MON-362 - Metabolic Score for Insulin Resistance in Patients with Autoimmune Thyroiditis and Graves' Disease

Introduction: Insulin resistance and lipid metabolism disorders are common in autoimmune thyroiditis (AIT) and Graves' disease.

Aim: To evaluate the relationship between METS-IR (metabolic score for insulin resistance), lipid profile and thyroid function in patients with AIT and Graves ' disease.

Methods: We evaluated a sample of 358 patients with AIT and 46 patients with Graves' disease with a mean age of 45.7 ± 16.0 years; 90.5 % were female.
We calculated the METS-IR [ln(2×fasting plasma glucose)+triglyceride)×body mass index]/[(ln (HDL-cholesterol)] and assessed thyroid function and obtained the FT3/FT4 ratio, the thyroid feedback quantile-based index (TFQI) and the TSH index (TSHI). We also evaluated thyroid antibodies, lipid profile, high-sensitivity C-reactive protein, vitamin B12, folic acid, CRP, anti-thyroid antibodies, and the insulin resistance indexes such as HOMA-IR, QUICKI (quantitative insulin sensitivity check index), HISI (hepatic insulin sensitivity index), WBISI (whole-body ISI) and IGI (insulinogenic index). The statistical analysis was done with the Student’s t-test and Pearson correlation. The results are in mean±DP. We considered a two-tailed P-value of < 0.05 significant.

Results: In the AIT group we found significative correlations between METS-IR and HOMA-IR (r = 0.31; p ≤ 0.001), WBISI (r = -0.27; p = 0.001) and IGI (r = 0.21; p = 0.007). In AIT group we also found significative correlations between METS-IR and glucose (r = 0.32; p ≤ 0.001), insulin (r = 0.26; p = 0.001), C-peptide (r = 0.40; p ≤ 0.001), total cholesterol (r = 0.16; p = 0.04), HDL (r = -0.58; p ≤ 0.001), LDL (r = 0.26; p = 0.001), triglycerides (r = 0.45; p ≤ 0.001), CRP (r = 0.27; p = 0.001), ApoA1 (r = -0.27; p = 0.001) and ApoB (r = 0.32; p ≤ 0.001). In the Graves group we found significative correlations between METS-IR and TSHI (r = -0.33; p = 0.03), T3/T4 Ratio (r = -0.42; p = 0.007), HOMAb (r = -0.34; p = 0.04), WBISI (r = -0.32; p = 0.04), IGI (r = 0.45; p = 0.004), FT3 (r = -0.33; p = 0.04), glucose (r = 0.48; p = 0.002), C-peptide (r = 0.36; p = 0.02), HDL (r = -0.43; p = 0.006), triglycerides (r = 0.39; p = 0.01) and CRP (r = 0.37; p = 0.02). The TFQI was significantly higher in AIT group comparing with Graves group (0.46 ± 0.19 vs 0.37 ± 0.17; p = 0.02).

Conclusions: In patients with AIT, METS-IR strongly correlated with other insulin resistance markers (HOMA-IR, WBISI, IGI) and metabolic factors like glucose, insulin, and C-peptide. In patients with Graves` disease, METS-IR correlated with TSH index, T3/T4 Ratio, and FT3 levels. In both groups, higher METS-IR was linked to higher CRP.

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