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Vol 73, No 5 (2022)
Original paper
Submitted: 2022-02-22
Accepted: 2022-03-30
Published online: 2022-07-18
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Association of antithyroid peroxidase antibodies with cardiac function in euthyroid women with type 1 diabetes mellitus — assessment with two-dimensional speckle‑tracking echocardiography

Magdalena Maria Łukawska-Tatarczuk12, Agnieszka Pawlak34, Jakub Zieliński5, Edward Franek24, Leszek Czupryniak1, Beata Mrozikiewicz-Rakowska1
DOI: 10.5603/EP.a2022.0041
·
Pubmed: 35971937
·
Endokrynol Pol 2022;73(5):812-822.
Affiliations
  1. Department of Diabetology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
  2. Department of Internal Diseases, Endocrinology, and Diabetology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Warsaw
  3. Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Warsaw, Poland
  4. Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw
  5. Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw, Warsaw, Poland

open access

Vol 73, No 5 (2022)
Original Paper
Submitted: 2022-02-22
Accepted: 2022-03-30
Published online: 2022-07-18

Abstract

Introduction: The presence of diabetes is associated with loss of cardioprotection in premenopausal women; however, the mechanisms involved remain unknown. Autoimmune factors are suspected to play a role in cardiovascular complications, especially in type 1 diabetes (T1DM). The aim of this pilot study was to explore whether antithyroid peroxidase antibody (aTPO) as a marker of increased immune activity is related to cardiac dysfunction in young, asymptomatic women with T1DM.

Material and methods: Eighty-eight euthyroid women (59 with T1DM and 29 healthy controls) underwent physical examination, laboratory tests, thyroid ultrasound, and two-dimensional speckle-tracking echocardiography. According to the antiperoxidase antibodies (aTPO) titre, the T1DM women were divided into an aTPO positive (T1DM aTPO+) (n = 34) and an aTPO negative (T1DM aTPO–) (n = 25) group. The relationship between thyroid autoimmunity parameters and echocardiographic parameters was evaluated.

Results: Global longitudinal strain (GLS) was slightly reduced in the T1DM aTPO+ group compared to T1DM aTPO– and significantly compared to controls (p = 0.051 and p = 0.015, respectively). Although, the lower values of longitudinal strain of left ventricular were found in the majority of segments in the T1DM aTPO+ group in comparison to T1DM aTPO– and controls, significant differences were only found in the two-chamber view (specifically in the anterior segments) between the T1DM aTPO+ and T1DM aTPO– groups (p = 0.030) and in the four-chamber view (specifically in the anterolateral segments) between the T1DM aTPO+ group and controls (p = 0.021). Echocardiographic parameters of diastolic and systolic function of both ventricles were significantly correlated with parameters of thyroid
autoimmunity. A logistic regression analysis showed that Hashimoto’s thyroiditis (HT) duration [odds ratio (OR): 0.997, 95% confidence interval (CI): 0.995–0.999, p = 0.008), the dose of levothyroxine (OR: 0.814, 95% CI: 0.689–0.960, p = 0.013), and reduced echogenicity on thyroid ultrasound (OR: 0.309, 95% CI: 0.120–0.793, p = 0.013) had a significant influence on reduced GLS.

Conclusions: Our results suggest that coexistence of aTPO with T1DM was associated with poorer myocardial function, particularly in the anterior and anterolateral segments, which may be related to an autoimmune factor. The impaired function of these segments is probably the first sign of myocardial systolic dysfunction in women with T1DM, which needs to be confirmed in further studies.

Abstract

Introduction: The presence of diabetes is associated with loss of cardioprotection in premenopausal women; however, the mechanisms involved remain unknown. Autoimmune factors are suspected to play a role in cardiovascular complications, especially in type 1 diabetes (T1DM). The aim of this pilot study was to explore whether antithyroid peroxidase antibody (aTPO) as a marker of increased immune activity is related to cardiac dysfunction in young, asymptomatic women with T1DM.

Material and methods: Eighty-eight euthyroid women (59 with T1DM and 29 healthy controls) underwent physical examination, laboratory tests, thyroid ultrasound, and two-dimensional speckle-tracking echocardiography. According to the antiperoxidase antibodies (aTPO) titre, the T1DM women were divided into an aTPO positive (T1DM aTPO+) (n = 34) and an aTPO negative (T1DM aTPO–) (n = 25) group. The relationship between thyroid autoimmunity parameters and echocardiographic parameters was evaluated.

Results: Global longitudinal strain (GLS) was slightly reduced in the T1DM aTPO+ group compared to T1DM aTPO– and significantly compared to controls (p = 0.051 and p = 0.015, respectively). Although, the lower values of longitudinal strain of left ventricular were found in the majority of segments in the T1DM aTPO+ group in comparison to T1DM aTPO– and controls, significant differences were only found in the two-chamber view (specifically in the anterior segments) between the T1DM aTPO+ and T1DM aTPO– groups (p = 0.030) and in the four-chamber view (specifically in the anterolateral segments) between the T1DM aTPO+ group and controls (p = 0.021). Echocardiographic parameters of diastolic and systolic function of both ventricles were significantly correlated with parameters of thyroid
autoimmunity. A logistic regression analysis showed that Hashimoto’s thyroiditis (HT) duration [odds ratio (OR): 0.997, 95% confidence interval (CI): 0.995–0.999, p = 0.008), the dose of levothyroxine (OR: 0.814, 95% CI: 0.689–0.960, p = 0.013), and reduced echogenicity on thyroid ultrasound (OR: 0.309, 95% CI: 0.120–0.793, p = 0.013) had a significant influence on reduced GLS.

Conclusions: Our results suggest that coexistence of aTPO with T1DM was associated with poorer myocardial function, particularly in the anterior and anterolateral segments, which may be related to an autoimmune factor. The impaired function of these segments is probably the first sign of myocardial systolic dysfunction in women with T1DM, which needs to be confirmed in further studies.

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Keywords

type 1 diabetes mellitus; thyroid autoimmunity; speckle tracking echocardiography; diabetic cardiomyopathy; heart failure

About this article
Title

Association of antithyroid peroxidase antibodies with cardiac function in euthyroid women with type 1 diabetes mellitus — assessment with two-dimensional speckle‑tracking echocardiography

Journal

Endokrynologia Polska

Issue

Vol 73, No 5 (2022)

Article type

Original paper

Pages

812-822

Published online

2022-07-18

Page views

1179

Article views/downloads

524

DOI

10.5603/EP.a2022.0041

Pubmed

35971937

Bibliographic record

Endokrynol Pol 2022;73(5):812-822.

Keywords

type 1 diabetes mellitus
thyroid autoimmunity
speckle tracking echocardiography
diabetic cardiomyopathy
heart failure

Authors

Magdalena Maria Łukawska-Tatarczuk
Agnieszka Pawlak
Jakub Zieliński
Edward Franek
Leszek Czupryniak
Beata Mrozikiewicz-Rakowska

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