Medenica Sanja, Stojanovic Vukasin, Capece Umberto, Mazzilli Rossella, Markovic Milica, Zamponi Virginia, Vojinovic Tanja, Migliaccio Silvia, Defeudis Giuseppe, Cinti Francesca
Department of Endocrinology, Internal Medicine Clinic, Clinical Center of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
Emergency Medicine Center of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
Hormones (Athens). 2024 Sep;23(3):429-437. doi: 10.1007/s42000-024-00563-w. Epub 2024 May 15.
The aim of this review is to discuss the several interconnections between thyroid autoimmunity and type 1 diabetes in terms of epidemiology, immunoserology, genetic predisposition, and pathogenic mechanisms. We will also analyze the impact of these conditions on both male and female fertility. A literature search was carried out using the MEDLINE/PubMed, Scopus, Google Scholar, ResearchGate, and Clinical Trials Registry databases with a combination of keywords. It was found that the prevalence of thyroid autoantibodies in individuals with type 1 diabetes (T1DM) varied in different countries and ethnic groups from 7 to 35% in both sexes. There are several types of autoantibodies responsible for the immunoserological presentation of autoimmune thyroid diseases (AITDs) which can be either stimulating or inhibiting, which results in AITD being in the plus phase (thyrotoxicosis) or the minus phase (hypothyroidism). Different types of immune cells such as T cells, B cells, natural killer (NK) cells, antigen presenting cells (APCs), and other innate immune cells participate in the damage of the beta cells of the islets of Langerhans, which inevitably leads to T1D. Multiple genetic and environmental factors found in variable combinations are involved in the pathogenesis of AITD and T1D. In conclusion, although it is now well-known that both diabetes and thyroid diseases can affect fertility, only a few data are available on possible effects of autoimmune conditions. Recent findings nevertheless point to the importance of screening patients with immunologic infertility for AITDs and T1D, and vice versa.
本综述的目的是从流行病学、免疫血清学、遗传易感性和致病机制等方面探讨甲状腺自身免疫与1型糖尿病之间的几种内在联系。我们还将分析这些病症对男性和女性生育能力的影响。使用MEDLINE/PubMed、Scopus、谷歌学术、ResearchGate和临床试验注册数据库，结合关键词进行了文献检索。结果发现，1型糖尿病（T1DM）患者中甲状腺自身抗体的患病率在不同国家和种族群体中有所不同，男女患病率均在7%至35%之间。有几种自身抗体可导致自身免疫性甲状腺疾病（AITD）的免疫血清学表现，这些抗体可能具有刺激或抑制作用，这导致AITD处于加相（甲状腺毒症）或减相（甲状腺功能减退）。不同类型的免疫细胞，如T细胞、B细胞、自然杀伤（NK）细胞、抗原呈递细胞（APC）和其他先天免疫细胞，参与了胰岛β细胞的损伤，这不可避免地导致了1型糖尿病。AITD和1型糖尿病的发病机制涉及多种以不同组合形式出现的遗传和环境因素。总之，尽管现在众所周知糖尿病和甲状腺疾病都会影响生育能力，但关于自身免疫性疾病可能产生的影响的数据却很少。然而，最近的研究结果表明，对免疫性不孕症患者进行AITD和T1D筛查很重要，反之亦然。
