Treatment of Obesity with Thyroid hormones in Europe. Data from the THESIS* Collaboration.

PURPOSE: The use of thyroid hormones (TH) to treat obesity is unsupported by evidence as reflected in international guidelines. We explored views about this practice, and associations with respondent characteristics among European thyroid specialists. METHODS: Specialists from 28 countries were invited to a survey via professional organisations. The relevant question was whether "Thyroid hormones may be indicated in biochemically euthyroid patients with obesity resistant to lifestyle interventions". RESULTS: Of 17,232 invitations 5695 responses were received (33% valid response rate; 65% women; 90% endocrinologists). Of these, 290 (5.1%) stated that TH may be indicated as treatment for obesity in euthyroid patients. This view was commoner among non-endocrinologists (8.7% vs. 4.7%, p < 0.01), private practice (6.5% vs. 4.5%, p < 0.01), and varied geographically (Eastern Europe, 7.3%; Southern Europe, 4.8%; Western Europe, 2.7%; and Northern Europe, 2.5%). Respondents from Northern and Western Europe were less likely to use TH than those from Eastern Europe (p < 0.01). Gross national income (GNI) correlated inversely with this view (OR 0.97, CI: 0.96-0.97; p < 0.001). Having national guidelines on hypothyroidism correlated negatively with treating obesity with TH (OR 0.71, CI: 0.55-0.91). CONCLUSIONS: Despite the lack of evidence, and contrary to guidelines' recommendations, about 5% of respondents stated that TH may be indicated as a treatment for obesity in euthyroid patients resistant to life-style interventions. This opinion was associated with (i) respondent characteristics: being non-endocrinologist, working in private practice, treating a small number of hypothyroid patients annually and (ii) national characteristics: prevalence of obesity, Eastern Europe, low GNI and lack of national hypothyroidism guidelines.

Insulin-like growth factor (IGF) system and hormonal-metabolic profile in women with polycystic ovary syndrome.

AIM of the study was to compare serum levels of IGF-1, IGF-2 and insulin­like growth factor­binding protein 3 (IGFBP-3) among non­obese and obese PCOS women, and to assess their relationship to metabolic and hormonal parameters.    METHODS: The study included 64 women diagnosed with PCOS (age 28.9 ± 5 years); 30 of them with BMI > 27 and 34 with BMI lower than 27. All subjects were examined for parameters of glucose and lipid metabolism, steroid hormones and serum IGF-1, IGF-2 and IGFBP-3 levels. RESULTS: No significant differences in serum IGFBP-3 (p=0.534), IGF-1 (p=0.29) and IGF-2 (p=0.56) between two groups have been detected. IGFBP-3 was in positive correlation with total cholesterol (p=0.026), LDL cholesterol (p=0.03) and triacylglycerols (p=0.022). IGF-1 were negatively correlated with insulin (p=0.022), HOMA IR (p=0.033), triacylglycerols (p=0.0196) and waist circumference (p=0.049). A positive correlation was detected between IGF-1 and HDL cholesterol (p=0.025). No significant relationship was observed between IGF-1 and steroid hormones. CONCLUSION: Serum levels of IGF-1, IGF-2 and IGFBP-3 in obese PCOS women do not differ from those detected in non­obese PCOS women. IGF-1 negatively correlated with metabolic parameters, indicating that lower IGF-1 may represent an important predictor of metabolic syndrome (MS) in PCOS women. All peptides seem to have little effect on ovarian steroidogenesis in PCOS (Tab. 1, Fig. 1, Ref. 30).

Type 2 diabetes mellitus and thyroid disease: a two-sided analysis.

AIM OF THE STUDY: To assess the prevalence of thyroid diseases in patients with type 2 diabetes mellitus (T2DM) in comparison with normal population; to determine prevalence of T2DM in patients with thyroid diseases. MATERIALS AND METHODS: First group consisted of 60 patients with T2DM without previous history of thyroid disease. Second group consisted of 60 patients with thyroid disease without any previously known impairment of glucose metabolism. Control group (CG) included 100 subjects who had no previous history of thyroid disease or glucose metabolism impairment. Blood tests were performed to evaluate thyroid and glucose metabolism parameters. RESULTS: We found a significantly higher prevalence of thyroid diseases in patients with T2DM when compared to CG. Patients with T2DM showed to have higher serum levels of free triiodothyronine (fT3), thyroid­stimulating hormone (TSH) and anti-thyroid peroxidase (anti-TPO) autoantibodies. We found no statistical significance in prevalence of T2DM in patients with thyroid diseases and CG. Among parameters of glucose metabolism, there were only higher fasting glucose levels in patients with hyperthyroidism and autoimmune thyroid disease (AITD). CONCLUSIONS: Patients with T2DM showed to have higher prevalence of AITD and primary hypothyroidism. We did not find higher prevalence of T2DM in patients with thyroid diseases (Tab. 3, Ref. 29).

Type II deiodinase polymorphism: A potential risk factor of type 2 diabetes mellitus.

ype 2 diabetes mellitus (T2DM) remains one of the most challenging global epidemics of the twenty-first century. It is estimated that more than 350 million people worldwide are affected by this metabolic disorder. It has many risk factors. Several studies presume that type II iodothyronine deiodinase polymorphism Thr92Ala (DII-Thr92-Ala, rs225014) is yet another risk factor. The aim of the study was to assess the impact of this polymorphism on parameters of glycid metabolism. Our group consisted of 200 subjects (74 males and 126 females) at average age of 63.85 ± 18.98 without prediabetes, diabetes mellitus or any thyropathy. Blood tests were performed to evaluate glucose metabolism parameters as well as DII-Thr92Ala polymorphism. Our study confirmed the relationship between Ala homozygotes and glycosylated haemoglobin (HbA1c) serum levels (Tab. 2, Ref. 14). Keywords: diabetes mellitus 2, deiodinase II, polymorphism Thr92Ala.

Humoral predictors of ankle-brachial index in patients with peripheral arterial disease and controls.

INTRODUCTION: Peripheral arterial disease (PAD) is a common condition due to atherosclerosis with high prevalence in population over 55 years. Although its pathophysiology is well recognized, the role of inflammatory markers is still not fully known. OBJECTIVES: The aim of the study was to assess the relation of C-reactive protein (CRP), tumor necrosis factors-alpha (TNF-alpha) and interleukin-6 (IL-6) to ankle-brachial index (ABI) and metabolic variables in patients with PAD. The second aim was to find the most significant humoral predictor of ABI. PATIENTS AND METHODS: The study groups consisted of 55 patients (36 men and 19 women) diagnosed with PAD (age 63.65 ± 6.11 years) and 34 control subjects (7 men, 27 women) of average age 59.88 ± 6.10 years with ABI > 0.9. Blood samples were analyzed for glycaemia, lipid profile and inflammatory markers (CRP, TNF-alpha and IL-6). RESULTS: A significantly higher serum total cholesterol (p = 0.04), triglycerides (p = 0.005) and lower HDL cholesterol (p < 0.0001) were found in the PAD group as compared to controls. Patients with PAD had significantly higher serum glucose (p = 0.008), CRP (p = 0.0044), IL-6 (p < 0.0001) and TNF-α (p < 0.0001) in comparison to controls. In a multiple linear regression analysis among variables log IL-6 and log HDL cholesterol were most significantly related to ABI (LW 4.75 for log IL-6, LW 4.016 for log HDL cholesterol, respectively, p < 0.01) in all subjects. CONCLUSIONS: We conclude that among traditional and humoral risk factors IL-6 is the strongest predictor of ABI. HDL cholesterol is also significant and strong predictor of decreased ABI and could be a potential biomarker of PAD in patients using lipid lowering drugs (Tab. 1, Ref. 31).

Environmental estrogen bisphenol A and autoimmunity.

Over the past few years, there has been evidence of the increasing prevalence of autoimmune diseases. Autoimmune diseases consist of many complex disorders of unknown etiology resulting in immune responses to self-antigens. The immune system, and its function, is under complex and integrated control and its disruption can be triggered by multiple factors. Autoimmunity development is influenced by multiple factors and is thought to be a result of interactions between genetic and environmental factors. Here, we review the role of a specific environmental factor, bisphenol A (BPA), in the pathogenesis of autoimmune diseases. BPA belongs to the group of environmental estrogens that have been identified as risk factors involved in the development of autoimmune diseases.

Nesidioblastosis in adults.

The persistent hyperinsulinemic hypoglycemia may be caused either by a solitary tumor of the pancreas secreting excessive amount of insulin, known as insulinoma or, rarely, by nesidioblastosis. Nesidioblastosis is a rare cause of persistent hyperinsulinemic hypoglycemia in adults. The incidence of nesidioblastosis in adults is unknown, but it is generally thought to be very low. The ß cell changes in adult nesidioblastosis suggest a dysregulation of the function of the cell. The cause of the functional dysregulation in adults is unknown. The pathogenesis of adult nesidioblastosis may be different from infantile congenital hyperinsulinism caused by a genetic effect. Histologically nesidioblastosis is almost always characterized by a proliferation of abnormal ß cells throughout the entire pancreas. Clinically and biochemically , it is not possible to distinguish between diffuse nesidioblastosis and insulinoma. If all highly selective noninvasive imaging techiques fail to identify a tumor, selective arterial calcium stimulation testing should be performed. The final diagnosis relies on the histopathologic evaluation. The treatment of adult nesidioblastosis is surgical resection of the pancreas.

Analysis of pheochromocytomas / paragangliomas from Eastern Slovakia.

This multi centre observational cohort study gives a view about the occurrence, clinical and laboratory presentation, localization, histological type and genetic background of pheochromocytoma (PHEO) and paraganglioma (PGL) in Eastern Slovakia. It included 28 patients (18 women + 10 men), of which 23 were diagnosed to have PHEO (82,1%) and 7 patients (25%) suffered from PGL with retroperitoneal, inguinal/pelvic and mediastinal distribution. Arterial hypertension was the major symptom present in 86 % with slight dominance of paroxysmal form (58%). In 3 cases (10,7%), the diagnosis was gained after differentiation of adrenal incidentaloma in asymptomatic patients. Five patients (17,8%) were classified to have malignant form of the disease. 9 patients (32,1%) were confirmed to have hereditary form - five of them (17,8%) with familiar medullar thyroid cancer (FMTC) and mutations in RET gene classified as multiple endocrine neoplasia 2A and 4 patients (14,3%) with germline mutations of SDHB gene, respectively. There was found a relatively high occurrence of other co-morbidities: thyroid disease in 20 patients (71,4%), impairment of glucose metabolism in 11 patients (39,3%) and apart from FMTC, 4 patients (14,3%) suffered also from other malignancy. Together with a bigger size of the primary tumor (6,6 cm), higher concentrations of metanephrines and prevalence of extra-adrenal tumors, malignant and hereditary forms, we suppose genetic and environmental factors of Eastern Slovakia may play a role in the etiopathogenesis of the tumors.

Adrenal metastases.

The adrenal gland is a frequent location for metastatic spread of a various number of malignant tumors. Among all tumors, carcinoma of lung, breast, ovary and malignant melanoma count to the most frequent ones. In nononcological and unselected populations, the prevalence of adrenal metastases is 0-21 %. The metastases are mostly discovered in patients during their follow-up carried out in consequence of their antecedent malignant disease. A malignant disease in adrenal gland may occasionally manifest as a solitary metastasis referred to as adrenal incidentaloma. If the malignant disease is disseminated at the time of adrenal mass diagnosis, no further differentiation of lesion is necessary as it does not influence the further therapeutic process. If the dissemination is not present, further differentiation of adrenal lesion is essential. CT and MRI characteristics of the adrenal mass play the key role in the differential diagnosis. The examination of adrenal overproduction is not necessary in case of known adrenal metastasis except when performing tests in order to rule out the catecholamine overproduction. In case of bilateral metastases, adrenal insufficiency should be also excluded. Surgical treatment is indicated in cases of solitary metastasis. The further management of patients with adrenal metastases belongs to the oncologist. The prognosis of the disease is usually very poor with average survival rate of three months (Fig. 2, Ref. 34).

Effect of growth hormone on bone status in growth hormone-deficient adults.

BACKGROUND: Growth hormone deficiency (GHD) is associated with reduced bone mineral content and increased risk of osteoporotic fractures. Reduced peak bone mass might explain the low bone mineral density (BMD) among patients with childhood onset GHD (CO-GHD) whilst the cause of osteopenia in adult-onset GHD (AO-GHD) is not fully understood. OBJECTIVES: Prospective multicentric study to asses bone status in GHD adults after two years of recombinant growth hormone replacement treatment. METHODS: In 94 GHD adults (49 men; Ø 34.5 yrs) we have measured BMD and bone markers (CTX, osteocalcin) during two years of rhGH treatment (at baseline, after 3 and 6 months, and after 1 and 2 years). Patients were adequately substituted for GHD and other pituitary deficiencies. RESULTS: We have observed an increase in BMD-lumbar spine: n=42, 0.8155 →0.9418 g/cm2, p<0.0001; femoral neck n=41; 0.8468 →0.9031; p= 0.0004; BMD-whole body 1.0179 →1.0774; p=0.0003. We have compared gender difference: BMD-L-spine by 15.8 % in men (n=21) and by 5.6 % in women (n=19) (p= 0.008); BMD-femoral neck increased by 11.03 % in men and by about 3.0 % in women (p=0.032). In women, the initial decrease in BMD was recorded after 3 months. CO-GHD adults yielded a higher increase in BMD -L-spine (16.6 %, p=0.022). A correlation exists between IGF-I levels and BMD in lumbar spine (1st year: R=0.348, p=0.026; 2nd year: R= 0.33, p=0.0081) and between IGF-I and osteocalcin (1st year: R=0.383; p=0.0038). CONCLUSION: Two-year therapy with recombinant human growth hormone improved bone status. IGF-I appears to be a good indicator of rhGH effect on bone (Tab. 3, Fig. 9, Ref. 36). Text in PDF www.elis.sk.

[The environmental estrogen bisphenol A and its effects on the human organism]. / Environmentálny estrogén bisfenol A a jeho úcinky na organizmus cloveka.

Bisphenol A (BPA), i.e. an environmental estrogen, is one of the most common synthetic chemicals which enter the human body from plastic bottles, food packaging and dental materials. As many studies show, a longterm exposure to BPA is connected with a risk of developing various diseases and endocrine disorders. Exposure to BPA, particularly during development, increases the risk of breast carcinoma, obesity, diabetes mellitus type 2 as well as reproductive disorders. It also increases the risk of testes carcinoma and prostate carcinoma. Some isolated studies support also the relation between BPA and the risk of cardiovascular and autoimmune diseases. The effect of other xenoestrogens, such as polychlorinated biphenyls, phthalates, dioxins, as well as others, is similar or perhaps even stronger. For the time being, however, the exact pathophysiologic mechanisms of these relations are not quite clear and require further experimental, but especially human, studies.

[Prevalence of hyponatremia in patients on department of internal medicine]. / Prevalencia hyponatriémie u hospitalizovaných na internej klinike.

INTRODUCTION: Hyponatremia is the most common electrolyte disorder detected by bio-chemical laboratories in the present time and interest about it increases because of new informations about its consequences. AIM: Objective of our work was to determine the prevalence of hyponatremia in patients hospitalized at clinic of internal medicine and to analyze its most common causes. PATIENTS AND RESULTS: The total number of hospitalized patients for a period of 6 months was 1,203. Severe hyponatremia, i.e. S Na < 130 mmol/ l was detected in 83 cases, i.e. 6.9% of all patients. 14 patients, i.e. 1.15% have more severe hyponatremia with S Na < 120 mmol/ l. The most common type of hyponatremia was hypervolemic hyponatremia (n = 41; 49.4%) associated with liver cirrhosis and hearth failure, less common was euvolemic hyponatremia (n = 28; 33.7%) and least common was hypovolemic hyponatremia (n = 14; 16.9%). The most common cause of euvolemic hyponatremia was syndrome of inappropriate antidiuretic hormone secretion (SIADH) and thiazide diure-tics therapy. Next to thiazide diuretics, other common cause of euvolemic hyponatremia, and so SIADH, was therapy by selective serotonin reuptake inhibitors (SSRI). CONCLUSION: The authors point out, that it is necessary to control serum sodium concentration on regular base in case of longterm therapy by thiazide diuretics or SSRI, especially in elderly patients.

[Hyponatraemia associated with the syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH) - options for treatment]. / Hyponatriémia pri syndróme neprimeranej sekrécie vazopresínu (SIADH) - moznosti liecby.

Hyponatremia is the most common electrolyte imbalance in outpatients and hospital inpatients and the syndrom of inappropriate secretion of antidiuretic hormone (SIADH) is one of the common causes of euvolemic hyponatremia. Recent studies showed significantly higher mortality and morbidity of hyponatriemic patients compared to normonatriemic controls. Moreover the morbidity and mortality of hyponatremic patients significantly increases in nontreated in comparison to those with the therapy. Clinical consequences of hyponatremia in SIADH could be devided according to stage of the disorder. The cerebral oedema with its symptoms (letargy, weakness, nausea, coma) is the most dangerous clinical feature. Clinical symptoms of hyponatremia also depend on how rapid the change of natremia is. Therefore the early diagnosis of disturbance and treatment are necessary. Not only acute but also chronic hyponatriemia must be treated. In the correction the restriction of water intake, loop diuretics (together with hypertonic solution of NaCl), demeclocyclin, urea and litium can be used. The blockers of vasopresin receptors - vaptans are perspective in treatment of patients with hyponatremia.

[An association between adiponectin and renal dysfunction in patients with type 2 diabetes mellitus]. / Adiponektín vo vztahu k oblickovej dysfunkcii u chorých s diabetes mellitus 2. typu.

INTRODUCTION: Adiponectin is a hormone of adipose tissue produced exclusively by adipocytes. According to recent studies its serum concentrations are negatively associated with obesity and diabetes mellitus type 2 (DM). The aim of the study was to clarify the relationship between renal functions and serum adiponectin in patients suffering from diabetic nephropathy. PATIENTS AND METHODS: The serum adiponectin levels were investigated in 120 patients and 40 controls. Patients in the diabetic group were divided according to albumin excretion rate into three groups - with normoalbuminuria (AER - albumin excretion rate/24 hod < 30 mg/24 h), with microalbuminuria (AER 30 300 mg/24 h) and with macroalbuminuria (AER > 300 mg/24 h). RESULTS: Serum adiponectin levels in diabetic group did not show any significant difference as compared with the control group. The highest concentrations of adiponectin were observed in patients with macroalbuminuria 24.22 ± 10.37 µg/ml (p < 0.0001) compared to those with normoalbuminuria and microalbuminuria, or control group, which was significant. Patients with normoalbuminuria 12.16 ± 5.3 µg/ml had the lowest concentrations of adiponectin. The univariate linear regression analysis revealed the negative correlation with BMI (r = -0.4, p < 0.0001) and glomerular filtration (r = -0.2, p < 0.05) and positive correlation with albuminuria (r = 0.5, p < 0.0001). Multiple linear regression confirmed that BMI and AER are independent predictive factors of adiponectin levels as well as that adiponectin and glomerular filtration are independent predictors of albuminuria. CONCLUSION: The beginning and progress of diabetic nephropathy play probably one of the most important roles in increased synthesis and excretion of adiponectin to blood circulation by diabetic patients with overt diabetic nephropathy. Key words: diabetes mellitus type 2 - adiponectin - obesity - diabetic nephropathy.

[Is polycystic ovary syndrome associated with autoimmune thyroiditis?]. / Je syndróm polycystických ovárií asociovaný s autoimunitnou tyreoiditídou?

INTRODUCTION: Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of fertile age and lately there is a discussion about its possible association with autoimmune diseases. The aim of the study was to examine incidence of autoimmune thyreoiditis (AIT) in PCOS women. PATIENTS AND METHODS: 64 PCOS patients were enrolled and 68 healthy menstruating women served as controls. All subjects were examined for thyrotropin (TSH), free thyroxin (fT4) and the presence as well as titers of antithyroid antibodies aTG (anti-thyreoglobulin) and aTPO (anti-thyreoperoxidase). RESULTS: There was no difference between PCOS and controls in average TSH levels (2.37 ± 1.46 mIU/l vs 2.37 ± 1.46 mIU/l) (p = 0.953), and fT4 levels (16.36 ± 5.34 pmol/l vs 16.49 ± 2.32 pmol/l) (p = 0.852). Autoantibodies titers were also non-significant aTG (53.09 ± 157.07 IU/ml vs 29.8 ± 100.77 IU/ml, p = 0.386) and aTPO (59.74 ± 149.03 IU/ml vs 45 ± 204.77 IU/ml, p = 0.805). However, PCOS women had significantly higher prevalence of aTPO (18.75 vs 7.35%, p = 0.045). On the other hand, the overall prevalence of AIT was similar in both groups. CONCLUSION: Our results show PCOS patients have slightly but significantly higher positivity of aTPO antibodies but the prevalence of AIT was insignificant.

Celiac disease manifested during the treatment of chronic hepatitis C by pegylated alpha interferon and ribavirin.

Authors report a case of patient suffering from haemophilia A and hepatitis C virus infection acquired probably after blood transfusions and substitution factors application. He was treated with pegylated interferon alpha and ribavirin, with the development of malabsorption symptoms during the therapy. Celiac disease was established by histological, histochemical and serological examinations. oth, interferon alpha and ribavirin treatment as well as virus of hepatitis C may trigger coeliac disease in genetically predisposed individuals. The immunological mechanism of celiac disease include balance disruption between Th1 and Th2 immunological response with Th1 predominance. Only few similar cases have been published in the professional literature to date. Development of celiac disease during interferon alpha therapy with haemophilia A was not published until now (Fig. 3, Ref. 13).

Pulmonary administration of activated recombinant factor VII.

Diffuse alveolar haemorrhage (DAH) is a serious pulmonary complication seen in patients with autoimmune disorders and patients treated with chemotherapy or after hematopoietic stem cell transplantation. The clinical management of DAH is complex and the condition has a high mortality rate. During inflammation, tissue factor is expressed in the lung alveoli and therefore pulmonary administration of human recombinant activated factor VIIa (rFVIIa) could be a rational treatment option (4.1). A case report of the patient with an acute, bronchoscopically confirmed DAH from intensive care unit university hospital is described. The patient was treated by the intrapulmonary administration of 50 microg/kg rFVIIa in 50 ml of 0.9% sodium chloride; 25 ml into each of the main bronchi. An excellent response, defined as complete and sustained haemostasis after a single dose of rFVIIa was achieved. The oxygenation capacity, as reflected by the paO2/FiO2 (arterial oxygen pressure/inspiratory fractional oxygen content) ratio, decreased immediately after the bronchoscopy and the local rFVIIa instillation, but the following course of the patient's illness was favourable. Symptomatic therapy--intrapulmonary administration of one dose of rFVIIa was found to have an excellent haemostatic effect in the patient with DAH. The intrapulmonary administration of rFVIIa seemed to have a high benefit-to-risk ratio. These findings warrant further exploration (Ref. 12).

[Evaluating of quality of life and functional status in patients with rheumatoid arthritis]. / Hodnotenie kvality zivota a funkcného stavu u pacientov s reumatoidnou artritídou.

There is a growing worldwide interest for more information regarding morbidity and especially chronic diseases as well as the economical burden which it creates for the disabled individual and the society as a whole. Recently, increased attention has been paid to the scientific assessment of quality of life in chronically ill. Measures of physical and other abilities have shown a great prognostic value regarding disease outcomes. Rheumatoid arthritis (RA) is a chronic, progressive, systemic inflammatory disease which negatively influences quality of life of patients. In rheumatology quality of life is assessed with two types of instruments: generic and specific. Current research has shown that specific measures are more sensitive to treatment induced changes in comparison with the generic measures. However, the choice of an instrument largely depends on the specific goal of the study. Both types of measures have shown strengths and weaknesses and they have been used simultaneously in order to provide a complex evaluation of quality of life.

Is Apelin a new biomarker in patients with polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is associated with multiple risk factors for cardiovascular diseases, including insulin resistance, diabetes mellitus type 2, obesity, hypertension, and dyslipidaemia. Many studies have assessed the role of adipokines in the etiopathogenesis of PCOS, however, no single biomarker has been recognized to be in causal relation to the syndrome. Apelin has been identified as a new adipokine linked to obesity and insulin resistance. Some studies demonstrated that the apelin / apelin receptor could play a pivotal role in the pathogenesis of polycystic ovary syndrome, however the other yielded controversial results. Underlying mechanisms of possible involvement of apelin/apelin receptor complex are discussed.

The Association Between Three Adipocytokines (Adiponectin, Resistin and Visfatin) And Thyroid Status in Patients With Type 2 Diabetes Mellitus and Autoimmune Thyroiditis.

Autoimmune thyroiditis (AIT) and type 2 diabetes mellitus (DM2) are the most common endocrinological diseases worldwide. Relation between these diseases explains several hypotheses. One of them is influence of some adipocytokines. This study evaluated association between three adipocytokines (adiponectin, resistin and visfatin) and thyroid and glycid status in patients with DM2 and AIT compared to the control group (CG). The group consisted of four subgroups: patients with DM2 without thyreopathies, patients with AIT on substitution therapy without diabetes and prediabetes, patients with DM2 and AIT on substitution therapy and healthy subjects as the CG. We investigated parameters of thyroid and glucose metabolism and serum levels of three adipocytokines. The mean level of resistin in the group of patients with diabetes and thyroiditis was significantly higher than in patients with thyroiditis without diabetes and than in the CG. We found a weak negative correlation between visfatin and fasting glucose levels in patients with thyroiditis without diabetes. We detected a weak negative correlation between resistin and glycated haemoglobin and a weak negative correlation between visfatin and thyroid gland volume in patients with diabetes without thyroiditis. In the CG we determined a weak positive correlation between visfatin and free thyroxin. Our results are consistent with several studies, which confirmed association between AIT and adipocytokines.