Autoimmune thyroid disease (AITD), known as the most common organ-specific autoimmune disorder, is frequently accompanied by other organ and non-organ-specific autoimmune diseases, including rheumatoid arthritis (RA). Although the exact pathogenic mechanisms of the coexistence of autoimmune disorders are still not completely defined, genetics, immune defects, hormones and environmental factors may play key roles in polyautoimmunity. In this review, the prevalence of AITD and antithyroid autoantibodies in RA patients and rheumatic manifestations in association with thyroid autoimmunity are discussed. Finally, we review the role of genetics in the association of both AITD and RA, especially CTLA-4 and PTPN22 polymorphisms.

Patients with T2DM showed to have higher prevalence of AITD and primary hypothyroidism. We did not find higher prevalence of T2DM in patients with thyroid diseases (Tab. 3, Ref. 29).

Type 2 diabetes mellitus (T2DM) remains one of the most challenging global epidemics of the twenty-fi rst century. It is estimated that more than 350 million people worldwide are affected by this metabolic disorder. It has many risk factors. Several studies presume that type II iodothyronine deiodinase polymorphism Thr92Ala (DII-Thr92-Ala, rs225014) is yet another risk factor. The aim of the study was to assess the impact of this polymorphism on parameters of glycid metabolism. Our group consisted of 200 subjects (74 males and 126 females) at average age of 63.85 ± 18.98 without prediabetes, diabetes mellitus or any thyropathy. Blood tests were performed to evaluate glucose metabolism parameters as well as DII-Thr92Ala polymorphism. Our study confi rmed the relationship between Ala homozygotes and glycosylated haemoglobin (HbA 1c) serum levels (Tab. 2, Ref. 14).

Zápal je všeobecná obranná reakcia tela proti rôznym škodlivým podráždeniam. Diagnostika zápalového procesu a monitorovanie jeho liečby je založené na kombinácii klinických a laboratórnych nálezov. Biochemické zápalové markery slúžia obvykle na podporu diagnózy infekcie, na jej monitorovanie a sledovanie efektívnosti antiinfekčnej liečby. Zápalový marker je potrebné vyberať podľa klinického stavu s ohľadom na zradnosť a nedostatky markerov, so znalosťou ich dynamiky a s ohľadom na dĺžku anamnézy. Ako optimálny postup pri zistení bakteriálnej infekcie sa odporúča vyšetrovať viaceré proteíny akútnej fázy. Je úlohou lekára určiť, kedy, za akých okolností, a ktorý marker nechať vyšetriť s ohľadom na to, aby pacient bol včas správne diagnostikovaný a dostal adekvátnu liečbu, a na druhú stranu, aby nebol zbytočne iatrogenizovaný a aby zdravotnícke zariadenie zbytočne neprichádzalo o financie.

Autoimmune thyroiditis (AIT) and type 2 diabetes mellitus (DM2) are the most common endocrinological diseases worldwide. Relation between these diseases explains several hypotheses. One of them is influence of some adipocytokines. This study evaluated association between three adipocytokines (adiponectin, resistin and visfatin) and thyroid and glycid status in patients with DM2 and AIT compared to the control group (CG). The group consisted of four subgroups: patients with DM2 without thyreopathies, patients with AIT on substitution therapy without diabetes and prediabetes, patients with DM2 and AIT on substitution therapy and healthy subjects as the CG. We investigated parameters of thyroid and glucose metabolism and serum levels of three adipocytokines. The mean level of resistin in the group of patients with diabetes and thyroiditis was significantly higher than in patients with thyroiditis without diabetes and than in the CG. We found a weak negative correlation between visfatin and fasting glucose levels in patients with thyroiditis without diabetes. We detected a weak negative correlation between resistin and glycated hemoglobin and a weak negative correlation between visfatin and thyroid gland volume in patients with diabetes without thyroiditis. In the CG we determined a weak positive correlation between visfatin and free thyroxin. Our results are consistent with several studies, which confirmed association between AIT and adipocytokines.

Adipocytokíny sú početné proteíny vylučované prevažne tukovým tkanivom. Regulujú mnohé kľúčové fyziologické procesy v ľudskom tele. Zvýšené alebo znížené hladiny tyreoidálnych hormónov pri rôznych tyreopatiách môžu mať vplyv na sérové hladiny jednotlivých adipocytokínov, najmä adiponektínu, rezistínu a visfatínu. Výsledky štúdií sú však kontroverzné alebo chýbajú. Mätúci vplyv môžu mať aj pridružené ochorenia metabolického charakteru (napr. inzulínová rezistencia a diabetes mellitus 2. typu alebo rozvíjajúca sa ateroskleróza).

Adrenal incidentalomas (AI) are very common and mostly they are non-functioning adenomas (NFA). NFAs are often associated with insulin resistance and metabolic syndrome. Several biomarkers, including certain growth factors, may participate in the pathogenesis of metabolic changes in patients with adrenal adenomas. Patients with NFA and age-matched control subjects were enrolled in the study. Data on age, gender, presence of metabolic syndrome or its components were obtained for each subject. Blood samples were obtained and glycemia, insulinemia, lipid profile, and selected growth factor levels were measured. Forty-three patients with NFA and 40 controls were included in the study. Differences were not found in the metabolic syndrome and its components prevalence or in the biochemical profile between patients and the control group. Significant differences were noticed in the levels of IGF1, IGF2, and IGFBP3 (p=0.016, p=0.005, p=0.004, respectively), but there were no differences in VEGF or EGF concentrations. In NFA patients, an association between glycemia and EGF levels was present (p=0.026). No significant correlations between tumor size and insulin or growth factor concentrations were present in AI patients. Significantly higher serum IGF1, IGF2, and IGFBP3 concentrations in NFA patients may support the role of the IGF axis in the pathogenesis of adrenocortical lesions. No correlation between IGFs or IGFBP3 and parameters of glucose or lipid metabolism was found. Present results may support the role of the growth hormone axis rather than hyperinsulinemia and insulin resistance in the pathogenesis of adrenocortical adenomas.

Ochorenia štítnej žľazy (ŠŽ), najmä autoimunitná tyroi ditída (AIT), a diabetes mellitus (DM), najmä 2. typu (DM2T), sú dve najčastejšie endokrinné ochorenia v klinickej praxi a ich vzájomný vzťah z rôznych aspektov je predmetom mnohých štúdií. Asociácia autoimunitne podmienených tyreopatií s diabetes mellitus 1. typu (DM1T) je tesnejšia ako je to pri DM2T, a to v dôsledku spoločnej autoimunitnej predispozície [1][2][3].Vzťah medzi ochoreniami ŠŽ a DM2T je podľa výsledkov viacerých štúdií slabší a vzťahy medzi oboma chorobami sú aj menej jasné [1,3,4]. To, že by AIT priamo spôsobovala alebo bola rizikovým faktorom vzniku prediabetu alebo DM2T, zatiaľ jednoznačne nepotvrdila