TSH oscillations in young patients with type 1 diabetes may be due to glycemic variability
Purpose A relationship between thyroid dysfunction and diabetes mellitus has been described by several authors but the role of glycemic variability is still unclear. We planned the present study to evaluate the influence of glycemic variability on thyroid hormones and TSH concentrations in patients...
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| Veröffentlicht in: | Journal of endocrinological investigation 2018-04, Vol.41 (4), p.389-393 |
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| container_title | Journal of endocrinological investigation |
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| creator | Bellastella, G. Maiorino, M. I. Scappaticcio, L. Casciano, O. Petrizzo, M. Caputo, M. Paglionico, V. A. Giugliano, D. Esposito, K. |
| description | Purpose
A relationship between thyroid dysfunction and diabetes mellitus has been described by several authors but the role of glycemic variability is still unclear. We planned the present study to evaluate the influence of glycemic variability on thyroid hormones and TSH concentrations in patients with type 1 diabetes mellitus (T1DM).
Methods
Seventy-seven young patients with T1DM were enrolled and evaluated for basal glucose concentrations, HbA1c, thyroid hormones and TSH concentrations. Glucose variability was investigated by considering the standard deviation of blood glucose readings and by calculating the mean amplitude of glycemic excursions and continuous overlapping net glycemic action (CONGA). The low (LBGI) and high (HBGI) blood glucose indices were also calculated. The correlations between TSH, thyroid hormones, glycemia and HbA1c were studied in patients and in controls, whereas those between TSH, thyroid hormones and indices of glucose variability only in patients.
Results
No correlations were observed in T1DM patients between free thyroid hormones and glycemic values, HbA1c and indices of glucose variability, while an inverse correlation was observed between TSH levels and glycemic values (
r
= −0.27;
p
= 0.01), CONGA index (
r
= −0.35;
p
= 0.001) and HBGI (
r
= −0.28;
p
= 0.01) but not with HbA1c (
r
= −0.1;
p
= 0.47).
Conclusions
Our results suggest a direct action of glycemic excursions on TSH secretion, regardless of variations of thyroid hormone concentrations. Thus, the evaluation of thyroid function through the assay of TSH concentrations in these patients should be made, if possible, by multiple samples on patients in euglycemic state to avoid underestimation or overestimation of thyroid dysfunction due to a wrong diagnosis of euthyroidism or dysthyroidism with consequent inappropriate choice of therapeutic options. |
| doi_str_mv | 10.1007/s40618-017-0752-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1934280930</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1934280930</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-97452e1753e1c89bb21c5104b578adf49d3fa3e359ce984254d8dab9bfb11edf3</originalsourceid><addsrcrecordid>eNp1kE1PHSEUhompUav-gG4MSTfdjHJguMDSGFtNTFyoGzcEmDO3mPm4DozN_Hsx19amScMCAs95Oech5AuwU2BMnaWarUBXDFTFlOSV3CEHoDirtNCrT3-d98nnlJ4YE0potUf2udZyJQ0ckMf7uys6phC7zuU4DonGgS7jPKzpplzgkBP9FfNPmpcNUqBNdB4zJtq7hXqkzYw0j3TdLQH7GOiLmwoRu5iXI7Lbui7h8ft-SB6-X95fXFU3tz-uL85vqiAUz5VRteQISgqEoI33HIIEVnuptGva2jSidQKFNAGNrrmsG904b3zrAbBpxSH5ts3dTOPzjCnbPqaAZaABxzlZMKLmmhnBCvr1H_RpnKehdGc5g5qVZUyhYEuFaUxpwtZupti7abHA7Jt4uxVvi3j7Jt7KUnPynjz7Hps_Fb9NF4BvgVSehjVOH1__P_UV7C6Nbg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2014040499</pqid></control><display><type>article</type><title>TSH oscillations in young patients with type 1 diabetes may be due to glycemic variability</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Bellastella, G. ; Maiorino, M. I. ; Scappaticcio, L. ; Casciano, O. ; Petrizzo, M. ; Caputo, M. ; Paglionico, V. A. ; Giugliano, D. ; Esposito, K.</creator><creatorcontrib>Bellastella, G. ; Maiorino, M. I. ; Scappaticcio, L. ; Casciano, O. ; Petrizzo, M. ; Caputo, M. ; Paglionico, V. A. ; Giugliano, D. ; Esposito, K.</creatorcontrib><description>Purpose
A relationship between thyroid dysfunction and diabetes mellitus has been described by several authors but the role of glycemic variability is still unclear. We planned the present study to evaluate the influence of glycemic variability on thyroid hormones and TSH concentrations in patients with type 1 diabetes mellitus (T1DM).
Methods
Seventy-seven young patients with T1DM were enrolled and evaluated for basal glucose concentrations, HbA1c, thyroid hormones and TSH concentrations. Glucose variability was investigated by considering the standard deviation of blood glucose readings and by calculating the mean amplitude of glycemic excursions and continuous overlapping net glycemic action (CONGA). The low (LBGI) and high (HBGI) blood glucose indices were also calculated. The correlations between TSH, thyroid hormones, glycemia and HbA1c were studied in patients and in controls, whereas those between TSH, thyroid hormones and indices of glucose variability only in patients.
Results
No correlations were observed in T1DM patients between free thyroid hormones and glycemic values, HbA1c and indices of glucose variability, while an inverse correlation was observed between TSH levels and glycemic values (
r
= −0.27;
p
= 0.01), CONGA index (
r
= −0.35;
p
= 0.001) and HBGI (
r
= −0.28;
p
= 0.01) but not with HbA1c (
r
= −0.1;
p
= 0.47).
Conclusions
Our results suggest a direct action of glycemic excursions on TSH secretion, regardless of variations of thyroid hormone concentrations. Thus, the evaluation of thyroid function through the assay of TSH concentrations in these patients should be made, if possible, by multiple samples on patients in euglycemic state to avoid underestimation or overestimation of thyroid dysfunction due to a wrong diagnosis of euthyroidism or dysthyroidism with consequent inappropriate choice of therapeutic options.</description><identifier>ISSN: 1720-8386</identifier><identifier>ISSN: 0391-4097</identifier><identifier>EISSN: 1720-8386</identifier><identifier>DOI: 10.1007/s40618-017-0752-5</identifier><identifier>PMID: 28856591</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Blood glucose ; Blood Glucose - analysis ; Case-Control Studies ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (insulin dependent) ; Diabetes Mellitus, Type 1 - physiopathology ; Endocrinology ; Female ; Glucose ; Glycemic Index ; Hormones ; Humans ; Male ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Middle Aged ; Original Article ; Oscillations ; Secretion ; Thyroid gland ; Thyroid hormones ; Thyroid-stimulating hormone ; Thyrotropin - metabolism</subject><ispartof>Journal of endocrinological investigation, 2018-04, Vol.41 (4), p.389-393</ispartof><rights>Italian Society of Endocrinology (SIE) 2017</rights><rights>Copyright Springer Science & Business Media 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-97452e1753e1c89bb21c5104b578adf49d3fa3e359ce984254d8dab9bfb11edf3</citedby><cites>FETCH-LOGICAL-c372t-97452e1753e1c89bb21c5104b578adf49d3fa3e359ce984254d8dab9bfb11edf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40618-017-0752-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40618-017-0752-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,782,786,27931,27932,41495,42564,51326</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28856591$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bellastella, G.</creatorcontrib><creatorcontrib>Maiorino, M. I.</creatorcontrib><creatorcontrib>Scappaticcio, L.</creatorcontrib><creatorcontrib>Casciano, O.</creatorcontrib><creatorcontrib>Petrizzo, M.</creatorcontrib><creatorcontrib>Caputo, M.</creatorcontrib><creatorcontrib>Paglionico, V. A.</creatorcontrib><creatorcontrib>Giugliano, D.</creatorcontrib><creatorcontrib>Esposito, K.</creatorcontrib><title>TSH oscillations in young patients with type 1 diabetes may be due to glycemic variability</title><title>Journal of endocrinological investigation</title><addtitle>J Endocrinol Invest</addtitle><addtitle>J Endocrinol Invest</addtitle><description>Purpose
A relationship between thyroid dysfunction and diabetes mellitus has been described by several authors but the role of glycemic variability is still unclear. We planned the present study to evaluate the influence of glycemic variability on thyroid hormones and TSH concentrations in patients with type 1 diabetes mellitus (T1DM).
Methods
Seventy-seven young patients with T1DM were enrolled and evaluated for basal glucose concentrations, HbA1c, thyroid hormones and TSH concentrations. Glucose variability was investigated by considering the standard deviation of blood glucose readings and by calculating the mean amplitude of glycemic excursions and continuous overlapping net glycemic action (CONGA). The low (LBGI) and high (HBGI) blood glucose indices were also calculated. The correlations between TSH, thyroid hormones, glycemia and HbA1c were studied in patients and in controls, whereas those between TSH, thyroid hormones and indices of glucose variability only in patients.
Results
No correlations were observed in T1DM patients between free thyroid hormones and glycemic values, HbA1c and indices of glucose variability, while an inverse correlation was observed between TSH levels and glycemic values (
r
= −0.27;
p
= 0.01), CONGA index (
r
= −0.35;
p
= 0.001) and HBGI (
r
= −0.28;
p
= 0.01) but not with HbA1c (
r
= −0.1;
p
= 0.47).
Conclusions
Our results suggest a direct action of glycemic excursions on TSH secretion, regardless of variations of thyroid hormone concentrations. Thus, the evaluation of thyroid function through the assay of TSH concentrations in these patients should be made, if possible, by multiple samples on patients in euglycemic state to avoid underestimation or overestimation of thyroid dysfunction due to a wrong diagnosis of euthyroidism or dysthyroidism with consequent inappropriate choice of therapeutic options.</description><subject>Adult</subject><subject>Blood glucose</subject><subject>Blood Glucose - analysis</subject><subject>Case-Control Studies</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Diabetes Mellitus, Type 1 - physiopathology</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Glucose</subject><subject>Glycemic Index</subject><subject>Hormones</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Oscillations</subject><subject>Secretion</subject><subject>Thyroid gland</subject><subject>Thyroid hormones</subject><subject>Thyroid-stimulating hormone</subject><subject>Thyrotropin - metabolism</subject><issn>1720-8386</issn><issn>0391-4097</issn><issn>1720-8386</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1PHSEUhompUav-gG4MSTfdjHJguMDSGFtNTFyoGzcEmDO3mPm4DozN_Hsx19amScMCAs95Oech5AuwU2BMnaWarUBXDFTFlOSV3CEHoDirtNCrT3-d98nnlJ4YE0potUf2udZyJQ0ckMf7uys6phC7zuU4DonGgS7jPKzpplzgkBP9FfNPmpcNUqBNdB4zJtq7hXqkzYw0j3TdLQH7GOiLmwoRu5iXI7Lbui7h8ft-SB6-X95fXFU3tz-uL85vqiAUz5VRteQISgqEoI33HIIEVnuptGva2jSidQKFNAGNrrmsG904b3zrAbBpxSH5ts3dTOPzjCnbPqaAZaABxzlZMKLmmhnBCvr1H_RpnKehdGc5g5qVZUyhYEuFaUxpwtZupti7abHA7Jt4uxVvi3j7Jt7KUnPynjz7Hps_Fb9NF4BvgVSehjVOH1__P_UV7C6Nbg</recordid><startdate>20180401</startdate><enddate>20180401</enddate><creator>Bellastella, G.</creator><creator>Maiorino, M. I.</creator><creator>Scappaticcio, L.</creator><creator>Casciano, O.</creator><creator>Petrizzo, M.</creator><creator>Caputo, M.</creator><creator>Paglionico, V. A.</creator><creator>Giugliano, D.</creator><creator>Esposito, K.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180401</creationdate><title>TSH oscillations in young patients with type 1 diabetes may be due to glycemic variability</title><author>Bellastella, G. ; Maiorino, M. I. ; Scappaticcio, L. ; Casciano, O. ; Petrizzo, M. ; Caputo, M. ; Paglionico, V. A. ; Giugliano, D. ; Esposito, K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-97452e1753e1c89bb21c5104b578adf49d3fa3e359ce984254d8dab9bfb11edf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Blood glucose</topic><topic>Blood Glucose - analysis</topic><topic>Case-Control Studies</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (insulin dependent)</topic><topic>Diabetes Mellitus, Type 1 - physiopathology</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Glucose</topic><topic>Glycemic Index</topic><topic>Hormones</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Oscillations</topic><topic>Secretion</topic><topic>Thyroid gland</topic><topic>Thyroid hormones</topic><topic>Thyroid-stimulating hormone</topic><topic>Thyrotropin - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bellastella, G.</creatorcontrib><creatorcontrib>Maiorino, M. I.</creatorcontrib><creatorcontrib>Scappaticcio, L.</creatorcontrib><creatorcontrib>Casciano, O.</creatorcontrib><creatorcontrib>Petrizzo, M.</creatorcontrib><creatorcontrib>Caputo, M.</creatorcontrib><creatorcontrib>Paglionico, V. A.</creatorcontrib><creatorcontrib>Giugliano, D.</creatorcontrib><creatorcontrib>Esposito, K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endocrinological investigation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bellastella, G.</au><au>Maiorino, M. I.</au><au>Scappaticcio, L.</au><au>Casciano, O.</au><au>Petrizzo, M.</au><au>Caputo, M.</au><au>Paglionico, V. A.</au><au>Giugliano, D.</au><au>Esposito, K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>TSH oscillations in young patients with type 1 diabetes may be due to glycemic variability</atitle><jtitle>Journal of endocrinological investigation</jtitle><stitle>J Endocrinol Invest</stitle><addtitle>J Endocrinol Invest</addtitle><date>2018-04-01</date><risdate>2018</risdate><volume>41</volume><issue>4</issue><spage>389</spage><epage>393</epage><pages>389-393</pages><issn>1720-8386</issn><issn>0391-4097</issn><eissn>1720-8386</eissn><abstract>Purpose
A relationship between thyroid dysfunction and diabetes mellitus has been described by several authors but the role of glycemic variability is still unclear. We planned the present study to evaluate the influence of glycemic variability on thyroid hormones and TSH concentrations in patients with type 1 diabetes mellitus (T1DM).
Methods
Seventy-seven young patients with T1DM were enrolled and evaluated for basal glucose concentrations, HbA1c, thyroid hormones and TSH concentrations. Glucose variability was investigated by considering the standard deviation of blood glucose readings and by calculating the mean amplitude of glycemic excursions and continuous overlapping net glycemic action (CONGA). The low (LBGI) and high (HBGI) blood glucose indices were also calculated. The correlations between TSH, thyroid hormones, glycemia and HbA1c were studied in patients and in controls, whereas those between TSH, thyroid hormones and indices of glucose variability only in patients.
Results
No correlations were observed in T1DM patients between free thyroid hormones and glycemic values, HbA1c and indices of glucose variability, while an inverse correlation was observed between TSH levels and glycemic values (
r
= −0.27;
p
= 0.01), CONGA index (
r
= −0.35;
p
= 0.001) and HBGI (
r
= −0.28;
p
= 0.01) but not with HbA1c (
r
= −0.1;
p
= 0.47).
Conclusions
Our results suggest a direct action of glycemic excursions on TSH secretion, regardless of variations of thyroid hormone concentrations. Thus, the evaluation of thyroid function through the assay of TSH concentrations in these patients should be made, if possible, by multiple samples on patients in euglycemic state to avoid underestimation or overestimation of thyroid dysfunction due to a wrong diagnosis of euthyroidism or dysthyroidism with consequent inappropriate choice of therapeutic options.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>28856591</pmid><doi>10.1007/s40618-017-0752-5</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1720-8386 |
| ispartof | Journal of endocrinological investigation, 2018-04, Vol.41 (4), p.389-393 |
| issn | 1720-8386 0391-4097 1720-8386 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1934280930 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Adult Blood glucose Blood Glucose - analysis Case-Control Studies Diabetes Diabetes mellitus Diabetes mellitus (insulin dependent) Diabetes Mellitus, Type 1 - physiopathology Endocrinology Female Glucose Glycemic Index Hormones Humans Male Medicine Medicine & Public Health Metabolic Diseases Middle Aged Original Article Oscillations Secretion Thyroid gland Thyroid hormones Thyroid-stimulating hormone Thyrotropin - metabolism |
| title | TSH oscillations in young patients with type 1 diabetes may be due to glycemic variability |
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