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This version published online on September 26, 2006
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2006-0478
A more recent version of this article appeared on December 1, 2006
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Submitted on March 1, 2006
Accepted on September 19, 2006

Insulin action in adipose tissue and muscle in hypothyroidism

George Dimitriadis*, Panayota Mitrou, Vaia Lambadiari, Eleni Boutati, Eirini Maratou, Demosthenes B. Panagiotakos, Efi Koukkou, Marinela Tzanela, Nikos Thalassinos, and Sotirios A. Raptis

2nd Department of Internal Medicine, Research Institute and Diabetes Center, Athens University Medical School, Athens, Greece, Hellenic National Diabetes Center, Athens, Greece, Department of Statistics, Harokopio University, Athens, Greece and Departments of Endocrinology "Elena Venizelou" and "Evangelismos" Hospitals, Athens, Greece

* To whom correspondence should be addressed. E-mail: gdim{at}internet.gr or gdimitr@med.uoa.gr.

Background: Although insulin resistance in thyroid hormone excess is well documented, information on insulin action in hypothyroidism is limited.

Methods: To investigate this, a meal was given to 11 hypothyroid (HO, age 45 ± 3 yr) and 10 euthyroid subjects (EU, age 42 ± 4 yr). Blood was withdrawn for 360min from veins (V) draining the anterior abdominal sc adipose tissue and the forearm and from the radial artery (A). Blood flow (BF) in adipose tissue was measured with 133Xe and in forearm with strain-gauge plethysmography. Tissue glucose uptake was calculated as (A-V)glucose(BF), Lipoprotein lipase (LPL) as (A-V)Triglycerides(BF) and lipolysis as [(V-A)glycerol(BF)]-LPL.

Results: The HO had higher glucose and insulin levels than the EU (P < 0.05). In HO vs. EU after meal ingestion (AreaUnderCurve0-360min): (a) BF (1290 ± 79 vs. 1579 ± 106ml/100ml tissue in forearm and 706 ± 105 vs. 1340 ± 144ml/100ml tissue in adipose tissue) and glucose uptake (464 ± 74 vs. 850 ± 155 µmol/100ml tissue in forearm and 208 ± 42 vs. 406 ± 47 µmol/100ml tissue in adipose tissue) were decreased (P < 0.05), but fractional glucose uptake was similar (28 ± 6 vs. 33 ± 6% per min in forearm and 17 ± 4 vs. 14 ± 3% per min in adipose tissue); (b) suppression of lipolysis by insulin was similar; (c) plasma triglycerides were elevated (489 ± 91 vs. 264 ± 36 µmol/100ml tissue, P < 0.05), while adipose tissue LPL (42 ± 11 vs. 80 ± 21 µmol/100ml tissue) and triglyceride clearance (45 ± 10 vs. 109 ± 21ml/100ml tissue) were decreased in HO (P < 0.05).

Conclusions: In hypothyroidism: (a) glucose uptake in muscle and adipose tissue is resistant to insulin; (b) suppression of lipolysis by insulin is not impaired; (c) hypertriglyceridemia is due to decreased clearance by the adipose tissue.




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