Relation of thyroid hormone abnormalities with subclinical inflammatory activity in patients with type 1 and type 2 diabetes mellitus

Author(s)

Neto, Arnaldo Moura ^[1] ; Ribeiro Parisi, Maria Candida ^[1] ; Alegre, Sarah Monte ^[2] ; Pavin, Elizabeth Joao ^[1] ; Tambascia, Marcos Antonio ^[1] ; Zantut-Wittmann, Denise Engelbrecht ^[1]

Affiliation

^[1] Univ Estadual Campinas, Fac Med Sci, Div Endocrinol, Dept Clin Med, UNICAMP, Rua Tessalia Vieira Camargo, 126 Barao Geraldo, BR-13084971 Campinas, SP - Brazil

^[2] Univ Estadual Campinas, Fac Med Sci, Dept Clin Med, Div Internal Med, Campinas, SP - Brazil

• Document type: Journal article
• Source: ENDOCRINE; v. 51, n. 1, p. 63-71, JAN 2016.
• Web of Science Citations: 9

Abstract

Thyroid hormone (TH) abnormalities are common in patients with diabetes mellitus (DM). These thyroid hormone abnormalities have been associated with inflammatory activity in several conditions but this link remains unclear in DM. We assessed the influence of subclinical inflammation in TH metabolism in euthyroid diabetic patients. Cross-sectional study involving 258 subjects divided in 4 groups: 70 patients with T2DM and 55 patients with T1DM and two control groups of 70 and 63 non-diabetic individuals, respectively. Groups were paired by age, sex, and body mass index (BMI). We evaluated the association between clinical and hormonal variables {[}thyrotropin, reverse T3 (rT3), total and free thyroxine (T4), and triiodothyronine (T3)] with the inflammation markers C-reactive protein (hs-CRP), serum amyloid A (SAA), and interleukin-6 (IL-6). Serum T3 and free T3 were lower in patients with diabetes (all P < 0.001) compared to the control groups. Interleukin-6 showed positive correlations with rT3 in both groups (P < 0.05). IL-6 was independently associated to FT3/rT3 (B = -0.193; 95 % CI -0.31; -0.076; P = 0.002) and FT4/rT3 (B = -0.107; 95 % CI -0.207; -0.006; P = 0.039) in the T1DM group. In the T2DM group, SAA (B = 0.18; 95 % CI 0.089; 0.271; P < 0.001) and hs-CRP (B = -0.069; 95 % CI -0.132; 0.007; P = 0.03) predicted FT3 levels. SAA (B = -0.16; 95 % CI -0.26; -0.061; P = 0.002) and IL6 (B = 0.123; 95 % CI 0.005; 0.241; P = 0.041) were related to FT4/FT3. In DM, differences in TH levels compared to non-diabetic individuals were related to increased subclinical inflammatory activity and BMI. Altered deiodinase activity was probably involved. These findings were independent of sex, age, BMI, and HbA1c levels. (AU)

• FAPESP's process: 10/08854-0 - Non-thyroidal illness syndrome in patients with Diabetes mellitus: laboratory pattern and correlation with glycemic control, complications and inflammatory activity
• Grantee: Denise Engelbrecht Zantut Wittmann
• Support type: Regular Research Grants
• FAPESP's process: 13/03295-1 - Thyroid hormone abnormalities in patients with micro and macrovascular complications of type 1 and 2 Diabetes Mellitus
• Grantee: Arnaldo Moura Neto
• Support type: Scholarships in Brazil - Doctorate