Evaluation of Triglyceride-Glucose Index in Patients with Hashimoto’s Thyroiditis

Abstract

Objectives: Recently, researchers have used the triglyceride-glucose (TyG) index for the possibility of metabolic syndrome and insulin resistance. Although altered glucose and lipid metabolism have been observed in patients with Hashimoto’s thyroiditis (HT), the impact of autoimmune factors on the TyG index in euthyroid HT patients has not been sufficiently studied. This research sought to assess the effects of autoimmunity on the TyG index in euthyroid HT patients. Materials and Methods: Our research was planned as a retrospective, single-center, observational study. The study included 50 participants diagnosed with HT and 52 control groups without thyroid disease, who were followed up in the internal medicine service and outpatient clinic. Results: The patient group had a mean age of 44.54±13.72 years, while the control group had a mean age of 33.5±13.17 years. The HT group was significantly older (p<0.001). No meaningful distinctions were detected regarding the gender distribution between the groups (p=0.357). In the HT group, the low-density lipoprotein (LDL) cholesterol level was 137.8±41.5 mg/dL, and the non-high-density lipoprotein (HDL) cholesterol level was 160.5±45.2 mg/dL, both of which were significantly higher compared to the control group (LDL: p=0.046, non-HDL: p=0.029). The TyG index showed similar results between the two groups, with measurements of 8.6±1.2 in the HT group and 8.4±1.3 in the control group (p=0.121). Conclusion: In contrast to previous studies, our study focused on the impact of autoimmunity on TyG index changes in patients with euthyroid HT, taking into account the relationship with thyroid hormones. Accordingly, a similar correlation was detected between the TyG index and age in patients with and without HT. As a result, we found that the TyG index did not change due to autoimmunity in patients with euthyroid HT.

Keywords

• Triglyceride/glucose index
• Hashimoto’s thyroiditis
• autoimmunity
• marker
• thyroid hormone

Hashimoto Tiroiditli Hastalarda Trigliserit-Glukoz İndeksinin Değerlendirilmesi

Abstract

Amaç: Son zamanlarda araştırmacılar, metabolik sendrom ve insülin direnci olasılığını tespit etmek için bir tarama yöntemi olarak trigliserit-glukoz (TyG) indeksini kullanmaya başladı. Hashimoto tiroiditi (HT) hastalarında glukoz ve lipit metabolizmasında değişiklik gözlenmesine rağmen, ötiroid HT hastalarında otoimmün faktörlerin TyG indeksi üzerindeki etkisi yeterince araştırılmamıştır. Bu araştırma, ötiroid HT hastalarında otoimmünitenin TyG indeksi üzerindeki etkilerini değerlendirmeyi amaçladı. Gereç ve Yöntem: Araştırmamız retrospektif, tek merkezli, gözlemsel bir çalışma olarak planlandı. Çalışmaya dahiliye servisinde ve polikliniğinde takip edilen HT tanısı alan 50 katılımcı ve tiroid hastalığı olmayan 52 kontrol grubu dahil edildi. Bulgular: Hasta grubunun yaş ortalaması 44,54±13,72 yıl, kontrol grubunun yaş ortalaması ise 33,5±13,17 yıl idi. HT grubu anlamlı derecede daha yaşlıydı (p<0,001). Gruplar arasında cinsiyet dağılımı açısından anlamlı bir farklılık saptanmadı (p=0,357). HT grubunda düşük yoğunluklu lipoprotein (LDL) kolesterol düzeyi 137,8±41,5 mg/dL ve yüksek yoğunluklu lipoprotein (HDL) olmayan kolesterol düzeyi 160,5±45,2 mg/dL olup her ikisi de kontrol grubuna göre anlamlı derecede yüksekti (LDL: p=0,046, HDL olmayan: p=0,029). TyG indeksi, HT grubunda 8,6±1,2 ve kontrol grubunda 8,4±1,3 ölçümleriyle iki grup arasında benzer sonuçlar gösterdi (p=0,121). Sonuç: Çalışmamızda önceki çalışmalardan farklı olarak ötiroid HT hastalarında tiroid hormonları ile ilişkisi dikkate alınarak otoimmünitenin TyG indeksi değişiklikleri üzerindeki etkisine odaklanılmıştır. Buna göre HT olan ve olmayan hastalarda TyG indeksi ile yaş arasında benzer bir korelasyon tespit edildi. Sonuç olarak ötiroid HT hastalarında TyG indeksinin otoimmüniteye bağlı olarak değişmediğini tespit ettik.

Keywords

• Trigliserit/glukoz indeksi
• Hashimoto tiroiditi
• otoimmünite
• marker
• tiroid hormonu

References

1. 1. Martinez B, Ortiz RM. Thyroid hormone regulation and insulin resistance: insights from animals naturally adapted to fasting. Physiology (Bethesda). 2017;32:141-151.
2. 2. Chubb SA, Davis WA, Inman Z, et al. Prevalence and progression of subclinical hypothyroidism in women with type 2 diabetes: the Fremantle Diabetes Study. Clin Endocrinol (Oxf). 2005;62:480-486.
3. 3. Gyawali P, Takanche JS, Shrestha RK, et al. Pattern of thyroid dysfunction in patients with metabolic syndrome and its relationship with components of metabolic syndrome. Diabetes Metab J. 2015;39:66-73.
4. 4. Lin SY, Wang YY, Liu PH, et al. Lower serum free thyroxine levels are associated with metabolic syndrome in a Chinese population. Metabolism. 2005;54:1524-1528.
5. 5. Roos A, Bakker SJ, Links TP, et al. Thyroid function is associated with components of the metabolic syndrome in euthyroid subjects. J Clin Endocrinol Metab. 2007;92:491-496.
6. 6. Park HT, Cho GJ, Ahn KH, et al. Thyroid stimulating hormone is associated with metabolic syndrome in euthyroid postmenopausal women. Maturitas. 2009;62:301-305.
7. 7. Garduño-Garcia Jde J, Alvirde-Garcia U, López-Carrasco G, et al. TSH and free thyroxine concentrations are associated with differing metabolic markers in euthyroid subjects. Eur J Endocrinol. 2010;163:273-278.
8. 8. Ruhla S, Weickert MO, Arafat AM, et al. A high normal TSH is associated with the metabolic syndrome. Clin Endocrinol (Oxf). 2010;72:696-701.

9. 9. Lee YK, Kim JE, Oh HJ, et al. Serum TSH level in healthy Koreans and the association of TSH with serum lipid concentration and metabolic syndrome. Korean J Intern Med. 2011;26:432-439.
10. 10. Oh JY, Sung YA, Lee HJ. Elevated thyroid stimulating hormone levels are associated with metabolic syndrome in euthyroid young women. Korean J Intern Med. 2013;28:180-186.
11. 11. Mehran L, Amouzegar A, Tohidi M, et al. Serum free thyroxine concentration is associated with metabolic syndrome in euthyroid subjects. Thyroid. 2014;24:1566-1574.
12. 12. Hage M, Zantout MS, Azar ST. Thyroid disorders and diabetes mellitus. J Thyroid Res. 2011;2011:439463.
13. 13. Kalra S, Aggarwal S, Khandelwal D. Thyroid dysfunction and type 2 diabetes mellitus: screening strategies and implications for management. Diabetes Ther. 2019;10:2035-2044.
14. 14. Vyakaranam S, Vanaparthy S, Nori S, et al. Study of insulin resistance in subclinical hypothyroidism. Int J Health Sci Res. 2014;4:147-153.
15. 15. Irace C, Carallo C, Scavelli FBet al. Markers of insulin resistance and carotid atherosclerosis. A comparison of the homeostasis model assessment and triglyceride glucose index. Int J Clin Pract. 2013;67:665-672.
16. 16. Unger G, Benozzi SF, Perruzza F, et al. Triglycerides and glucose index: a useful indicator of insulin resistance. Endocrinol Nutr. 2014;61:533-540.
17. 17. Mohd Nor NS, Lee S, Bacha F, et al. Triglyceride glucose index as a surrogate measure of insulin sensitivity in obese adolescents with normoglycemia, prediabetes, and type 2 diabetes mellitus: comparison with the hyperinsulinemic-euglycemic clamp. Pediatr Diabetes. 2016;17:458-465.
18. 18. Lee DY, Lee ES, Kim JH, et al. Predictive value of triglyceride glucose index for the risk of incident diabetes: a 4-year retrospective longitudinal study. PLoS One. 2016;11:e0163465.
19. 19. Kitae A, Hashimoto Y, Hamaguchi M, et al. The triglyceride and glucose index is a predictor of incident nonalcoholic fatty liver disease: a populationbased cohort study. Can J Gastroenterol Hepatol. 2019;2019:5121574.
20. 20. Barzegar N, Tohidi M, Hasheminia M, et al. The impact of triglycerideglucose index on incident cardiovascular events during 16 years of followup: Tehran Lipid and Glucose Study. Cardiovasc Diabetol. 2020;19:155.
21. 21. Tagami T, Tamanaha T, Shimazu S, et al. Lipid profiles in the untreated patients with Hashimoto thyroiditis and the effects of thyroxine treatment on subclinical hypothyroidism with Hashimoto thyroiditis. Endocr J. 2010;57:253-8.
22. 22. Mikos H, Mikos M, Rabska-Pietrzak B, et al. The clinical role of serum concentrations of selected cytokines: IL-1β, TNF-α and IL-6 in diagnosis of autoimmune thyroid disease (AITD) in children. Autoimmunity. 2014;47:466-472.
23. 23. Contreras-Haro B, Hernandez-Gonzalez SO, Gonzalez-Lopez L, et al. Fasting triglycerides and glucose index: a useful screening test for assessing insulin resistance in patients diagnosed with rheumatoid arthritis and systemic lupus erythematosus. Diabetol Metab Syndr. 2019;11:95.
24. 24. Choi W, Park JY, Hong AR, et al. Association between triglycerideglucose index and thyroid function in euthyroid adults: The Korea National Health and Nutritional Examination Survey 2015. PLoS One. 2021;16:e0254630.
25. 25. Lei Y, Yang J, Li H, et al. Changes in glucose-lipid metabolism, insulin resistance, and inflammatory factors in patients with autoimmune thyroid disease. J Clin Lab Anal. 2019;33:e22929.
26. 26. Yuan Y, Chen S, Lin C, et al. Association of triglyceride-glucose index trajectory and frailty in urban older residents: evidence from the 10-year follow-up in a cohort study. Cardiovasc Diabetol. 2023;22:264.
27. 27. Consitt LA, Clark BC. The vicious cycle of myostatin signaling in sarcopenic obesity: myostatin role in skeletal muscle growth, insulin signaling and implications for clinical trials. J Frailty Aging. 2018;7:21-27.
28. 28. Akyüzlü ZN, Mutlu HH. Tiroit hastalığı olanlarda trigliserit/glikoz indeksi insülin direnci belirteci olarak kullanılabilir mi?. ETD. 2020;59:165-173.
29. 29. Dessein PH, Joffe BI, Veller MG, et al. Traditional and nontraditional cardiovascular risk factors are associated with atherosclerosis in rheumatoid arthritis. J Rheumatol. 2005;32:435-442.
30. 30. Sinicato NA, da Silva Cardoso PA, Appenzeller S. Risk factors in cardiovascular disease in systemic lupus erythematosus. Curr Cardiol Rev. 2013;9:15-19.
31. 31. Pereira RM, de Carvalho JF, Bonfá E. Metabolic syndrome in rheumatological diseases. Autoimmun Rev. 2009;8:415-419.
32. 32. Mazaheri T, Sharifi F, Kamali K. Insulin resistance in hypothyroid patients under Levothyroxine therapy: a comparison between those with and without thyroid autoimmunity. J Diabetes Metab Disord. 2014;13:103.
33. 33. Biyikli HH, Arduc A, Isik S, et al. Assessing the relationship between serum ghrelin levels and metabolic parameters and autoimmunity in patients with euthyroid Hashimoto’s thyroiditis. Endocr Pract. 2014;20:818-824.