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Background The association of autoimmune thyroid disease (AITD) with diabetes mellitus (DM) type 1 (DM1) has been previously documented. However, there is paucity of data regarding the association of AITD and DM type 2 (DM2). The aim of the study was to shed light on the role of AITD on DM2, we studied the impact of AITD in euthyroid patients with pre-diabetes. Methods Euthyroid pre-diabetic patients were defined by impaired fasting glucose (IFG) (≥100mg/dl) and/or glucose intolerance (IGT) [glucose 120min post-oral glucose tolerance test (OGTT) ≥140mg/dl]. We assessed static and dynamic insulin resistance (IRI) and insulin secretion indices (ISI), and the disposition index (DI). Age, gender, waist circumference, waist-to-height ratio, body mass index, anti-hypertensive and hypolipidemic treatment were recorded. Results Out of 166 patients studied (132 females) 53 (31.9%) had AITD; IFG prevalence was similar to non-AITD patients (92.2% versus 94.3%, p=0.55). In contrast, IGT was less prevalent in AITD compared to non-AITD patients (9.4% versus 28.3%, p=0.008). IRI did not differ between the two groups. The dynamic ISI: area under the curve (AUC) of insulin-to-glucose ratio (IncAUCins/glu), 1 st -phase and 2 nd -phase insulin release, and the DI showed a worse insulin secretion in non-AITD compared to AITD patients [0.54 (0.49, 0.2-2.42) versus 0.45 (0.41, 0.09-2.07), p = 0.029; 1029.3 (837.1, 323-2614.2) versus 864.3 (826.9, -282.5-2772.5), p=0.033; 354.8 (268.4, 132.8-851.1) versus 286.5 (254.7, 24.7-906.3), p=0.035; 0.09 (0.09, 0.006-0.55) versus 0.07 (0.06, -0.01-0.51), p=0.02, respectively]. On the other hand, hsCRP was higher in AITD versus non-AITD individuals [2.8 (5, 0-16) versus 1.2 (3, 0-13), p=0.008]. Conclusion Although individuals with prediabetes and AITD presented with higher levels of low-grade inflammation, their dynamic ISI and the DI, were less impaired, implying a better dynamic insulin secretion in patients with established abnormality of carbohydrate metabolism who carry an additional autoimmune metabolic component. |
