Mazaheri Tina, Sharifi Faranak, Kamali Koorosh
Zanjan University of Medical Sciences, Zanjan, Iran.
Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
J Diabetes Metab Disord. 2014 Oct 30;13(1):103. doi: 10.1186/s40200-014-0103-4. eCollection 2014.
A chronic inflammation resulting from an imbalance between pro-inflammatory and anti-inflammatory cytokines in Hashimoto's thyroiditis (HT) might be responsible for IR in hypothyroidism. This study was performed to investigate a probable association between autoimmune background of hypothyroidism and IR.
In this clinical study, 63 subjects with Hashimoto's thyroiditis and 49 subjects with post-ablation hypothyroidism were enrolled. All the participants were euthyroid for more than one year through Levothyroxine therapy. Serum concentrations of Thyroid-stimulating Hormone (TSH), Free Thyroxin (FT4, FT3), Anti-Thyroid Peroxidase Antibodies (Anti-TPO Abs), Total Cholesterol (TC), HDL-Cholesterol (HDL-C), Triglyceride (TG), Fasting Blood Glucose (FBG), and insulin levels were measured and Oral Glucose Tolerance Test (OGTT) was performed for all of the subjects. Participants with anti TPO levels more than 1000 IU /ml were classified as having highly positive antibodies.
No significant differences regarding to plasma insulin, glucose and lipid concentration, were detected between subjects with and without Hashimoto's thyroiditis. However, subjects with highly positive Anti TPO Abs had higher prevalence of elevated fasting insulin level than those with lower titers of Anti TPO Abs and subjects without autoimmune background (94.1% vs. 62.8% and 71.4% respectively, P = 0.05). Subjects with highly positive titers of Abs also had a lower serum HDL-c levels than the rest of the subjects (40.6 ± 2.1 vs. 47.2 ± 1.7 and 47.4 ± 1.4, P = 0.04).
There is no obvious association between thyroid autoimmunity and metabolic indexes of hypothyroid patients. Only patients with Ani TPO antibody levels more than 1000 IU/ml may experience higher insulin level and less HDL-c with the same BMI.
桥本甲状腺炎（HT）中促炎细胞因子和抗炎细胞因子失衡导致的慢性炎症可能是甲状腺功能减退症中胰岛素抵抗（IR）的原因。本研究旨在调查甲状腺功能减退症的自身免疫背景与IR之间可能存在的关联。
在这项临床研究中，招募了63例桥本甲状腺炎患者和49例消融术后甲状腺功能减退症患者。所有参与者通过左甲状腺素治疗甲状腺功能正常超过一年。测量血清促甲状腺激素（TSH）、游离甲状腺素（FT4、FT3）、抗甲状腺过氧化物酶抗体（Anti-TPO Abs）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯（TG）、空腹血糖（FBG）和胰岛素水平，并对所有受试者进行口服葡萄糖耐量试验（OGTT）。抗TPO水平超过1000 IU/ml的参与者被分类为抗体高度阳性。
桥本甲状腺炎患者和非桥本甲状腺炎患者在血浆胰岛素、血糖和脂质浓度方面未检测到显著差异。然而，抗TPO Abs高度阳性的受试者空腹胰岛素水平升高的患病率高于抗TPO Abs滴度较低的受试者和无自身免疫背景的受试者（分别为94.1%对62.8%和71.4%，P = 0.05）。抗体滴度高度阳性的受试者血清HDL-c水平也低于其他受试者（40.6±2.1对47.2±1.7和47.4±1.4，P = 0.04）。
甲状腺自身免疫与甲状腺功能减退患者的代谢指标之间没有明显关联。只有抗TPO抗体水平超过1000 IU/ml的患者在相同BMI下可能会出现更高的胰岛素水平和更低的HDL-c。
