Περίληψη:
Thyroid disease and type 1 but also type 2 diabetes mellitus (DM) are
strongly associated, and this has important clinical implications for
insulin sensitivity and treatment requirements. The pathophysiological
basis of this association has only recently been better elucidated. It
rests on a complex interaction of common signalling pathways and, in the
case of type 1 diabetes and autoimmune thyroid disease, on a linked
genetic susceptibility. The pathophysiological mechanisms underlying
this linked regulation are increasingly being unravelled. They are
exemplified in the regulation of 5’ adenosine monophosphate-activated
protein kinase (AMPK), a central target not only for the modulation of
insulin sensitivity but also for the feedback of thyroid hormones on
appetite and energy expenditure. The present review will discuss these
concepts and their consequences for the clinical care of patients with
DM and thyroid disorders. Moreover, it makes reference to the added
effect of metformin in suppressing TSH.
Συγγραφείς:
Duntas, Leonidas H.
Orgiazzi, Jacques
Brabant, Georg