EFFECT OF METFORMIN ON THYROID STIMULATING HORMONE IN EUTHYROID TYPE 2 DIABETES MELLITUS PATIENTS

BACKGROUND Subclinical hypothyroidism is the term used to describe a condition where there is isolated elevated serum thyroid stimulating hormone level in the setting of normal serum free thyroxin levels in the absence or presence of symptoms. There is no uniformity in various studies regarding association between subclinical hypothyroidism and type 2 diabetes mellitus with regard to prevalence and change in metabolic profile. METHODS After enrolment of patients, a detailed relevant history of patients was taken and detailed clinical examination was done. All information obtained from patients was recorded in predesigned proforma. After 8 hours of fasting, serum levels of glucose, HbA1c, total cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) by fully automated clinical biochemistry analyser EM 200 were checked. Serum free T3, free T4 and thyroid stimulating hormone (TSH) were measured using standard assay. RESULTS Fasting glucose was significantly higher (P = .00001) in diabetes mellitus plus subclinical hypothyroidism group than patients with diabetes mellitus (DM) and euthyroid group (156.3 + 15.77 mg / dl vs. 128.1 + 21.44 mg / dl). Fasting insulin was significantly higher (P = .00001) in diabetes mellitus plus subclinical hypothyroidism group than patients with DM and euthyroid group (3.69 + 0.82 mu / L vs. 2.36 + 0.75 mu / L). There was no significant difference between two groups regarding HbA1c. CONCLUSIONS From our study we conclude that prevalence of subclinical hypothyroidism was higher in type 2 diabetes patients than normal population and there was female predominance. Body mass index was significantly higher in subclinical hypothyroidism group and there was no significant difference between the two groups regarding duration of diabetes mellitus. Patients with subclinical hypothyroidism have poor glycaemic control. KEYWORDS Subclinical Hypothyroidism, Diabetes Mellitus, Metabolic Profile

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The Role of Melanocyte-Stimulating Hormone in Insulin Resistance and Type 2 Diabetes Mellitus

Treatments in Endocrinology ◽

10.2165/00024677-200605010-00002 ◽

2006 ◽

Vol 5 (1) ◽

pp. 7-13 ◽

Cited By ~ 14

Author(s):

Jessica Lynn Costa ◽

Ute Hochgeschwender ◽

Miles Brennan

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Melanocyte Stimulating Hormone ◽

Stimulating Hormone

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Correlation between Insulin Resistance and Thyroid Nodule in Type 2 Diabetes Mellitus

International Journal of Endocrinology ◽

10.1155/2017/1617458 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Yunzhao Tang ◽

Tiantian Yan ◽

Gang Wang ◽

Yijun Chen ◽

Yanjuan Zhu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Thyroid Nodule ◽

Thyroid Nodules ◽

Thyroid Stimulating Hormone ◽

Control Group ◽

Free Triiodothyronine

Objective. The present study explored the association between insulin resistance (IR) and the clinical characteristics of thyroid nodules in patients with type 2 diabetes mellitus (T2DM).Methods. All the patients were newly diagnosed with T2DM. 201 patients with thyroid nodule disease and 308 patients without the nodular thyroid disease. The participants were evaluated by relevant examination. Correlation analyses and regression analyses were performed to examine the relationships between the two groups.Results. HOMA-IR values, serum FT4 (free thyroxine) levels, and age were higher in the thyroid nodule group than in the control group. The proportion of women in the thyroid nodule group is greater than the proportion of women in the control group. Logistic regression analysis showed that age, sex, FT4, and HOMA-IR were positive factors for thyroid nodule. The volume and size of the thyroid nodule were positively correlated with HOMA-IR, irrespective of gender. The thyroid nodule volume and size and the TSH (thyroid stimulating hormone) were greater in females than in males, whereas FT3 (free triiodothyronine) was lower in females.Conclusion. IR might be a risk factor for thyroid nodule. Whether alleviating the IR might slow the growth, or diminish the volume and size of the thyroid nodules, is yet to be elucidated.

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The Effect of Thyroid Dysfunction on the Cardiovascular Risk of Type 2 Diabetes Mellitus Patients in Ghana

Journal of Diabetes Research ◽

10.1155/2018/4783093 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Osei Sarfo-Kantanka ◽

Fred Stephen Sarfo ◽

Eunice Oparebea Ansah ◽

Ishmael Kyei

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Thyroid Dysfunction ◽

Thyroid Stimulating Hormone ◽

Risk Scores ◽

Diabetes Clinic ◽

Cross Sectional ◽

Chd Risk

Background. Thyroid dysfunction is known to exaggerate the coronary heart disease (CHD) risk associated with type 2 diabetes mellitus (T2DM) among whites. The effect is yet to be studied among African populations. Methods. This is a cross-sectional study involving 780 T2DM patients enrolled in a diabetes clinic in Kumasi, Ghana. CHD risk was estimated using the Framingham and UKPDS risk scores. Risks were categorised as low (<10%), intermediate (10–19%), and high (≥20%). Associations between metabolic risk factors, thyroid dysfunction, and CHD risk were measured using Spearman’s partial correlation analysis while controlling for age and gender. Differences were considered statistically significant at p<0.05. Results. 780 T2DM patients (57.7% females), mean ± SD age of 57.4 ± 9.4 was analysed. The median (IQR) 10-year CHD score estimated using the Framingham and UKPDS risk engines for males and females was 12 (8–20), 9.4 (5.7–13.4), p<0.0001 and 3 (1–6), 5.8 (3.4–9.6), p<0.0001, respectively. Positive correlation was found between CHD risk and HbA1c, total cholesterol, low-density lipoprotein cholesterol, systolic blood pressure, and thyroid stimulating hormone. Conclusion. The presence of thyroid dysfunction significantly increased the CHD risk associated with T2DM patients in Ghana.

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Study of Subclinical Thyroid Disorders in Type 2 Diabetes Mellitus

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/20 ◽

2021 ◽

Vol 8 (02) ◽

pp. 103-107

Author(s):

Salim Javeedh ◽

Vidya T.A

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Subclinical Hypothyroidism ◽

Thyroid Disease ◽

Microvascular Complications ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Significant Difference

BACKGROUND Thyroid disease is more common in people with diabetes mellitus than in general population. Among thyroid disorders, subclinical hypothyroidism is more common than the overt form. Hypothyroidism is associated with dyslipidaemia, hypertension and cardiac disease. Subclinical hypothyroidism has also been reported to have these features. With this background, we aimed to determine the prevalence of subclinical thyroid disorder and its influence on the metabolic profile of patients with type 2 diabetes mellitus (DM). METHODS 234 type 2 diabetes patients, 117 males and 117 females, who were previously not known to have thyroid disease, were screened for thyroid dysfunction using serum free T3, free T4, and thyroid stimulating hormone (TSH) levels. Patients were evaluated for clinical features of thyroid disease and investigated for microvascular complications of DM, dyslipidaemia and cardiac disease. Individuals with subclinical hypothyroidism were further screened for anti-thyroid peroxidase (TPO) antibodies. RESULTS In this study, subclinical hypothyroidism was present in 29 (12.4 %) of 234 type 2 diabetics; no case of subclinical hyperthyroidism was detected. 25 of these 29 patients with subclinical hypothyroidism were females. Elevated TPO antibody levels were present in 82.8 % (24 out of 29) subclinical hypothyroidism (SCH) patients. SCH was found to be associated with higher body mass index (BMI) and patients aged more than 50 years. No significant difference was found in glycaemic profile or lipid profile between patients with SCH and euthyroid subjects. There was no significant difference among SCH patients with and without microvascular complications. Left Ventricle (LV) diastolic dysfunction was present in 34.4 % of SCH patients. CONCLUSIONS SCH is common among type 2 diabetics, especially in females and most commonly due to autoimmune thyroid disease. SCH in type 2 DM is associated with a higher BMI and an older age group, but it does not seem to have an influence on glycaemic profile, lipid profile or microvascular complications of diabetes. KEYWORDS Thyroid Stimulating Hormone (TSH), Type 2 Diabetes Mellitus (T2DM), Subclinical Hypothyroidism (SCH), BMI, Anti–TPO (Thyroid Peroxidase) Antibody

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