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Endocrine Abstracts (2015) 37 EP363 | DOI: 10.1530/endoabs.37.EP363

Department of Internal Medicine and Diabetology, University of Medical Science, Poznan, Poland.


Background: Larger thyroid volume and nodular thyroid disease were found to be associated with insulin resistance (IR) in patients with type 2 diabetes (T2DM). Similar analyses is lacking in T1DM.

Aims: To check the association between thyroid volume and IR using estimated glucose disposal rate (eGDR) in patients T1DM.

Materials and methods: We included 99 consecutive patients with T1DM aged 29 (mean, S.D.=6) with diabetes duration 13 (6) years. Exclusion criteria were: history of thyroid disease, current treatment of L-thyroxine or anti-thyroid drugs. Anti-thyroid peroxidase (ATPO), anti-thyroglobulin (ATg) antibodies, and anti-TSH receptor antibodies (TRAb) were determined. Assays for TSH and free thyroid hormones (trijodothyronine, fT3, and thyroxine (fT4)) were also performed. Thyroid was measured using ultrasonography. IR was assessed using eGDR, calculated according to the formula (24.4−12.97×WHR−3.39×HT−0.60×HbA1c), where WHR -waist-to-hip ratio and HT – history of hypertension (yes=1 and no=0).

Results: The prevalence of thyroid autoimmunity (positivity for ATPO, ATg, or TRAb) in the study group was 31%. Subclinical hypothyroidism was diagnosed in 7%, and overt hypothyroidism in 2% of patients. Mean (S.D.) thyroid volume was 15.6 (6.2) ml in patients with eGDR ≤7.5 (patients with IR) and 11.7 (4.7) ml in patients with eGDR above 7.5 (P=0.002). Thyroid volume correlated inversely with eGDR (r=−0.35, P<0.001). In multivariate linear regression model association between thyroid volume and eGDR was independent from sex, duration of diabetes, BMI, TSH, and presence of thyroid autoimmunity (β: −0.22, P=0.025).

Conclusion: Lower insulin sensitivity is associated with larger thyroid volume in patients with T1DM independently from BMI and signs of autoimmune thyroid disease.

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