Yalakanti Dhanunjaya, Dolia Pragna B
Institute of Biochemistry, Madras Medical College & RGGGH, Chennai, Tamilnadu 600003 India.
Indian J Clin Biochem. 2016 Apr;31(2):152-61. doi: 10.1007/s12291-015-0518-9. Epub 2015 Aug 13.
Diabetes mellitus and thyroid disorders are common endocrinopathies, which often occur parallel. Dyslipidemia is very common in both of these conditions. The development of hypothyroidism is well-known in type 1 diabetics, but it was not distinctly understood in type 2 diabetics. Thus we tried to examine the association between type II deiodinase (D2 or DIO2) Thr92Ala single nucleotide gene polymorphism and thyroid function among type 2 diabetes mellitus patients. A total of 130 type 2 diabetics were screened and genotyped for DIO2 Thr92Ala polymorphism. Fasting plasma glucose, Glycosylated haemoglobin, lipid and thyroid profiles, malondialdehyde (MDA) and paraoxonase were estimated according to standard procedures. A significant altered level of thyroid hormones (TH's) was found in Ala/Ala genotype when compared with Thr/Thr or Thr/Ala genotype. DIO2 and T3:T4 ratio significantly decreased, whereas total T4 and thyroid stimulating hormone levels significantly elevated among Ala/Ala genotype (131 ± 30 ng/ml; 0.12 ± 0.05; 7.17 ± 2.05 µg/dl; 4.77 ± 3.1 µIU/ml, respectively) when compared with Thr/Thr + Thr/Ala genotypes (176 ± 33 ng/ml; 0.21 ± 0.05; 5.21 ± 1.1 µg/dl; 2.59 ± 1.61 µIU/ml respectively). Moreover, D2 levels were significantly negatively correlated with TH's levels except total T4 among Ala/Ala genotypes. All the patients were having a poor glycemic control, and their glycemic status was positively correlating with MDA levels. On the other hand, serum paraoxonase activity decreased among Ala/Ala genotype (104 ± 21 vs. 118 ± 18 nmol/min/ml). In conclusion, DIO2 Ala92 homozygous variant found to be associated with altered levels of DIO2, Thyroid profile and paraoxonase. Hence, we recommend to do detail study of genetic factors related to thyroid function and prevent additional diabetic complications.
糖尿病和甲状腺疾病是常见的内分泌疾病,常同时发生。血脂异常在这两种疾病中都很常见。1型糖尿病患者中甲状腺功能减退的发生是众所周知的,但在2型糖尿病患者中并不十分清楚。因此,我们试图研究2型糖尿病患者中II型脱碘酶(D2或DIO2)Thr92Ala单核苷酸基因多态性与甲状腺功能之间的关联。共筛选了130名2型糖尿病患者,并对DIO2 Thr92Ala多态性进行基因分型。按照标准程序测定空腹血糖、糖化血红蛋白、血脂和甲状腺指标、丙二醛(MDA)和对氧磷酶。与Thr/Thr或Thr/Ala基因型相比,Ala/Ala基因型患者的甲状腺激素(TH)水平有显著改变。与Thr/Thr + Thr/Ala基因型(分别为176±33 ng/ml;0.21±0.05;5.21±1.1 μg/dl;2.59±1.61 μIU/ml)相比,Ala/Ala基因型患者的DIO2和T3:T4比值显著降低,而总T4和促甲状腺激素水平显著升高(分别为131±30 ng/ml;0.12±0.05;7.17±2.05 μg/dl;4.77±3.1 μIU/ml)。此外,在Ala/Ala基因型中,除总T4外,D2水平与TH水平显著负相关。所有患者血糖控制不佳,其血糖状态与MDA水平呈正相关。另一方面,Ala/Ala基因型患者的血清对氧磷酶活性降低(104±21对118±18 nmol/min/ml)。总之,发现DIO2 Ala92纯合变异与DIO2水平、甲状腺指标和对氧磷酶的改变有关。因此,我们建议对与甲状腺功能相关的遗传因素进行详细研究,以预防更多的糖尿病并发症。