Endocrine Abstracts (2002) 3 P102

Comparison of effect of insulin in hypothyroidism and after the thyroid hormone therapy

S Stanická1, K Vondra1, T Pelikánová2, P Vlèek3, J Nìmec3, Z Masek1, J Skibová2 & V Zamrazil1


1Institute of Endocrinology, Prague, Czech Republic; 2Institute for Clinical and Experimental Medicine, Prague, Czech Republic; 3Faculty Teaching Hospital Motol, Prague, Czech Republic.


The influence of the hypothyroidism (H) on the glucose metabolism (GM) has not been studied by modern methods till now. We described the changes in the effect of insulin on GM in patients in artificial H and after the thyroid hormone therapy (T).

Materials and Methods: We have investigated 15 female patients (age 32.8 plus/minus 8.1 years) in H (ssTSH 84.45 plus/minus 19.69 milli international units per litre; fT4 1.68 plus/minus 0.77 picomoles per litre; BMI 24.56 plus/minus 3.00 kilograms per meter 2; fasting glucose 4.47 plus/minus 0.40 millimoles per litre; HbA1c 5.80 plus/minus 0.94 percent) and again following T (ssTSH 0.05 plus/minus 0.09 milli international units per litre; fT4 23.49 plus/minus 3.94 picomoles per litre; BMI 23.93 plus/minus 3.30 kilograms per meter 2; fasting glucose 4.91 plus/minus 0.49 millimoles per litre; HbA1c 5.38 plus/minus 0.60 percent). The effect of insulin was evaluated by the metabolic glucose clearence (MCRg) during a hyperinsulinaemic euglycaemic (5 millimoles per litre) clamp in period 90-120 minute. The results were statistically evaluated using the Wilcoxon paired test.

Results: The effect of insulin was significantly lower in patients in H with the normal level of fasting glucose and HbA1c than in patients following T. That was evaluated using MCRg (6.04 plus/minus 1.27 to 9.49 plus/minus 3.39 millilitres per (kilogram times minute), p<0.01).

Conclusion: We conclude that the hypothyroidism leads to the significant reduction of the effect of insulin on the metabolic glucose clearence.

Supported by the research intention of the Institute of Endocrinology MZ: 000000023761. The study protocol was in accordance with the Bioethical convention.

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