Correlation of Plasma Free Thyroxine Levels with Insulin Sensitivity and Metabolic Clearance Rate of Insulin in Patients with Hyperthyroid Graves' Disease.

Ohguni, Satoshi; Notsu, Kazumi; Kato, Yuzuru

doi:10.2169/internalmedicine.34.339

Cited by 32 publications

(30 citation statements)

References 19 publications

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“…With regard to the transient increase in IR in early pregnancy described here, we can only speculate on the potential mechanisms: levels of chorionic gonadotropin [25], progesterone [25] and thyroid hormones [26] peak in the same period and these hormones can influence IR directly or indirectly. Progesterone decreases insulin sensitivity [27], chorionic gonadotropin has a thyrotropic effect [28] and, in turn, thyroid hormones have a dual effect decreasing insulin sensitivity and increasing insulin clearance [29]. Even though we do not have data about morning sickness in these patients, the increase in insulin requirements coincides with the period when morning sickness is more prominent [22].…”

Section: Discussionmentioning

confidence: 99%

Insulin requirements throughout pregnancy in women with type 1 diabetes mellitus: three changes of direction

et al. 2009

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Aims/hypothesis The aim of the study was to analyse the insulin requirements of women with type 1 diabetes mellitus throughout pregnancy. Methods We have examined the weekly mean blood glucose (mmol/l), insulin requirements (U kg −1 day −1 ) and total insulin requirements (U/day) in 65 women with type 1 diabetes mellitus and tight metabolic control since before pregnancy (HbA 1c ≤6.0%).Results Both insulin requirement and total insulin requirement displayed a peak in week 9, a nadir in week 16 and a second peak in week 37. For the change in insulin requirement (4.08% per week) and in total insulin requirement (5.19% per week), the sharpest slope was observed from week 16 to week 37. However, two changes of direction took place in the first 11 weeks and eight out of nine episodes of severe hypoglycaemia requiring treatment with glucagon or i.v. glucose took place in the first 16 weeks. Conclusions/interpretation Pregnant women with type 1 diabetes mellitus and tight metabolic control since before pregnancy displayed changes in insulin requirement and total insulin requirement with successive changes of direction. The sharpest slope was observed between 16 and 37 weeks, but insulin requirements were more unstable in the first 16 weeks. This information could help patients and physicians to react to changes in glycaemic pattern in a prompt and adequate way.

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Section: Discussionmentioning

confidence: 99%

Insulin requirements throughout pregnancy in women with type 1 diabetes mellitus: three changes of direction

et al. 2009

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“…Patients with thyroid disturbances change their body composition dramatically during development of thyroid disease (51) and during antithyroid drug treatment; also circulating leptin is probably changed although conflicting results have appeared (Table 2). Thyrotoxic patients are resistant to insulin (52,53). Insulin and glucocorticoids are inversely related, both increase total leptin levels in vitro and in vivo, and glucocorticoids are known to increase insulin levels and to cause insulin resistance (54).…”

Section: Leptin Thyroid Hormones and Body Compositionmentioning

confidence: 99%

Circulating leptin and thyroid dysfunction

Zimmermann-Belsing

Brabant²,

Holst³

et al. 2003

Eur J Endocrinol

148

111

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The identification and sequencing of the ob gene and its product, leptin, in 1994 opened new insights in the study of the mechanisms controlling body weight and led to a surge of research activity. Since its discovery, leptin has been the subject of an enormous amount of work especially within the fields of nutrition, metabolism and endocrinology. Leptin is accepted as an adipose signal, and even though the underlying mechanisms are not fully clarified, leptin, in addition to the thyroid hormones, is believed to be involved in regulation during the switch from the fed to the starved state. It is not clear whether leptin and the melanocortin pathways interact with the thyroid axis under physiological conditions other than during starvation or in response to severe illness, both states in which the hypothalamo -pituitary -thyroid axis may be severely suppressed. In addition to the suggested central relationship between leptin and thyroid hormones, there might also be a peripheral relationship although this effect is not clear. Both thyroid hormones and leptin might be involved in the adaptive thermogenesis through mitochondrial uncoupling proteins and heat production because both thyroxine and triiodothyronine are involved in the starvation-induced decrease in thermogenesis. Both rodent and human studies of leptin have failed to show any consistent relationship between thyroid function and serum leptin concentrations. However, leptin might have an important role in thyroid pathophysiology due to thyroid hormone involvement in thermogenesis and regulation of uncoupling proteins. In this review, we have focused on leptin in relation to thyroid pathophysiology.

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“…Insulin resistance was evaluated by euglycemic clamp study performed according to the method of DeFronzo et al [12], using the artificial pancreas (STG-22, Nikkiso Co., Tokyo, Japan) as reported previously [13]. The study was carried out in 20 patients with type 2 diabetes selected at random from 102 hospitalized diabetic patients.…”

Section: Subjectsmentioning

confidence: 99%

Reverse Correlation between Urine Nitric Oxide Metabolites and Insulin Resistance in Patients with Type 2 Diabetes Mellitus.

et al. 2000

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Abstract.We studied the possible relationship between nitric oxide (NO) production and insulin resistance in patients with type 2 diabetes mellitus. Urine NO metabolites (NOx) were measured as an index for NO production by HPLC combined with a Cd column, Griess reaction and a spectrophotometer in 403 healthy control subjects and 102 hospitalized patients with type 2 diabetes. Glucose infusion rate (GIR) was measured as a reverse index for insulin resistance by euglycemic glucose clamp study using an artificial pancreas in 20 of 102 diabetic patients. Urine NOx was lower in the patients with type 2 diabetes than in healthy control subjects (mean±SE: 3.18±0.02 versus 3.25±0.01 log[pmol/gCr], p<0.01).Urine NOx was correlated with body mass index (BMI) in 102 diabetic patients (r= -0.372, p <0.00l), but not related to either age, sex, fasting plasma glucose, HbAI~ or blood pressure. Urine NOx was correlated with GIR independent of BMI in 20 diabetic patients (r=0.774, P<0.0001).These findings suggest that NO production is closely related with insulin resistance in patients with type 2 diabetes.

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Correlation of Plasma Free Thyroxine Levels with Insulin Sensitivity and Metabolic Clearance Rate of Insulin in Patients with Hyperthyroid Graves' Disease.

Cited by 32 publications

References 19 publications

Insulin requirements throughout pregnancy in women with type 1 diabetes mellitus: three changes of direction

Insulin requirements throughout pregnancy in women with type 1 diabetes mellitus: three changes of direction

Circulating leptin and thyroid dysfunction

Reverse Correlation between Urine Nitric Oxide Metabolites and Insulin Resistance in Patients with Type 2 Diabetes Mellitus.

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