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master's thesis
The association between thyroid parameters and insulin resistance in patients with autoimmune thyroid disease
Split: University of Split, School of Medicine, 2022. urn:nbn:hr:171:481303
Kastner, Paul Philipp
University of Split
School of Medicine

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Kastner, P. P. (2022). The association between thyroid parameters and insulin resistance in patients with autoimmune thyroid disease (Master's thesis). Split: University of Split, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:171:481303

Kastner, Paul Philipp. "The association between thyroid parameters and insulin resistance in patients with autoimmune thyroid disease." Master's thesis, University of Split, School of Medicine, 2022. https://urn.nsk.hr/urn:nbn:hr:171:481303

Kastner, Paul Philipp. "The association between thyroid parameters and insulin resistance in patients with autoimmune thyroid disease." Master's thesis, University of Split, School of Medicine, 2022. https://urn.nsk.hr/urn:nbn:hr:171:481303

Kastner, P. P. (2022). 'The association between thyroid parameters and insulin resistance in patients with autoimmune thyroid disease', Master's thesis, University of Split, School of Medicine, accessed 13 May 2024, https://urn.nsk.hr/urn:nbn:hr:171:481303

Kastner PP. The association between thyroid parameters and insulin resistance in patients with autoimmune thyroid disease [Master's thesis]. Split: University of Split, School of Medicine; 2022 [cited 2024 May 13] Available at: https://urn.nsk.hr/urn:nbn:hr:171:481303

P. P. Kastner, "The association between thyroid parameters and insulin resistance in patients with autoimmune thyroid disease", Master's thesis, University of Split, School of Medicine, Split, 2022. Available at: https://urn.nsk.hr/urn:nbn:hr:171:481303

Metadata
TitleThe association between thyroid parameters and insulin resistance in patients with autoimmune thyroid disease
Title (croatian)Povezanost parametara štitnjače i inzulinske rezistencije u bolesnika s autoimunom bolešću štitnjače
AuthorPaul Philipp Kastner
MentorSigrun Renate Merger (mentor)
Committee memberJohannes Brachmann (predsjednik povjerenstva)
Committee memberJoško Božić (član povjerenstva)
Committee memberMarino Vilović (član povjerenstva)
GranterUniversity of Split
School of Medicine
Split
Defense date and country2022, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
Abstract
Objectives: Our main goal was to observe associations between laboratory thyroid parameters free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating-hormone (TSH), thyroid peroxidase antibodies (TPOAbs), thyroglobulin antibodies (TgAbs), deiodinase activity (SPINA-GD), thyrotroph thyroid resistance index (TTSI), thyroid stimulating hormone index (TSHI), and the homeostatic model assessment of insulin resistance (HOMA-IR). We were particularly interested in comparing these relationships in patients with and without autoimmune thyroid disease. A secondary intention was to examine possible influences connected to the prevalence of low fT3 serum levels in our patient collective, especially due to our suspicion of fT3 serum level alterations in autoimmune thyroid patients. Patients and methods: This cross-sectional study was performed retrospectively in a patient collective of 179 mostly German participants, featuring 25 males and 154 females. The distribution of thyroid autoimmune status vs. non-autoimmune status was fairly equal. Most patients have been in a euthyroid state, a large part under current LT4 substitution therapy. We directly compared differences in laboratory parameters in our different subgroups and also examined linear relationships by the use of regression models. Results: Two-tailed significant differences could be shown for lower serum fT3 levels, lower SPINA-GD, as well as lower fT3/fT4 in autoimmune thyroid patients. We also observed lower fT3 levels in postmenopausal females and showed the linear inverse relationship between fT3 and age. We were able to identify BMI, regular alcohol consumption, and male gender as significant predictors for higher HOMA-IR values in our study population. Furthermore, we showed linear relationships between fT3 serum levels and insulin as well as and HOMA-IR. We also identified LT4 substitution therapy as being the main negative predictor for SPINAGD. Conclusion: Thyroid autoimmune disease is a significant predictor for the prevalence of fT3 serum levels below 3 pg/ml, while LT4 substitution therapy is a significant predictor for the reduced activity of peripheral deiodinases. FT3 serum level is the most significant predictor of basic thyroid parameters towards HOMA-IR and insulin levels. Targeted prospective studies need to follow to evaluate on associations found in our study.
Abstract (croatian)
Ciljevi: Naš glavni cilj bio je promatrati povezanost između laboratorijskih parametara štitnjače slobodni trijodtironin (fT3), slobodni tiroksin (fT4), hormon koji stimulira štitnjaču (TSH), antitijela na peroksidazu štitnjače (TPOAbs), antitijela na tireoglobulin (TgAbs), aktivnost dejodinaze (SPINA-GD), tireotrof indeks otpornosti štitnjače (TTSI), indeks hormona stimulirajućeg štitnjače (TSHI), i homeostatskog modela procjene inzulinske rezistencije (HOMA-IR). Posebno nas je zanimala usporedba tih odnosa u bolesnika s i bez autoimune bolesti štitnjače. Sekundarna namjera bila je ispitati moguće utjecaje povezane s prevalencijom niske razine fT3 u serumu kod naše skupine pacijenata, posebno zbog sumnje na promjene razine fT3 u serumu u autoimunih bolesnika štitnjače. Pacijenti i metode: Ova presječna studija provedena je retrospektivno na skupini od 179 pacijenata, uglavnom njemačkih sudionika, uključujući 25 muškaraca i 154 žene. Distribucija autoimunog statusa štitnjače u odnosu na ne-autoimuni status bila je prilično jednaka. Većina pacijenata bila je u eutireoidnom stanju, velikim udjelom pod supstitucijskom terapijom LT4 u tom trenutku. Izravno smo usporedili razlike laboratorijskih parametara naših različitih podskupina te smo također ispitali linearne odnose korištenjem regresijskih modela. Rezultati: Mogle su se vidjeti dvostrane značajne razlike kod nižih razina fT3 u serumu, niži SPINA-GD, kao i niži fT3/fT4 u pacijenata s autoimunom bolesti štitnjače. Također smo primijetili niže razine fT3 kod žena u postmenopauzi i pokazali smo linearni inverzni odnos između fT3 i dobi. Uspjeli smo izdvojiti BMI, redovitu konzumaciju alkohola i muški spol kao značajne predispozicije za više vrijednosti HOMA-IR u našoj studijskoj populaciji. Nadalje, pokazali smo linearne odnose između serumskih razina fT3 i inzulina kao i HOMA-IR. Također smo izdvojili supstitucijsku terapiju LT4 kao glavnu negativnu predispoziciju za SPINA-GD. Zaključci: Autoimuna bolest štitnjače značajan je predznak prevalencije serumskih razina fT3 ispod 3 pg/ml, dok je supstitucijska terapija LT4 značajan predznak smanjene aktivnost perifernih dejodinaza. Razina fT3 u serumu najznačajniji je predznak osnovnih parametara štitnjače prema razinama HOMA-IR i inzulina. Ciljane studije o mogućnostima bi trebale slijediti kako bi se procijenile povezanosti pronađene u našoj studiji.
Keywords
Keywords (croatian)
Languageenglish
URN:NBNurn:nbn:hr:171:481303
Study programmeTitle: Medical Studies in English
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2022-07-19 07:58:32