Department of Endocrinology, ShanXi Medical University, Taiyuan, China.
Department of Nuclear Medicine, ShanXi Medical University, Taiyuan, China.
J Food Biochem. 2021 Jun;45(6):e13753. doi: 10.1111/jfbc.13753. Epub 2021 May 5.
Subclinical hypothyroidism (SCH) as mild thyroid disorder or comorbidity in patients with endocrine disorders is closely related with insulin resistance (IR) and poor glycemic control. The present study attempted to investigate the effect of SCH on IR and glycemic control in patients with type 2 diabetes mellitus (T2DM). In addition, the effects of ellagic acid (EA) on SCH C57BL/6J and db/db mice were also investigated to explore potential therapeutic drug against SCH-induced abnormal glucose metabolism. T2DM patients were recruited in our study and categorized into two groups according to thyroid stimulating hormone (TSH) value: T2DM without SCH group (TSH ≤4 μIU/ml; n = 30) and T2DM with SCH group (TSH >4μIU/ml; n = 60). Methimazole (MMI; 0.08 mg kg day ) was intragastrically administrated for 12 weeks to establish SCH in C57BL/6J and db/db mice. Compared with T2DM patients without SCH, poor glycemic and cholesterol control were emerged in T2DM patients with SCH and that were prominent in patients with TSH more than 10 μIU/ml. In addition, a significant positive correlation between serum TSH and fasting plasma-glucose (FPG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), or glycated hemoglobin (HbA1c) was observed in T2DM patients with SCH. Moreover, abnormal glucose metabolism in C57BL/6J and db/db mice with SCH has been attenuated by EA administration. Our findings provided data regarding the positive correlation between high TSH level with poor glycemic control in T2DM patients with SCH. EA might be a supportive strategy for preventing SCH-induced abnormal glucose metabolism. PRACTICAL APPLICATIONS: Subclinical hypothyroidism (SCH) is a potential risk factor associated with abnormal glucose metabolism in patients with type 2 diabetes mellitus (T2DM). A clinical theory of a positive correlation between high TSH level and poor glycemic control was validated in type 2 diabetes mellitus patients and mouse models. Ellagic acid (EA) might be a supportive strategy for preventing SCH-induced abnormal glucose metabolism that provided a treatment option in T2DM patients with subclinical hypothyroidism in clinical practice.
亚临床甲状腺功能减退症（SCH）作为内分泌疾病患者的轻度甲状腺疾病或合并症，与胰岛素抵抗（IR）和血糖控制不佳密切相关。本研究试图探讨 SCH 对 2 型糖尿病（T2DM）患者 IR 和血糖控制的影响。此外，还研究了鞣花酸（EA）对 SCH C57BL/6J 和 db/db 小鼠的影响，以探索治疗 SCH 引起的异常葡萄糖代谢的潜在治疗药物。我们的研究招募了 T2DM 患者，并根据促甲状腺激素（TSH）值将其分为两组：无 SCH 的 T2DM 组（TSH≤4μIU/ml；n=30）和有 SCH 的 T2DM 组（TSH>4μIU/ml；n=60）。甲巯咪唑（MMI；0.08mg/kg·天）灌胃 12 周，建立 C57BL/6J 和 db/db 小鼠 SCH 模型。与无 SCH 的 T2DM 患者相比，有 SCH 的 T2DM 患者血糖和胆固醇控制较差，TSH 大于 10μIU/ml 的患者更为明显。此外，在有 SCH 的 T2DM 患者中，血清 TSH 与空腹血糖（FPG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）或糖化血红蛋白（HbA1c）呈显著正相关。此外，EA 可减轻 SCH 引起的 C57BL/6J 和 db/db 小鼠的葡萄糖代谢异常。我们的研究结果提供了 SCH 患者 TSH 水平升高与血糖控制不佳之间存在正相关的证据。EA 可能是预防 SCH 引起的异常葡萄糖代谢的一种支持策略。
亚临床甲状腺功能减退症（SCH）是 2 型糖尿病（T2DM）患者异常葡萄糖代谢的潜在危险因素。在 2 型糖尿病患者和小鼠模型中验证了 TSH 水平升高与血糖控制不佳之间存在正相关的临床理论。鞣花酸（EA）可能是预防 SCH 引起的异常葡萄糖代谢的一种支持策略，为临床实践中患有亚临床甲状腺功能减退症的 2 型糖尿病患者提供了一种治疗选择。
