Background: It is related that thyroid appears can be affected by insulin resistance (IR). Early and severe IR is a characteristic of Congenital Generalized Lipodystrophy (CGL), characterized by near to total absence of subcutaneous adipose tissue. There are few studies about thyroid abnormalities in CGL.
Aim: To describe thyroid structure and function in patients with CGL and correlate with HOMA-IR. Methods: The patients were submitted to a medical interview, physical examination, thyroid ultrasonography and biochemical, lipid profile and thyroid hormones evaluation.
Results: Twenty-three patients with a CGL were included, median age was 13.3 years (3.6 to 38.7), 15 (65%) were younger than 19 years, 14/23 (60.8%) were women and 14 (60.8%) patients had diabetes. All patients had low leptin levels, low HDL cholesterol and 18/23 (78,2%) had hypertriglyceridemia (316.55-1052mg/dL). The prevalence of thyroid hormonal dysfunction was 17.4% (4/23): subclinical (1/23) and clinical hypothyroidism (1/23), subclinical (1/23) and clinical hyperthyroidism (1/23). TSH level was 1.27 uUI/mL (0.48 - 6.71), fT4, 1.06 ng/dL (0.82 - 1.92) and T3, 1.27 ng/dL (0, 69 - 1.76). Antithyroperoxidase (ATPO) and anti-titreoglobulin (ATG) antibodies were positive in 4% (1/23) and in 17.3% (4/23). There was a negative correlation between HOMA-IR and fT4 (r= 0.036). The thyroid volume was 4.3 cm³ (1.04 - 60.4), it was altered in 19% of the patients: 33% had nodules and another 33%, parenchyma heterogenicity. There was a positive correlation between HOMA-IR and volume (r= 0.035). A case of thyroid carcinoma was diagnosed in an 8 years-old girl.
Conclusion: The prevalence of thyroid abnormalities was higher than in population data, especially in a young population. IR correlated positively with thyroid volume and negatively with T4l levels. This study did not show correlation between IR and autoimmunity. These data support that thyroid may be directly influenced by the high levels of insulin present in CGL.
V.O. Fernandes: None. G.D. Lima: None. A.D. Montenegro: None. A.B. Carvalho: None. G.M. Rodrigues: None. I.P. Melo: None. L.V. Martins: None. L.A. Batista: None. L. Aguiar: None. R.M. Montenegro: None.