Naslov
Relationship between Hashimoto's thyroiditis, autoimmune and metabolic markers in adult onset autoimmune diabetes

Autori
Duvnjak, Lea ; Majić Milotić, Dubravka ; Senta, Matea ; Blaslov, Kristina ; Knežević Ćuća, Jadranka

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Diabetologia 2015 ; 58 (Suppl. 1):S247-248 / - , 2015

Skup
51st EASD Annual Meeting

Mjesto i datum
Stockholm, Švedska, 14.09.2015. - 18.09.2015

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Hashimoto's thyreoiditis; autoimmune diabetes in adults; central obesity

Sažetak
Hashimoto’s thyroiditis and juvenile type 1 diabetes mellitus (T1DM) are the most common combination of autoimmune (AI) disorders. It was recently proposed that besides genetic susceptibility central obesity might contribute to unknown mechanisms underlying the thyroid-antibody production. Latent AI diabetes in adults (LADA) is characterized by clinical presentation resembling type 2 diabetes but with T1DM autoimmune markers, primarily glutamic acid autoantibody (GAD Ab). Little is known about the presence of Hashimoto’s thyroiditis in LADA and adult onset T1DM. We aimed to investigate the relationship between Hashimoto's disease presence, AI markers and metabolic features in patients with LADA and adult-onset T1DM. Four hundred and seven patients diagnosed with AI diabetes over the age of 30 years were divided according to Ab positivity into three groups: GAD single positive group (representing LADA) ; islet cell Ab (ICA)+GAD positive and ICA+GAD+protein thyrosine phosphatase Ab (IA2) positive group representing adult-onset T1DM. ICA Ab was measured by indirect immunofluorescence. GAD and IA2 Abs were detected by enzyme like immunoadsorbent assay (ELISA). Hashimoto’s thyroiditis was diagnosed by thyroid ultrasound guided needle biopsy and serologic tests for thyreoiglobulin and tissue peroxidase Abs by chemiluminescent immunoassay (CLIA). Body mass index (BMI), waist circumference, arterial hypertension (AH), THS, fT3, fT4, triglycerides, HDL cholesterol and statin use were also evaluated. LADA group showed significantly higher Hashimoto's thyroiditis presence compared to the groups of adult-onset T1DM. Althought all patients had TSH and peripheral thyroid hormone levels within the normal range, TSH was significantly higher in the LADA group compared to other two groups. Higher BMI, waist circumference, statin use and AH presence were more common in the LADA group. In the regression analysis including Ab status, BMI, waist circumference, the use of statins and the presence of AH adjusted for gender and age at diagnosis, single GAD positivity was significantly associated with Hashimoto's thyroiditis (OR 1.977 (1.174-3.328), p=0.001). The association was also significant for waist circumference and statin use (OR 1.038 (1.003- 1.072), p=0.031 ; OR 1.525 (1.171 -1.716), p=0.008). Hashimoto's thyroiditis is more prevalent in patients with LADA compared to other forms of AI diabetes in adults. The possible association of both GAD positivity and waist circumference with the presence of Hashimoto's thyroiditis in LADA patients was found. These results might indicate the potential contribution of central obesity in Hashimoto's pathogenesis which needs to be clarified in further studies.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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