Higher free triiodothyronine concentration is associated with lower prevalence of microangiopathic complications and bet
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ORIGINAL ARTICLE
Higher free triiodothyronine concentration is associated with lower prevalence of microangiopathic complications and better metabolic control in adult euthyroid people with type 1 diabetes Bogusz Falkowski 1 Anita Rogowicz-Frontczak1 Agata Grzelka1 Aleksandra Uruska1 Judyta Schlaffke1 Aleksandra Araszkiewicz1 Dorota Zozulinska-Ziolkiewicz1 ●
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Received: 15 January 2018 / Accepted: 9 March 2018 © The Author(s) 2018
Abstract Purpose Type 1 diabetes mellitus (T1DM) is a disorder of insulin deficiency but with a wide range of hormones simultaneously disturbed. The study was performed to explore relation of free triiodothyronine (FT3) with metabolic control and occurrence of microangiopathic complications. Methods A total of 266 adult T1DM participants [56% men; 32 (interquartile range, IQR: 25–39) years and disease duration 13 (IQR: 8–19) years] in euthyroid state with negative history for hypothyroidism were included to the study. Participants were screened for thyroid-stimulating hormone (TSH), free thyroxine (FT4) and FT3. Moreover, microangiopathic complications (retinopathy, diabetic kidney disease, peripheral and autonomic neuropathy), markers of metabolic control such as glycated hemoglobin (HbA1c) were evaluated. Results A total of 114 (42.9%) people had diagnosed at least one microangiopathic complication. In multivariable linear regression higher HbA1c was statistically significant independent predictor of lower FT3 (β = −0.25; p < 0.0001) after adjustment for sex, T1DM duration, HbA1c, waist-to-hip ratio (WHR) (R2 = 0.15, p < 0.0001). Higher FT3 was simultaneously a predictor of lower prevalence of microangiopathy in multivariate logistic regression analysis (odds ratio, 0.51; 95% confidence interval, 0.27–0.98; p = 0.04) after an adjustment for: age, hypertension, HbA1c, WHR and total cholesterol (TC). Conclusions FT3 as tissue active hormone plays a clinically important role in T1DM people. The higher FT3 concentration is related to the lower prevalence of microangiopathy and better metabolic control of the disease in adult euthyroid people with T1DM. Keywords FT3 Free triiodothyronine Type 1 diabetes mellitus Microangiopathic complications Euthyroid sick syndrome Glycated hemoglobin ●
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Introduction Thyroid hormones are crucial for energy homeostasis and regulation of metabolism pace. They affect metabolism both centrally in connection with the hypothalamus and peripherally through key targets, such as the brown and white
* Bogusz Falkowski [email protected] 1
Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Mickiewicza 2, Poznan 60-834, Poland
adipose tissue, the liver, muscles and pancreatic β-cells. Almost every major biochemical process, related to energy distribution in the human organism, such as lipogenesis, lipolysis, gluconeogenesis, glucose handling, insulin resistance, is affected by thyroid hormones [1]. In the current literature, there are not a lot of studies assessing
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