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The Crosstalk Between Insulin Resistance, Systemic Inflammation, Redox Imbalance and the Thyroid in Subjects with Obesity

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The Crosstalk Between Insulin Resistance, Systemic Inflammation, Redox Imbalance and the Thyroid in Subjects with Obesity Journal of Mind and Medical Sciences Volume 8 Issue 1 Article 19 The crosstalk between insulin resistance, systemic inflammation, redox imbalance and the thyroid in subjects with obesity Nicoleta Răcătăianu IULIU HAŢIEGANU UNIVERSITY OF MEDICINE AND PHARMACY, DEPARTMENT OF ENDOCRINOLOGY, CLUJ-NAPOCA, ROMANIA Nicoleta Valentina Leach IULIU HAŢIEGANU UNIVERSITY OF MEDICINE AND PHARMACY, THE 5TH DEPARTMENT OF INTERNAL MEDICINE, CLUJ-NAPOCA, ROMANIA, [email protected] Sorana D. Bolboacă IULIU HAŢIEGANU UNIVERSITY OF MEDICINE AND PHARMACY, DEPARTMENT OF MEDICAL INFORMATICS AND BIOSTATISTICS, CLUJ-NAPOCA, ROMANIA Maria Loredana Soran NATIONAL INSTITUTE FOR RESEARCH AND DEVELOPMENT OF ISOTOPIC AND MOLECULAR TECHNOLOGIES, CLUJ-NAPOCA, ROMANIA Mirela Flonta INFECFollowTIOUS this and DISEASES additional CLINICAL works at: HOSPI https:/TAL,/scholar LABORA.valpo.edu/jmmsTORY DEPARTMEN T, CLUJ-NAPOCA, ROMANIA Part of the Digestive, Oral, and Skin Physiology Commons, Endocrinology, Diabetes, and Metabolism Commons, Medical Biochemistry Commons, Medical Immunology Commons, Medical Nutrition See next page for additional authors Commons, Medical Pharmacology Commons, and the Medical Physiology Commons Recommended Citation Răcătăianu, Nicoleta; Leach, Nicoleta Valentina; Bolboacă, Sorana D.; Soran, Maria Loredana; Flonta, Mirela; Valea, Ana; Lazăr, Andrada-Luciana; and Ghervan, Cristina () "The crosstalk between insulin resistance, systemic inflammation, redox imbalance and the thyroid in subjects with obesity," Journal of Mind and Medical Sciences: Vol. 8 : Iss. 1 , Article 19. DOI: 10.22543/7674.81.P139148 Available at: https://scholar.valpo.edu/jmms/vol8/iss1/19 This Research Article is brought to you for free and open access by ValpoScholar. It has been accepted for inclusion in Journal of Mind and Medical Sciences by an authorized administrator of ValpoScholar. For more information, please contact a ValpoScholar staff member at [email protected]. The crosstalk between insulin resistance, systemic inflammation, edor x imbalance and the thyroid in subjects with obesity Authors Nicoleta Răcătăianu, Nicoleta Valentina Leach, Sorana D. Bolboacă, Maria Loredana Soran, Mirela Flonta, Ana Valea, Andrada-Luciana Lazăr, and Cristina Ghervan This research article is available in Journal of Mind and Medical Sciences: https://scholar.valpo.edu/jmms/vol8/iss1/ 19 Journal of Mind and Medical Sciences https://scholar.valpo.edu/jmms/ https://proscholar.org/jmms/ I S S N : 2 3 9 2 - 7 6 7 4 The crosstalk between insulin resistance, systemic inflammation, redox imbalance and the thyroid in subjects with obesity Nicoleta Răcătăianu1, Nicoleta Valentina Leach2*, Sorana D. Bolboacă3, Maria Loredana Soran4, Mirela Flonta5, Ana Valea1, Andrada-Luciana Lazăr6, Cristina Ghervan1 1 IULIU HAŢIEGANU UNIVERSITY OF MEDICINE AND PHARMACY, DEPARTMENT OF ENDOCRINOLOGY, CLUJ-NAPOCA, ROMANIA 2 IULIU HAŢIEGANU UNIVERSITY OF MEDICINE AND PHARMACY, THE 5TH DEPARTMENT OF INTERNAL MEDICINE, CLUJ-NAPOCA, ROMANIA 3 IULIU HAŢIEGANU UNIVERSITY OF MEDICINE AND PHARMACY, DEPARTMENT OF MEDICAL INFORMATICS AND BIOSTATISTICS, CLUJ-NAPOCA, ROMANIA 4 NATIONAL INSTITUTE FOR RESEARCH AND DEVELOPMENT OF ISOTOPIC AND MOLECULAR TECHNOLOGIES, CLUJ-NAPOCA, ROMANIA 5 INFECTIOUS DISEASES CLINICAL HOSPITAL, LABORATORY DEPARTMENT, CLUJ-NAPOCA, ROMANIA 6 IULIU HAŢIEGANU UNIVERSITY OF MEDICINE AND PHARMACY, DEPARTMENT OF DERMATOLOGY, CLUJ-NAPOCA, ROMANIA ABSTRACT We aimed at assessing the interaction between visceral adipose tissue (VAT), insulin resistance (IR), circulating levels of monocyte chemoattractant protein-1 Category: Original Research Paper (MCP-1) and malondialdehyde (MDA) and the thyroid parameters in obese Received: November 13, 2020 subjects. Methods. Obese subjects without thyroid pathologies or diseases Accepted: January 26, 2021 associated with systemic inflammation and OS were recruited. Insulinemia, visceral fat thickness, metabolic and thyroid parameters were assayed. Circulating Keywords: levels of MCP-1 and MDA were used to quantify inflammation and OS. Results. insulin resistance, serum monocyte chemoattractant A number of 160 obese subjects were included. The MCP-1 level increased with protein-1 (MCP-1), oxidative stress (OS), thyroid dysfunction, visceral adiposity the degree of obesity and HOMA-IR. MCP 1 was positively associated with anti- * thyroperoxidase antibody (TPOab) levels and the frequency of Hashimoto’s Corresponding author: thyroiditis (HT). The MDA level was positively correlated with the degree of obesity, aspartate aminotransferase and MCP-1. MDA was an independent Nicoleta Valentina Leach, predictor for the occurrence of hypothyroidism. IR patients showed higher fT3 Iuliu Haţieganu University of Medicine and Pharmacy, The 5th Department of Internal Medicine, Cluj-Napoca, levels and a positive association between insulin and TPOab levels. Conclusions. Romania Systemic inflammation increased with VAT, IR and OS and was correlated with E-mail: [email protected] the frequency and the severity of HT, suggesting that, in obesity, MCP-1 could be part of the etiopathogenesis of autoimmune thyroiditis. MDA was an independent risk factor for hypothyroidism; therefore, redox imbalance associated with obesity can produce cell damage and thyroid dysfunction. FT3 is increased in IR patients, thus being a marker for the severity of metabolic impairment. Introduction the relationship between thyroid nodules and insulin resistance (IR) has been established [4]. Several studies Obesity has become a public health problem with a [5,6] have shown that patients with obesity have a high highly increased prevalence among adults and children. prevalence of thyroid disorders, although the mechanisms Furthermore, the risk of developing a metabolic syndrome linking obesity to thyroid pathology are not completely is higher in patients with obesity; metabolic syndrome is understood. IR, low-grade systemic chronic inflammation, the result of the interplay between an unhealthy lifestyle and increased oxidative stress (OS) associated with obesity and genetic predisposition [1,2]. can directly cause the impairment of thyroid cells and may There is an interconnection between obesity and altered trigger factors for autoimmune thyroiditis [7,8]. thyroid function [3]. Thus, patients suffering from obesity Additionally, an increased resistance to thyroid seem to have lower levels of free T4 (fT4) together with a hormones was established in patients suffering from higher volume of the thyroid gland compared to those with obesity, a condition which significantly improved after a body mass index (BMI) within normal limits. Moreover, bariatric surgery together with the improvement of the To cite this article: Nicoleta Răcătăianu, Nicoleta Valentina Leach, Sorana D. Bolboacă, Maria Loredana Soran, Mirela Flonta, Ana Valea, Andrada-Luciana Lazăr, Cristina Ghervan. The crosstalk between insulin resistance, systemic inflammation, redox imbalance and the thyroid in subjects with obesity. J Mind Med Sci. 2021; 8(1): 139-148. DOI: 10.22543/7674.81.P139148 Nicoleta Răcătăianu et al. thyrotroph thyroxine resistance index and the thyroid- subjects with obesity at a cut-off HOMA-IR ≥ 2.5 and stimulating hormone index [8]. Baseline thyroid compare IR to non-IR groups in terms of inflammation, stimulating hormone (TSH) levels might be related to redox imbalance, and thyroid parameters, considering IR weight-loss after laparoscopic gastric banding. Thus, the as a marker of severe metabolic impairment. amount of short-term weight loss after the aforementioned Our study's novelty consists of the complex, integrative procedure is greater in patients with low normal TSH than analyses of the associations between metabolic markers, those with normal and high-normal values [9]. systemic inflammation, OS and thyroid parameters, and Visceral adipose tissue (VAT) is a significant their evaluation as possible risk factors for the changes in determinant of IR vi increased production of thyroid morpho-functioning, commonly observed in proinflammatory cytokines (leptin, TNFα, IL-6), and subjects with obesity. chemokines such as monocyte chemoattractant protein-1 (MCP-1). MCP-1 determines monocytes' recruitment and Materials and Methods their differentiation into macrophages, increasing the A cross-sectional, observational study was conducted inflammatory cascade and interfering with local and with the recruitment of eligible subjects, using a non- systemic insulin signaling [10]. Although several studies probabilistic sampling method, i.e. convenient sampling. have assessed serum MCP-1 levels in patients with fatty Patients with obesity, presenting from November 2015 to liver [11] or thyroid diseases [12], not enough data have December 2017 to the Endocrinology outpatient clinic for been reported regarding the effect of "low grade" systemic obesity investigation, were consecutively enrolled. inflammation associated with obesity on thyroid morpho- Subjects aged >18 years and with a BMI ≥ 30 kg/m2 were functioning. The interplay between high sensitive-C included in the sample. Patients with previously known reactive protein (hs-CRP) levels and subclinical thyroid disorders or diseases associated with increased hypothyroidism (SH) has also been analyzed in a cross- systemic inflammation and OS, including diabetes sectional study; however, no association between hs-CRP mellitus, depression, epilepsy, schizophrenia, cancer, and SH was found [13]. rheumatoid arthritis, decompensated liver disease,
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