Display options
Cite
Guarnotta V, Pillitteri G, Gambino G, et al. Levothyroxine and insulin requirement in autoimmune polyglandular type 3 syndrome: a real-life study. J Endocrinol Invest. 2020;44(7):1387-1394doi: 10.1007/s40618-020-01421-3.
Guarnotta, V., Pillitteri, G., Gambino, G., Radellini, S., Vigneri, E., Pizzolanti, G., & Giordano, C. (2021). Levothyroxine and insulin requirement in autoimmune polyglandular type 3 syndrome: a real-life study. Journal of endocrinological investigation, 44(7), 1387-1394. https://doi.org/10.1007/s40618-020-01421-3
Guarnotta, V, et al. "Levothyroxine and insulin requirement in autoimmune polyglandular type 3 syndrome: a real-life study." Journal of endocrinological investigation vol. 44,7 (2021): 1387-1394. doi: https://doi.org/10.1007/s40618-020-01421-3
Guarnotta V, Pillitteri G, Gambino G, Radellini S, Vigneri E, Pizzolanti G, Giordano C. Levothyroxine and insulin requirement in autoimmune polyglandular type 3 syndrome: a real-life study. J Endocrinol Invest. 2021 Jul;44(7):1387-1394. doi: 10.1007/s40618-020-01421-3. Epub 2020 Oct 24. PMID: 33099763; PMCID: PMC8195810.
Copy Download .nbib Format: NLM
Share it on

J Endocrinol Invest. 2021 Jul;44(7):1387-1394. doi: 10.1007/s40618-020-01421-3. Epub 2020 Oct 24.

Levothyroxine and insulin requirement in autoimmune polyglandular type 3 syndrome: a real-life study.

Journal of endocrinological investigation

V Guarnotta, G Pillitteri, G Gambino, S Radellini, E Vigneri, G Pizzolanti, C Giordano

Affiliations

  1. Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza "G. d'Alessandro" (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy.
  2. Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza "G. d'Alessandro" (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy. [email protected].
  3. Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza "G. d'Alessandro" (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy. [email protected].

PMID: 33099763 PMCID: PMC8195810 DOI: 10.1007/s40618-020-01421-3

Abstract

PURPOSE: To evaluate factors influencing the insulin and levothyroxine requirement in patients with autoimmune polyglandular syndrome type 3 (APS-3) vs. patients with type 1 diabetes mellitus (T1DM) and autoimmune hypothyroidism (AH) alone, respectively.

METHODS: Fifty patients with APS-3, 60 patients with T1DM and 40 patients with AH were included. Anthropometric, clinical and biochemical parameters were evaluated in all patients. Insulin requirement was calculated in patients with APS-3 and T1DM, while levothyroxine requirement was calculated in APS-3 and AH.

RESULTS: Patients with APS-3 showed higher age (p = 0.001), age of onset of diabetes (p = 0.006) and TSH (p = 0.004) and lower total insulin as U/day (p < 0.001) and U/Kg (p = 0.001), long-acting insulin as U/day (p = 0.030) and U/kg (p = 0.038) and irisin (p = 0.002) compared to T1DM. Patients with APS-3 had higher waist circumference (p = 0.008), duration of thyroid disease (p = 0.020), levothyroxine total daily dose (p = 0.025) and mcg/kg (p = 0.006), triglycerides (p = 0.007) and VAI (p = 0.010) and lower age of onset of thyroid disease (p = 0.007) than AH. At multivariate analysis, levothyroxine treatment and VAI were associated with insulin and levothyroxine requirement in APS-3, respectively. VAI was independently associated with insulin requirement in T1DM. Circulating irisin levels were independently associated with levothyroxine requirement in AH.

CONCLUSION: Patients with APS-3 show lower insulin requirement and higher levothyroxine requirement than T1DM and AH alone, respectively. Levothyroxine treatment and VAI affect insulin and levothyroxine requirement, respectively, in APS-3. In T1DM, adipose tissue dysfunction, indirectly expressed by high VAI, is associated with an increased insulin requirement, while circulating irisin levels influence the levothyroxine requirement in AH.

Keywords: Autoimmune hypothyroidism; Cardiovascular risk; Irisin; Type 1 diabetes mellitus; Visceral adiposity index

References

  1. Am J Physiol. 1985 May;248(5 Pt 1):E593-601 - PubMed
  2. Diabetes Care. 2020 Jan;43(Suppl 1):S14-S31 - PubMed
  3. J Int Med Res. 2019 Apr;47(4):1592-1601 - PubMed
  4. Biomed Res Int. 2016;2016:6219730 - PubMed
  5. J Clin Endocrinol Metab. 2011 Jul;96(7):2206-15 - PubMed
  6. Endocrinology. 1997 Mar;138(3):1204-14 - PubMed
  7. Peptides. 2014 Oct;60:51-5 - PubMed
  8. Nature. 2012 Jan 11;481(7382):463-8 - PubMed
  9. N Engl J Med. 2005 Dec 22;353(25):2643-53 - PubMed
  10. An Pediatr (Barc). 2006 Jun;64(6):583-7 - PubMed
  11. Ann Intern Med. 1982 Jan;96(1):53-5 - PubMed
  12. Diabetes Care. 2010 Apr;33(4):920-2 - PubMed
  13. Am J Physiol. 1989 Jan;256(1 Pt 1):E159-66 - PubMed
  14. Diabetes Care. 2015 Aug;38(8):1615-21 - PubMed
  15. Int J Endocrinol. 2018 Jun 14;2018:2861034 - PubMed
  16. Diabetes Ther. 2019 Jun;10(3):773-789 - PubMed
  17. Cell Metab. 2014 Feb 4;19(2):302-9 - PubMed
  18. J Thyroid Res. 2011;2011:152850 - PubMed
  19. J Endocrinol Invest. 2020 Feb;43(2):157-162 - PubMed
  20. J Endocrinol Invest. 2013 Jul-Aug;36(7):537-43 - PubMed
  21. World J Diabetes. 2015 Feb 15;6(1):67-79 - PubMed
  22. Endocrinology. 1994 Aug;135(2):649-54 - PubMed
  23. Diabetol Int. 2018 Mar 9;9(2):108-112 - PubMed
  24. Eur J Endocrinol. 2008 Apr;158(4):543-9 - PubMed
  25. J Clin Endocrinol Metab. 2005 Jan;90(1):124-7 - PubMed
  26. Lancet. 1997 Nov 22;350(9090):1505-10 - PubMed
  27. Nat Rev Endocrinol. 2017 Jun;13(6):324-337 - PubMed
  28. PLoS One. 2014 Mar 20;9(3):e91969 - PubMed
  29. Endocr Rev. 2019 Jun 1;40(3):789-824 - PubMed
  30. J Pharmacol Pharmacother. 2012 Apr;3(2):156-60 - PubMed
  31. Dtsch Med Wochenschr. 1999 Dec 10;124(49):1476-81 - PubMed
  32. Endocr Rev. 2019 Feb 1;40(1):118-136 - PubMed
  33. Clin Biochem Rev. 2005 May;26(2):19-39 - PubMed
  34. Mini Rev Med Chem. 2008 Jan;8(1):91-6 - PubMed
  35. J Clin Diagn Res. 2014 Feb;8(2):70-2 - PubMed
  36. Am J Physiol. 1984 Nov;247(5 Pt 1):E681-7 - PubMed
  37. J Diabetes Res. 2013;2013:390534 - PubMed
  38. Biochem Biophys Res Commun. 2010 Mar 12;393(3):526-30 - PubMed
  39. Diabetes. 2014 Feb;63(2):514-25 - PubMed
  40. J Endocrinol Invest. 2018 Jan;41(1):91-98 - PubMed
  41. Am J Vet Res. 2008 Jan;69(1):76-81 - PubMed
  42. Postgrad Med. 1993 Jan;93(1):249-52, 255-6, 260-2 - PubMed
  43. Eur J Pediatr. 2005 Feb;164(2):73-9 - PubMed
  44. J Endocrinol Invest. 2012 Apr;35(4):384-8 - PubMed

Publication Types