Advances in Clinical and Experimental Medicine
2014, vol. 23, nr 6, November-December, p. 913–918
Publication type: original article
The Effects of Thyroid Dysfunctions on Insulin Resistance in Patients with Hepatosteatosis
1 Department of Internal Medicine, Numune Training and Research Hospital, Adana, Turkey
Background. Hepatosteatosis can develop due to insulin resistance. The effect of thyroid function status on insulin sensitivity and resistance is of great interest but the data is still conflicting.
Objectives. The aim of this study was to evaluate the effects of thyroid dysfunctions on insulin resistance in patients with hepatosteatosis.
Material and Methods. A total of 407 patients with hepatosteatosis were divided into three groups: 102 subjects with hypothyroidism, 103 with hyperthyroidism and 202 with normal thyroid function (control group). We measured serum thyroid stimulating hormone (TSH), free T4 (FT4) and free T3 (FT3) concentrations, blood glucose and insulin levels, serum lipid levels, hepatic transaminases and the homeostasis model assessment of insulin resistance (HOMA IR).
Results. Neither hypothyroidism patients nor hyperthyroidism patients showed significant differences in HOMA IR, glucose and insulin levels (p > 0.05 for each). The frequency of insulin resistance was similar in all groups (p > 0.05).
Conclusion. Based on our findings, hypothyroidism and hyperthyroidism are not correlated to insulin resistance in patients with hepatosteatosis. Different causes which are associated with insulin resistance should be investigated in patients with thyroid dysfunction and hepatosteatosis.
insulin resistance, hepatosteatosis, hypothyroidism, hyperthyroidism.
- Powers AC: Diabetes Mellitus. In: Harrison’s principles of internal medicine. Eds.: Longo DL et al., Mc Graw Hill, New York 2012, 18th ed., 2972–2975.
- Singh Bhawna M, Goswami B, Mallika V: Association between insulin resistance and hypothyroidism in females attending a tertiary care hospital. IJCB 2010, 25, 141–145.
- Gastaldelli A, Cusi K, Pettiti M, Hardies J, Miyazaki Y, Berria B, Buzzigoli E, Sironi AM, Cersosimo E, Ferrannini E, Defronzo RA: Relationship between hepatic/visceral fat and hepatic insulin resistance in nondiabetic and type 2 diabetic subjects. Gastroenterology 2007, 133, 496.
- Reaven GM: Banting lecture. Role of insulin resistance in human disease. Diabetes 1988, 37, 1595–1607.
- Dimitriadis GD, Raptis SA: Thyroid hormone excess and glucose intolerance. Exp Clin Endocrinol Diabetes 2001, 109, 225–239.
- Dimitriadis G, Baker B, Marsh H, Mandarino L, Rizza R, Bergman R, Haymond M. Gerich J: Effect of thyroid hormone excess on action, secretion, and metabolism of insulin in humans. Am J Physiol 1985, 248, 593–601.
- Randin JP, Tappy L, Scazziga B: Insulin sensitivity and exogenous insulin clearance in Graves’ disease. Measurement by the glucose clamp technique and continuous indirect calorimetry. Diabetes 1986, 35, 178–181.
- Ximenes HM, Lortz S, Jörns A, Lenzen S: Triiodothyronine (T3)-mediated toxicity and induction of apoptosis in insulin-producing INS-1 cells. Life Sciences 2007, 80, 2045–2050.
- Serter R, Demirbas B, Korukluoglu B, Culha C, Cakal E, Aral Y: The effect of L-thyroxine replacement therapy on lipid based cardiovascular risk in sub clinical hypothyroidism. Invest J Endocrinol 2004, 27, 897–903.
- American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract 2002, 8, 457–469.
- Maratou E, Hadjidakis DJ, Kollias A, Tsegka K, Peppa M, Alevizaki M, Mitrou P, Lambadiari V, Boutati E, Nikzas D, Tountas N, Economopoulos T, Raptis SA, Dimitriadis G: Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. Eur J Endocrinol 2009, 160, 785–790.
- Owecki M, El Ali Z, Nikisch E, Sowinski J: Serum insulin levels and the degree of thyroid dysfunction in hypothyroid women. Neuro Endocrinol Lett 2008, 29, 137–140.
- Kapadia KB, Bhatt PA, Shah JS: Association between altered thyroid state and insulin resistance. J Pharmacol Pharmacother 2012, 3, 156–160.
- Gierach M, Gierach J, Junik R: Insulin resistance and thyroid disorders. Endokrynol Pol 2014, 65, 70–76.
- Owecki M, Nikisch E, Sowiński J: Hypothyroidism has no impact on insulin sensitivity assessed with HOMA-IR in totally thyroidectomized patients. Acta Clin Belg 2006, 61, 69–73.
- Quinn SF, Gosink BB: Characteristic sonographic signs of hepatic fatty infiltration. Am J Roentgenol 1985, 145, 753–755.
- Targher G, Bertolini L, Padovani R, Rodella S, Tessari R, Zenari L: Prevalence of nonalcoholic fatty liver disease and its association with cardiovascular disease among type 2 diabetic patients. Diab Care 2007, 30, 1212–1218.
- Shantha GPS, Kumar AA, Jeyachandran V, Rajamanickam D, Rajkumar K, Salim S, Subramanian KK, Natesan S: Association between primary hypothyroidism and metabolic syndrome and the role of C reactive protein: a cross–sectional study from South India. Thyroid Res 2009, 2, 2.
- Bugianesi E, McCullough AJ, Marchesini G: Insulin resistance: a metabolic pathway to chronic liver disease. Hepatology 2005, 42, 987–1000.
- Hollenbeck C, Reaven GM: Variations in insulin stimulated glucose uptake in healthy individuals with normal glucose tolerance. J Clin Endocrinol Metab 1987, 64, 1169–1173.
- McCulloch AJ, Johnston DG, Baylis PH, Kendall-Taylor P, Clark F, Young ET, Alberti KG: Evidence that thyroid hormones regulate gluconeogenesis from glycerol in man. Clin Endocrinol 1983, 19, 67–76.
- Czech MP, Malbon CC, Kerman K, Gitomer W, Pilch PF: Effect of thyroid status on insulin action in rat adipocytes and skeletal muscle. J Clin Invest 1980, 66, 574–582.
- Dimitriadis GD, Leighton B, Parry-Billings M, West D, Newsholme EA: Effects of hypothyroidism on the sensitivity of glycolysis and glycogen synthesis to insulin in the soleus muscle of the rat. Biochem J 1989, 257, 369–373.
- Harris PE, Walker M, Clark F, Home PD, Alberti KG: Forearm muscle metabolism in primary hypothyroidism. Eur J Clin Invest 1993, 23, 585–588.
- Shen DC, Davidson MB, Kuo SW, Kuo SW, Sheu WH: Peripheral and hepatic insulin antagonism in hyperthyroidism. J Clin Endocrinol Metab 1988, 66, 565–569.
- Jorgen J, Hollenbeck CB, Zhou MY, Ann M Coulston, Claire Jones, Ida Chen YD: Relation Between Insulin Resistance, Hyperinsulinemia, Postheparin Plasma Lipoprotein Lipase Activity, and Postprandial Lipemia. Arterıoscl Throm Vas 1995, 15, 320–324.
- Frayn KN: Insulin resistance and lipid metabolism. Curr Opin Lipidol 1993, 4, 197–204.
- Joy D, Thava VR, Scott BB: Diagnosis of fatty liver disease: is biopsy necessary? Eur J Gastroenterol Hepatol 2003, 15, 539–543.
- Saverymuttu SH, Joseph AE, Maxwell JD: Ultrasound scanning in the detection of hepatic fibrosis and steatosis. BMJ 1986, 292, 13–15.