The association of autoimmune thyroiditis and non-functional adrenal incidentalomas with insulin resistance

Abstract

Objective: Patients with incidental nonfunctioning adrenal adenoma are associated with increased risk of obesity, impaired glucose tolerance and dyslipidemia. We aimed to investigate the relationship between thyroid function, serum lipids and insulin resistance in patients with nonfunctioning adrenal incidentaloma. Subjects and methods: Forty patients who had diagnosed as adrenal incidentaloma (AI) in our department were included in the study. Serum free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), anti-thyroperoxidase antibody (anti-TPO Ab) and anti-thyroglobulin antibody (anti-Tg Ab), lipid profile, hs-CRP, fasting insulin levels were measured and insulin resistance calculated by HOMA-IR. Thyroid volume (TV) was assessed. Results: None of the patients showed specific signs and symptoms of hormone excess. TV, TSH and fT3 levels in the patient and control groups did not differ significantly (p > 0.05). The serum fT4, anti-TG Ab, anti-TPO Ab levels in the patient group were significantly higher than in the control group (p = 0.013, p < 0.0001, p = 0.016 respectively). The HOMA-IR, hs-CRP and HDL cholesterol levels in the AI patients were significantly higher than the control group (p = 0.034, p = 0.041, p = 0.002, respectively).

Frequency of Nodular Goiter in Patients with Non-Functional Adrenal Incidentaloma

“…In a study by Karaköse et al with NFAI patients, they reported that fT4, antithyroglobulin, and anti-TPO levels were significantly higher in the NFAI group compared to the control group, whereas, thyroid volumes, TSH, and fT3 levels were comparable in both the groups. Moreover, they determined a significant relationship between HOMA-IR levels and thyroid volume and fT4 levels (24). The present study failed to obtain any difference between NFAI and control groups in terms of TSH, fT4, and anti-TPO levels.…”

The Association Between Thyroid Volume and Insulin Resistance in Patients with Non-Functional Adrenal Incidentaloma

“…The association between adrenal mass and thyroid has been evaluated in several studies. It has been found that the frequency of autoimmune thyroid disease increases (6,23), and thyroid nodules are more common (6) in AI patients, and this situation is frequently related to the underlying IR. The co-existence of adrenal and thyroid incidentaloma may be due to increased and widespread use of advanced radiologic imaging devices (24).…”

Fatores de risco associados à síndrome metabólica em mulheres com tireoidite crônica autoimune

“…Nos últimos anos, alguns estudos têm demonstrado associação entre disfunções tireoidianas, desenvolvimento de distúrbios metabólicos e doenças cardiovasculares 6,9 , enquanto outros trabalhos reportaram associação entre concentrações de T4 livre (T4L), ocorrência de resistência insulínica e dislipidemia mesmo em indivíduos eutireoideos 10 . Os hormônios tireoidianos atuam em várias vias metabólicas referentes aos carboidratos e lipídeos, influenciando na regulação da gliconeogênese hepática, lipogênese e lipólise 10 . Sendo assim, é de se esperar que disfunções tireoidianas que interferem em vias metabólicas específicas predisponham a SM e aumentem fatores de risco cardiovascular 11 .…”