Prevalence of Anti-Thyroid Peroxidase in Adults with Type 1 Diabetes Participating in Poznań Prospective Study

Abstract

Background. Type 1 diabetes (DM 1) is frequently associated with autoimmune thyroid diseases (AITD). Screening for AITD in adults is rarely performed. The aim of this study was to evaluate the prevalence of anti-thyroid peroxidase (anti-TPO) and thyroid function and their association with metabolic control in adults participating in Poznan Prospective Study (PoProStu). Material and Methods. The analysis included 74 patients (26 women and 48 men) aged 38.5 (IQR: 34.5-42.5), who have had diabetes for 15.0 (14-16) years. All patients have been treated with intensive functional insulin therapy (IFIT) from the onset of the disease. Anti-TPO and thyroid-stimulating hormone (TSH) were determined. The concentration of anti-TPO ≥ 5.61 IU/mL was considered positive. Based on the levels of anti-TPO the patients were divided into two groups: anti-TPO positive and anti-TPO negative. Metabolic control was assessed by the level of glycated hemoglobin (HbA 1c ). Results. Anti-TPO was positive in 32 (43.2%) patients. Prevalence of autoantibodies was significantly higher in women (53% vs 21%; p = 0.009). There was no significant difference in HbA 1c levels [median (IQR): 7.6% (7.1-8.6) vs 7.6% (7.1-8.8); p = 0.82] and TSH levels [median (IQR): 2.05 µIU/mL (1.23-3.15) vs 1.62 µIU/mL (1.00-2.10); p = 0.06] between anti-TPO positive and negative patients. After excluding patients with a thyroid dysfunction, a significant difference in TSH levels between anti-TPO positive and negative group was found [median (IQR): 2.11 µIU/mL (1.29-3.31) vs 1.66 µIU/mL (1.29-3.31); p = 0.04]. Conclusions. High anti-TPO prevalence is found in adult patients with long-standing DM 1, and autoantibodies occur more often in women. Therefore, screening for asymptomatic thyroid dysfunction should be performed in this group, as already recommended by the joint statement of Polish Society of Endocrinology and Diabetes Poland (Adv Clin Exp Med 2015, 24, 1, 79-84).

Autoantibody Development under Treatment with Immune-Checkpoint Inhibitors

“…Antithyroid antibodies are common in populations without overt thyroid disease, associated with or induced by concomitant autoimmune disease (i.e., type 1 diabetes mellitus, RA, and Celiac disease; refs. [11][12][13][14][15][16][17], mutations in CTLA-4 (18,19), upregulation of MHC class II molecules on thyrocytes leading to thyroid antigen presentation to autoreactive cells (20), or as we show here, ipilimumab treatment. Our data also confirm previous studies reporting that patients rarely develop RA autoantibodies (21)(22)(23)(24) or autoimmune hepatitis antibodies even in the presence of the related irAE (25)(26)(27)(28).…”

Lipid ratios as a predictive marker of Subclinical Atherosclerosis inflammation among Type 1 Diabetic patients with Thyroid Dysfunction

“…In our study, there was no difference between HbA1c levels in both groups. These results are in accordance with reports from the literature 17,23 .…”

Higher concentrations of osteoprotegerin in type 1 diabetic patients are related to retinopathy: Results from the Poznań Prospective Study

“…The PoProStu enrolled 100 consecutive patients with newly diagnosed DM 1, aged below 35 years, hospitalized due to diabetic ketoacidosis at the Department of Internal Medicine and Diabetology at the Poznan University of Medical Sciences (Poland) from 1994 to 1999, as described by Grzelka et al 12 From the onset of the disease, all the patients have been treated with IFIT, defined as a treatment method requiring multiple insulin injections during the day, counting carbohydrate equivalents, and considering upcoming physical activity. Annual follow-ups were conducted.…”