DOI: http://dx.doi.org/10.18203/2349-3933.ijam20192254

Thyroid hormones, blood glucose and glycosylated hemoglobin in healthy Sudanese subjects

Abdelmuhsin H. Eisa, Amir A. Bashir, Asim A. Osman, Ibrahim A. Ali, Kamal M. Awad, Elnagi Y. Hajo, Elmutaz H. Taha, Abeadalla A. Alborai, Omer A. Musa

Abstract


Background: Diabetes mellitus and thyroid diseases are the most prevalent metabolic disorders in Sudan. The value of HbA1C reflects the glycemic status over the last 2-3 months. So, in this study, an insight for thyroid hormone regulation of glucose metabolism is investigated. Is to study the association between thyroid hormones levels, fasting blood sugar (FBS) and HbA1c in healthy adults.

Methods: A cross sectional study was performed in a healthy Sudanese cohort in the period between September 2017 to November 2018, involving 610 healthy adult Sudanese aged 20 to 60 years. HbA1c, fasting blood sugar (FBS), T3, T4 and TSH were measured.

Results: The study results demonstrated a significant association between the median concentration of T3 and T4 with plasma level of HbA1c. A significant linear correlation between serum concentration of T3 and fasting blood sugar (FBS) was observed. Inverse correlation was detected between serum TSH and HbA1c, FBS in study population.

Conclusions: The present study concluded that FBS and HbA1c levels were increased with increasing of both T3 and T4. Based on this study all the thyroid patients’ especially hyperthyroid patients should have regular checkup of their glucose levels.


Keywords


Blood glucose, Glycosylated haemoglobin, Thyroid hormones

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References


American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2011;34(1):S62-S69.

World Health Organization. Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus: Abbreviated Report of WHO Consultation, 2001. Available at: https://www.who.int/diabetes/publications/report-hba1c_2011.pdf.

International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32:1327-34.

De Rosa MC, Sanna MT, Messana I, Castagno-la M, Galtieri A, Tellone E, et al. Glycated human haemoglobin (HbA1c): Functional characteristics and molecular modeling studies. Biophys Chem. 1998;72:323-35.

World Health Organization. Prevention and Control of Iron Deficiency Anaemia in Women and Children: Report of the UNICEF/WHO Regional Consultation, 1999. Available at: https://www.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/e73102/en/.

Kim MK, Kwon HS, Baek KH, Lee JH, Park WC, Sohn HS, et al. Effects of thyroid hormone on A1C and glycated albumin levels in nondiabetic subjects with overt hypothyroidism. Diabetes Care. 2010;33(12):2546-48.

Yadav P, Kaushik GG, Sharma S. Importance of screening type-ii diabetics for thyroid dysfunction and dyslipidemia. Inter J Biochem Biophy. 2015;3(2):7-12.

Brenta G. Why can insulin resistance be a natural consequence of thyroid dysfunction?. J Thyroid Res. 2011;2011.

Wang C. The Relationship between type 2 diabetes mellitus and related thyroid diseases. J Diabetes Res. 2013:390534.

Sohal S, Wats A, Vij C. Evaluation of glycosylated hemoglobin (HbA1c) levels in hypothyroid and hyperthyroid patients. Annals Applied Bio-Sci. 2016;3(1):A101-107.

Soni N, Kaushik GG, Yadav V. To study glycemic status and lipid fractions in subclinical hypothyroid, overt hypothyroid and hyperthyroid subjects. Inter J Adv Res. 2014;2(9);761-7.

Weinstein SP, O'Boyle E, Haber RS. Thyroid hormone increases basal and insulin-stimulated glucose transport in skeletal muscle: the role of GLUT4 glucose transporter expression. Diabetes. 1994;43(10):1185-9.

Moeller LC, Dumitrescu AM, Walker RL, Meltzer PS, Refetoff S. Thyroid hormone responsive genes in cultured human fibroblasts. J Clin Endocrinol Metabol. 2005;90(2):936-43.

Kim HB, Han KH, Lee BW, Kim H, Lee MH, Chung ES, et al. HbA1c and serum fructosamine levels in hyperthyroidism. J Korean Soci Endocrinol. 1992;7(1):46-51.

Park EA, Jerden DC, Bahouth SW. Regulation of phosphoenolpyruvate carboxykinase gene transcription by thyroid hormone involves two distinct binding sites in the promoter. Biochemical J. 1995;309(3):913-9.

Weinstein SP, O'Boyle E, Fisher M, Haber RS. Regulation of GLUT2 glucose transporter expression in liver by thyroid hormone: evidence for hormonal regulation of the hepatic glucose transport system. Endocrinol. 1994 Aug 1;135(2):649-54.

Tam AA, Tam H, Usluogullari CA, Dede I, Balkan F, Kaya C, et al. The levels of HbA1c in patients with thyroid dysfunction Gaziantep Med J. 2015;21(1):5-8.

Makadia MG, Patel VI, Patel PK, Shah AD, Chaudhari KS, Shah HN, et al. Study of Glycated Haemoglobin (HbA1c) in non-diabetic subjects with subclinical hypothyroidism. J Clin Diag Res. 2017;11(4):BC01-BC04.

Gram-Hansen P, Eriksen J, Mourits-Andersen T, Olesen L. Glycosylated haemoglobin (HbA1c) in iron- and vitamin B12 deficiency. J Intern Med. 1990;227(2):133-6.

Coban E, Ozdogan M, Timuragaoglu A. Effect of iron deficiency anemia on the levels of hemoglobin A1c in nondiabetic patients. Acta Haematol. 2004;112(3):126-8.

Ng JM, Jennings PE, Laboi P, Jayagopal V. Erythropoetin treatment significantly alters measured glycatedhaemoglobin (HbA1c). Diabet Med. 2008;25(2):239-40.

Coban E, Ozdogan M, Timuragaoglu A. Effect of iron deficiency anaemia on the levels of haemoglobinA1c in nondiabetic patients. Acta Haematol. 2004;112(3):126-28.

El-Agouza I, Abu Shohla A, Sirdah M. The effect of iron deficiency anaemia on the levels of haemoglobin subtypes: possible consequences for clinical diagnosis. Clin Lab Haematol. 2002;24:285-89.

Pasupathi P, Chandrasekar V and Kumar US. Evaluation of oxidative stress, antioxidant and thyroid hormone status in patients with diabetes mellitus. J Medicine. 2009;10:60-6.

Rochon C, Tauveron I, Dejax C, Benoit P, Capitan P, Fabricio A, et al, Response of glucose disposal to hyperinsulinaemia in human hypothyroidism and hyperthyroidism. Clin Sci. 2003;104(1):7-15.

Udiong CEJ, Udoh AE, Etukudoh ME. Evaluation of thyroid function in diabetes mellitus in calabar, Nigeria. India J Clin Biochem. 2007;22(2):74-8.

Schlienger JL, Anceau A, Chabrier G, North ML, Stephan F. Effect of diabetic control on level of circulating thyroid hormones. Diabetologia. 1982;22:486-8.

Gursoy N, Ercan T, Erdinç E, Ayhan AK. The relationship between the glycemic control and the hypothalamuspituitary-thyroid axis in diabetic patients, Turkish J Endocrinol Metab. 1999;4:163-8.