retinal astrocytes and microvascular endothelial cells demonstrated a significant reduction of DIO2 protein compared with cells cultured in physiologic glucose. High glucose inhibited generation of T3, leading to a significantly increased T4/T3 ( P < 0.0079). Supplementation of cells with T3, but not T4, prevented the high glucose-induced rise in endothelial nitric oxide synthase, intercellular cell adhesion molecule 1, and endothelial cell death ( P < 0.0079). Conclusions Decreased intraretinal T3 owing to diabetes-induced loss of DIO2 may lead to dysfunction and death of cells in the retina, thereby contributing to the pathogenesis of early diabetic retinopathy.

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Impact of non-severe infections on cortisol and thyroid stimulating hormone baseline levels in hospitalized patients: A monocentric cross-sectional study

Mrabet,

Mabrouk,

Boubaker

et al. 2024

Endocrine Regulations

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Objective. The hormonal balance is dependent on the internal and external stimuli. The baseline cortisol (BC) and thyroid stimulating hormone (TSH) levels have been observed to vary and have a predictive value in critical illness settings. Few reports have studied their variation in non-severe acute illness. The present study aims to describe the variation of BC and TSH levels and to determine the factors influencing BC and TSH levels in patients admitted with non-severe acute illness. Patients and Methods. This is a cross-sectional study of patients admitted to Infectious Diseases and Endocrinology units at the Department of Endocrinology-Diabetology and Internal Medicine at Tahar Sfar University Hospital between March 15th and September 15th, 2020. BC and TSH levels were obtained during the hospitalization. Results. A total of 143 patients were included in this study with 75 presenting with infection. All infections were community-acquired and predominantly non-severe. The BC levels were higher in patients with infection (p=0.004), especially those admitted via the emergency department (p=0.009) with a fever (p=0.015). The BC positively correlated with the temperature (p=0.002, r’=0.350), CRP levels (p=0.002, r’=0.355), neutrophil to lymphocyte ratio (p=0.045, r’=0.235), and SOFA score (p=0.023, r’=0.262). On the other hand, TSH levels were comparable in the presence of infection (p=0.400). TSH levels did not correlate with the fever, the severity of infection, or inflammation biomarkers. Both BC and TSH did not predict unfavorable outcomes in non-severe infected patients. Conclusion. In patients admitted with critical acute infections, the BC levels seem to indicate a relatively more severe infectious state. On the other hand, TSH levels did not show significant variations in these patients.

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The Impact of Hypothyroidism on Diabetes Mellitus and Its Complications: A Comprehensive Review

Cited by 3 publications

References 42 publications

The effect of hypothyroidism on cardiovascular events and type 2 diabetes mellitus developing in rheumatoid arthritis

The effect of hypothyroidism on cardiovascular events and type 2 diabetes mellitus developing in rheumatoid arthritis

Diabetes Modulates Iodothyronine Deiodinase 2 Expression in the Mouse Retina: A Role for Thyroid Hormone in the Pathogenesis of Diabetic Retinopathy

Impact of non-severe infections on cortisol and thyroid stimulating hormone baseline levels in hospitalized patients: A monocentric cross-sectional study

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