Endocrine Abstracts

Introduction: Autoimmune thyroid disease (AITD) and abnormal carbohydrate metabolism are the commonest endocrine disorders in the general population. However, the effect that AITD may exert in β-cell secretion and insulin action in patients pre-diabetes has not been investigated before.

Methods/design: One hundred and eighty-two patients (157 females) 46.5±14.2 years with pre-diabetes (impaired fasting glucose (IFG) or/and impaired glucose tolerance (IGT) or/and HbA1c≥5.7%) had oral glucose tolerance test (OGTT) with glucose (mg/dl) and insulin (μIU/ml) measurement at 0, 30′, 60′, 90′, 120′ min along with calculation of insulin resistance an secretion indices (IRI, ISI) analyzed according to the presence of AITD in an unselected sample. Age, gender, waist circumference (cm), and body mass index (BMI kg/m²), TSH levels were recorded. HOMA, QUICKI as IRI and 1/fasting insulin, disposition index, AUCins/glu as ISI were assessed. Patients with abnormal TSH and/or DM2 were excluded from the study.

Results: Fifty-four (29.7%) had whereas 128 did not have AITD. 58.2% of patients had IFG (59.3% vs 57.8%, respectively) and 18.2% had IGT (11% vs 21.3%, respectively). IRI: Matsuda index was statistically significant higher in non-AITD patients (P=0.009). AUC ins/glu was higher with statistical significance in AITD group compared to non-AITD group (P=0.045). Univariate regression analysis showed that age, BMI, and AITD had significant impact on the index incAUCins/glu (P=0.025, P=0.009 and P=0.031, respectively) that remained significant in multivariate analysis.

Conclusion: Patients with AITD and pre-diabetes had higher AUCins/glu values and lower ISI(comp) compared to non-AITD. The presence of thyroid antibodies could be a possible factor modifying β-cell secretion in patients with established abnormality of carbohydrate metabolism.