Abstract
Aim. The number of patients with endocrine disorders in the world, in particular, Graves’ disease is continuously increasing. Recent studies have determined the fact of insulin resistance in thyroid disorders. On the one hand, numerous researches prove correlation of hypothyroidism with arterial hypertension, ischaemic heart disease and lipid metabolism disorder, on the other – carbohydrate metabolism disorder and hyper-sympathicotonia are closely associated with hyperthyroidism. The subject of the research was to study the correlation of insulin resistance, lipid and carbohydrate metabolism indices in patients with Graves’disease. Material and Methods. During the study 53 (37 female and 16 male) patients with Graves’ disease with noticed IR have been examined. At the beginning, after 3– and 6-months thyreostatic therapy with insulin sensitizers (metformin or pioglitazone) the following investigations have been performed: assessing thyroid-stimulating hormone levels, free thyroxine and triiodothyronine; assessing glycated haemoglobin, glucose, C-peptide and fasting insulin as primary IR markers; calculating НОМА-IR index for analysing tissue sensitivity to insulin; calculating НОМА-β index for evaluating the functional capacity of β-cells of islets of Langerhans; measuring Caro indices to monitor hyperinsulinemia, measuring total cholesterol level, low-density lipoproteins, very-low-density lipoproteins, high-density lipoproteins , triglycerides, for analysing IR in relation to lipid metabolism. Results. The research results found out that free thyroid hormones and thyroid-stimulating hormone are closely related to lipid metabolism. Thus, thyroid-stimulating hormone was characterized as having direct correlation with low-density lipoproteins, while the free thyroxine inversely correlated with total cholesterol, low-density lipoproteins, and high-density lipoproteins. The free triiodothyronine negatively correlated with high-density lipoproteins. The research has also determined the direct correlation between insulin and free thyroxine, as well as free triiodothyronine in patients with diffuse toxic goitre. Conclusions. The study proves the presence of insulin resistance in patients with Graves’ disease that generates interest to further study of the changes in insulin sensitivity, relation of insulin resistance to thyroid-stimulating hormone, thyroid hormones and looking for the ways to correct these disorders.
Highlights
The number of patients with endocrine disorders in the world, in particular, Graves’ disease is continuously increasing [1, 2]
The following fact has been noticed: thyroid-stimulating hormone levels (TSH) directly correlated with low-density lipoproteins (LDL) (r=0,201), on the contrary FТ4 inversely correlated with the free cholesterol (r=–0,267), LDL (r=–0,241), and high-density lipoproteins (HDL) (r=–0,209)
TSH was characterized as having direct correlation with low-density lipoproteins, while the free thyroxine inversely correlated with total cholesterol, low-density lipoproteins and high-density lipoproteins, and free triiodothyronine negatively correlated with high-density lipoproteins
Summary
The number of patients with endocrine disorders in the world, in particular, Graves’ disease is continuously increasing [1, 2]. For the last 5 years, the incidence of endocrine disorders in Ukraine has increased by 13 % and the number of patients registered with thyrotoxicosis annually increases by 5 %, which is significantly higher than the world and European indices [3]. By “insulin resistance” (IR) we traditionally mean the altered tissue response to endogenous insulin, that is manifested by impaired glucose uptake in the adipose tissue and skeletal muscles, as well as suppression of hepatic gluconeogenesis [4]. Numerous researches prove the correlation of hypothyroidism with arterial hypertension, ischaemic heart disease and lipid metabolism disorder, on the other – carbohydrate metabolism disorder and hyper-sympathicotonia are closely associated with hyperthyroidism [5]
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