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PubMed1996

Disrupted co-ordination of Pax-8 and thyroid transcription factor-1 gene expression in a dedifferentiated rat thyroid tumour cell line derived from FRTL-5.

The mutant rat thyroid cell line FRTL-5/TA, isolated from a non-functional tumour which originated spontaneously from wild-type FRTL-5 cells, shows autonomous TSH-independent growth and loss of the thyroid-specific phenotype, lacking thyroid-specific expression of thyroglobulin (Tg) and thyroid peroxidase (TPO) genes. To investigate the role of the transcription factors Pax-8 and thyroid transcription factor-1 (TTF-1) in rat thyroid tumorigenesis, RNA expression of these two thyroid-specific nuclear factors was measured in FRTL-5/TA tumour cells and compared with the expression in wild-type FRTL-5 cells. TTF-1 gene expression was similar to that in wild-type FRTL-5, and showed a similar down-regulation after stimulation with TSH. The finding suggested normal TTF-1 mRNA and protein expression in both cell lines. By contrast, Pax-8 mRNA transcript signal was markedly reduced in FRTL-5/TA cells, reaching levels as low as 8% of the normal, basal level in FRTL-5 cells. These data indicated that the loss of thyroid-specific expression of Tg and TPO genes in FRTL-5/TA cells was not related to changes in TTF-1 gene expression but rather to reduced Pax-8 gene expression. It was concluded that a disruption of the co-ordinated expression of TTF-1 and Pax-8 is implicated in the loss of thyroid phenotype of FRTL-5/TA cells in terms of reduced Tg and TPO expression.

Animals↗
PubMedDate not supplied

[Comparative study of Hashimoto thyroiditis and "focal thyroiditis"].

As shown by a semiquantitative analysis of histological changes in the thyroid tissue, there is a correlation between some characteristic features of autoimmune thyroiditis (Hashimoto's thyroiditis). Formation of lymphoid nodules in the thyroid in autoimmune thyroiditis was followed up and its three stages were distinguished. Autoimmune thyroiditis has three degrees of activity by diffuse lymphoid-plasmocytic infiltration, thyroid tissue destruction and lymphoid nodules formation. Differences between autoimmune thyroiditis and focal thyroiditis are revealed. The above differences include spread and cellular composition, content of the lymphoid-plasmocytic infiltrate, the degree of the destructive changes, B-cell hyperplasia, expression of CD-4 on T-helpers and CD-19 on B-lymphocytes, cytological picture. These differences allow differential diagnosis between these diseases.

Adenoma↗
PubMed2003

Mutant thyroid hormone receptor beta represses the expression and transcriptional activity of peroxisome proliferator-activated receptor gamma during thyroid carcinogenesis.

The molecular genetics underlying thyroid carcinogenesis is not clear. Recent identification of a PAX8-peroxisome proliferator-activated receptor gamma (PPARgamma) fusion gene in human thyroid follicular carcinoma suggests a tumor suppressor role of PPARgamma in thyroid carcinogenesis. Mice harboring a knockin mutant thyroid hormone beta receptor (TRbetaPV) spontaneously develop thyroid follicular carcinoma through pathological progression of hyperplasia, capsular invasion, vascular invasion, anaplasia, and eventually, distant organ metastasis. This mutant mouse (TRbeta(PV/PV) mouse) provides an unusual opportunity to ascertain the role of PPARgamma in thyroid carcinogenesis. Here, we show that the expression of PPARgamma mRNA was repressed in the thyroid gland of mutant mice during carcinogenesis. In addition, TRbetaPV acted to abolish the ligand (troglitazone)-mediated transcriptional activity of PPARgamma. These results indicate that repression of PPARgamma expression and its transcriptional activity are associated with thyroid carcinogenesis and raise the possibility that PPARgamma could be tested as a therapeutic target in thyroid follicular carcinoma.

Adenocarcinoma, Follicular↗
PubMedDate not supplied

[Assessment of the effectiveness of conservative therapy of autoimmune thyroiditis using echographic study of the thyroid].

A thyroid enlargement was noted during ultrasound investigation of 41 patients with autoimmune thyroiditis. The structure of glandular tissue was inhomogeneous with zones of rarity and density. Repeated echography of the thyroid in 20 patients with autoimmune thyroiditis after prolonged thyrotherapy (thyroiodine at a daily dose of 0.1-0.2 g and 1.2 tablets of Thyreocomb daily) revealed diminished sizes of the thyroid in 9 patients, unchanged sizes of the thyroid in 11, unchanged echostructure of the thyroid in 17, in 3 patients thyroid tissue echogeneity was increased, its structure became more homogeneous, sizes became less. This method provides additional information on the topography, sizes and echostructure of the thyroid, assessing the effectiveness of conservative therapy.

Adult↗
PubMedDate not supplied

Thyroid tumors and thyroid function in women exposed to internal and external radiation.

The frequency of tumors and other conditions of the thyroid gland were examined in 686 female radium dial workers first employed before 1930, who had a radium body-burden measurement while living (1958-76). If one assumed that the two thyroid cancers ascertained were radiation-induced and that a linear dose-response relationship existed, the estimated thyroid cancer risk was 69 (4-124, 95% confidence range) per 10(6) person-rem thyroid dose equivalent from internal and external radiation. Using data from the Connecticut tumor registry to obtain expected numbers of thyroid cancer, the estimated risk (2 observed vs. 0.67 expected cases) was 46 (95% confidence interval = -19 to 101) excess cases per 10(6) person-rem. Risk estimates were based on crude estimates of external radiation exposure and uncertain quality factors for internal radiation from alpha particles ingested. The frequencies of benign tumor (adenoma), nodules, and goiters were not significantly higher in the higher thyroid-dose groups (5-19, greater than or equal to 20 or greater than or equal to 50 rem) than in the lowest dose group (less than 5 rem). In 1237 female dial workers first employed before 1930, with or without a radium body-burden measurement, no deaths due to thyroid cancer (underlying cause of death on death certificates) were observed during 1950-76, when 0.4 deaths were expected. In a subgroup of 84 Illinois female dial workers who were long-term survivors, means for thyroid function test (T3 resin uptake and free thyroxine index) results did not differ among the thyroid-dose groups.

Adenocarcinoma↗
PubMed1984

Expression of intermediate filament proteins in thyroid gland and thyroid tumors.

The presence of intermediate filament proteins of cytokeratin/prekeratin type and vimentin type was evaluated in non-neoplastic thyroid glands and in different types of thyroid neoplasms. Follicular epithelium of both normal and goitrous thyroids showed a strong reaction with anticytokeratin antibodies that widely cross-react with various simple epithelia. On the other hand, in normal thyroid, there were only occasionally (in one of 12 cases) solitary cells reacting with antibodies to epidermal prekeratin. In nodular goiters, such cells were often seen (eight of 18), especially among the lining cells of cysts, and in chronic thyroiditis in all (12 of 12) cases. Only the stromal cells and intraluminal macrophages reacted with antibodies to vimentin. Neoplastic cells of papillary carcinomas showed a positive staining reaction both with antibodies to cytokeratins and to epidermal prekeratin. Follicular carcinoma cells, although positive for cytokeratins, could generally not be stained with antibodies to epidermal prekeratin. Medullary carcinoma cells also showed cytokeratin positivity and, only occasionally, positivity for epidermal prekeratin. Anaplastic carcinomas were also reactive with antibodies to cytokeratin but, for the most part, were negative for epidermal prekeratin. Interestingly, some neoplastic cells of all types of thyroid carcinomas also appeared to contain vimentin, as shown with both polyclonal and monoclonal antivimentin antibodies. In contrast to carcinomas, the intermediate filaments of thyroid sarcomas and lymphomas were only of vimentin type. Furthermore, it was found that the papillary structures in benign goiters were only reactive with cytokeratin antibodies and lacked, in contrast to papillary carcinomas, epidermal prekeratin-like immunoreactivity. Hence, the analysis of intermediate filament proteins of thyroid tumors can be utilized to differentiate between papillary and follicular carcinomas and between benign and malignant papillary lesions as well as between anaplastic thyroid carcinomas and sarcomas or lymphomas.

Adenocarcinoma↗
PubMed1982

[Anti-thyroglobulin and anti-thyroid microsomal antibodies in thyroid disorders].

Serum anti-thyroglobulin antibody (TgAb) and anti-thyroid microsomal antibody (McAb) in 213 cases of thyroid disorders and 32 cases of non-thyroid disorders were studied. The antibodies were checked by commercial tanned red cell hemagglutination kits (Thymune-T and Thymune-M) purchased from Wellcome Reagents, Limited, England. The positive rates of TgAb and McAb in patients with untreated toxic diffuse goiter (45 cases) were 25.6% and 74.4%, respectively; 22.2% and 44.4% in toxic diffuse goiter on antithyroid therapy (36 cases); 42.9% and 71.4% in hyperthyroidism after thyroidectomy (7 cases); 60% and 80% in Hashimoto's thyroiditis (10 cases) and 100% and 50% in idiopathic primary hypothyroidism (2 cases). In hyperthyroidism and Hashimoto's thyroiditis, the positive rates of McAb were much higher than those of TgAb. The positive rates of TgAb and McAb in non-toxic nodular goiter were 11.7% and 10.4%, respectively; 6.1% and 3.0% in non-toxic diffuse goiter and 3.1% and 3.1% in non-thyroid disorders, There were 13 cases whose TgAb titers were 80 x (dilution factor) or higher and 25 cases whose McAb titers were 1600 x or higher. All of them belonged to the autoimmune thyroid diseases. It is, therefore, concluded that patients with autoimmune thyroid diseases have not only higher positive rates of TgAb and McAb but also higher titers of such antibodies, and determinations of TgAb and McAb by using the tanned red cell hemagglutination technique are of help in the diagnosis of autoimmune thyroid diseases.

Adolescent↗
PubMed1995

Thyroid disease and abnormal thyroid function tests in women with eating disorders and depression.

Forty-two female patients with an eating disorder and major depression were compared with 48 female patients with major depression in a retrospective chart study for the prevalence of thyroid disease and laboratory thyroid function abnormalities in the absence of thyroid disease. Eating disorder patients, aged 30-80 years, had a significantly higher incidence in thyroid diseases (53%) then those with major depression alone (17%). The incidence of thyroid disease did not differ between the two groups among patients aged 11-29 years. Abnormal thyroid screening values occurred in 40% of euthyroid eating disorder patients and 34% of those with major depression. While the overall prevalence of thyroid disease in depressed females (15%) was similar to that in the general population (10.5%), thyroid disease in the eating disordered/depressed patients was twice the rate expected (24%) in the general population. Female patients who require psychiatric hospitalization should be routinely evaluated for thyroid function, especially those diagnosed with an eating disorder and depression.

Adolescent↗
PubMed1998

A method to differentiate between thyroglobulin derived from normal thyroid tissue and from thyroid carcinoma based on analysis of reactivity to lectins.

OBJECTIVE: The composition of sugar chains on thyroglobulin (Tg) produced in thyroid carcinoma cells (C-Tg) is different from Tg produced in normal thyroid tissues (N-Tg). In this study, we designed a new method for detecting Tg derived from thyroid carcinoma based on the differences between C-Tg and N-Tg in the reactivity with lectins. MATERIALS AND METHODS: Thyroglobulin preparations obtained from various thyroid tissues were incubated with lectins, and the amount of lectin-unbound Tg (ub-Tg) in the supernatant relative to Tg untreated with lectin was determined by enzyme-linked immunosorbent assay and expressed as ub-Tg(%). In addition, to study further the differences in glycosylation between C-Tg and N-Tg, concanavalin A binding to Tg digested with Staphylococcus aureus V8 protease was analyzed on nitrocellulose membrane after Western blotting. RESULTS: The ub-Tg(%) in C-Tg from papillary carcinoma was significantly higher than in Tg from Graves' disease, benign goiter, and normal thyroid tissue for both concanavalin A and ricinus communis agglutinin-120. Concanavalin A did not appear to bind to Tg from papillary carcinoma after V8 treatment by Western blot analysis. The ub-Tg(%) in Tg from follicular adenoma was significantly higher than C-Tg from follicular carcinoma, whereas there were no differences in ub-Tg(%) between follicular carcinoma and normal thyroid tissue in concanavalin A treatment. CONCLUSIONS: These results suggest our new methods can distinguish both between C-Tg from papillary carcinoma and N-Tg, and between follicular carcinoma and follicular adenoma in thyroid tissue specimens. Thus, this type of analysis may be applicable to differentiate C-Tg from N-Tg in thyroid aspirates for the adjunctive cytodiagnosis of thyroid carcinoma.

Biomarkers↗
PubMed1983

Antibodies that promote thyroid growth. A distinct population of thyroid-stimulating autoantibodies.

We used a strain of differentiated rat-thyroid cells in continuous culture (the FRTL-5 strain) to detect the presence of growth-promoting antibodies in serum samples from patients with autoimmune thyroid disease. We found that IgG preparations from 17 of 20 patients (85 per cent) with active Graves' disease and two of five patients (40 per cent) with Hashimoto's thyroiditis could augment thyroid-cell growth. In parallel with IgG-induced elevations in intracellular cyclic AMP levels in the same cell line, all 20 of the patients with active Graves' disease had thyroid-stimulatory antibodies. Patients' IgG preparations fell into three subclasses: those with both potent cyclic AMP stimulation and potent growth-promoting activity; those with potent cyclic AMP stimulation but low-level growth promotion; and those with potent growth promotion and low-level cyclic AMP action. Growth-promoting antibodies were not detected in patients with Graves' disease in remission (seven patients), nodular goiter (seven), subacute thyroiditis (five), or atrophic thyroiditis (one). Simultaneous assays of growth promotion and cyclic AMP stimulation may be useful in the care of patients with autoimmune thyroid disease.

Adult↗
PubMed1991

Spatial correlation between thyroid epithelial cells expressing class II MHC molecules and interferon-gamma-containing lymphocytes in human thyroid autoimmune disease.

In this immunohistochemical study we addressed the question whether aberrant class II MHC expression by thyroid epithelial cells (thyrocytes) in established thyroid autoimmune disease is the result of release of interferon-gamma (IFN-gamma) by adjacent lymphocytes. Thyroids from eight cases of Hashimoto's thyroiditis, 13 cases of Graves' disease and 10 cases of focal thyroiditis were studied. Both thyrocytes expressing class II MHC and lymphocytes containing immunoreactive IFN-gamma were found in all 31 autoimmune thyroids. In a serial section study of these thyroids, IFN-gamma-expressing lymphocytes were found within 50 microns of class II MHC-positive thyrocytes in 89% of 282 randomly selected fields. Conversely, class II MHC-positive thyrocytes were found within 50 micron of aggregates of IFN-gamma-positive lymphocytes in 82% of 272 randomly selected fields. These findings support the view that in established thyroid autoimmune disease expression of class II MHC by thyrocytes is the result of local release of IFN-gamma.

Autoimmune Diseases↗
PubMed1995

Interdependence of corticosterone and thyroid hormones in larval toads (Bufo boreas). I. Thyroid hormone-dependent and independent effects of corticosterone on growth and development.

In a previous study (Hayes et al. [1993] J. Exp. Zool., 266:206-215), we demonstrated that exogenous corticosterone (B) inhibited growth, and had varied effects on development and metamorphosis in the toad (Bufo boreas). The current study determined the relation between the actions of B and thyroid hormones on body growth (length and weight), tail growth and reduction (length and height), rear leg growth and differentiation, and foreleg emergence (FLE). Thiourea (Thio; a goitrogen) and metyrapone (MTP; a glucocorticoid synthesis inhibitor) were used to determine the role of endogenous hormones in growth and development. These inhibitors were also used in various combinations with the thyroid hormones, thyroxine (T4) and triiodothyronine (T3), to determine the extent to which B's actions depend on the thyroid hormones. B was ineffective at inducing tail reduction (length and height) in the presence of Thio, but B enhanced the effects of both thyroid hormones, suggesting that the actions of B on the tail were dependent on thyroid hormones. B inhibited body growth even in the presence of Thio, but did not enhance thyroid hormone's inhibition of growth. B alone stimulated foreleg emergence (FLE) and enhanced thyroid hormone's activity on FLE when B and the thyroid hormones were given in combination, but did not induce FLE in the presence of Thio. B stimulated rear leg development, but not in the presence of Thio, suggesting that this effect was due to interactions with thyroid hormones. Furthermore, MTP antagonized the stimulatory effect of T4 on rear leg development, suggesting that endogenous B also interacted with exogenous thyroid hormones.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗
PubMed2005

Localization of the immunodominant region on human thyroid peroxidase in autoimmune thyroid diseases: an update.

Recent studies in the field of autoimmune thyroid diseases have largely focused on the delineation of B-cell auto-epitopes recognized by the main autoantigens to improve our understanding of how these molecules are seen by the immune system. Among these autoantigens which are targeted by autoantibodies during the development of autoimmune thyroid diseases, thyroid peroxidase is a major player. Indeed, high amounts of anti-thyroid peroxidase autoantibodies are found in the sera of patients suffering from Graves' disease and Hashimoto's thyroiditis, respectively hyper and hypothyroidism. Since anti-thyroid peroxidase autoantibodies from patients'sera mainly recognize a discontinuous immunodominant region on thyroid peroxidase and due to the complexity of the three dimensional structure of human thyroid peroxidase, numerous investigations have been necessary to closely localize this immunodominant region. The aim of the present review is to summarize the current knowledge regarding the localization of the immunodominant region recognized by human thyroid peroxidase-specific autoantibodies generated during the development of autoimmune thyroid diseases.

Journal Article↗
PubMed1998

Prostate-thyroid axis: stimulatory effects of ventral prostate secretions on thyroid function.

BACKGROUND: Endocrine cells of the prostate secrete thyrotropin (TSH)-releasing hormone (TRH), TRH- and TSH-like peptides, and growth factors. Propylthiouracil- and methimazole-induced hypothyroidism increased prostatic levels of TRH in rats as in hypothalamus, whereas thyroxine (T4) replacement decreased TRH. From these reports, we inferred the existence of a prostate-thyroid axis. METHODS: The influence of the prostate on the thyroid gland was studied in albino rats. Ventral prostate was surgically removed on day 31 postpartum. The animals were sacrificed on day 60 postoperation. Serum thyroid hormones were assayed by radioimmunoassay (RIA). For in vitro studies, normal thyroid and ventral prostate glands were cocultured with or without thyroid-stimulating hormone (TSH) antibody, to assess the direct influence of prostatic secretions on thyroid hormone secretion. RESULTS: Serum total and free T4 and triiodothyronine (T3) were significantly reduced in ventral prostatectomized rats. Histological analysis of the thyroid showed that the diameters of the peripheral and middle follicles, colloid epithelial cells, and nuclei were increased in prostatectomized rats, indicating hypothyroid status. Total T3 and T4 were significantly elevated in the culture medium when thyroid and prostate were cocultured, irrespective of the presence of TSH antibody. CONCLUSIONS: The present study suggests that ventral prostatic secretions have a stimulatory role on the thyroid gland.

Aging↗
PubMed1995

Association of chronic lymphocytic thyroiditis and thyroid papillary carcinoma. A study of surgical cases among Japanese, and white and African Americans.

BACKGROUND: An association between lymphocytic thyroiditis and thyroid papillary carcinoma is still controversial. To determine a definite statistical relation, a histopathologic study was performed on tissues from in three races, because there is a racial and age-related difference in the susceptibility to thyroiditis. METHODS: The prevalence and severity of thyroiditis combined with adenomatous goiter, follicular adenoma, or papillary carcinoma was defined by examination of surgically resected materials from Japanese (626 patients), and white and African Americans (330 and 90 patients, respectively). RESULTS: The prevalence of lymphocytic infiltrates, which are indicative of autoimmune thyroiditis, was significantly higher in patients with papillary carcinoma than in patients with adenomatous goiter or follicular adenoma among Japanese females (63.0%) and males (50.0%), white females (76.0%), and African American females (46.2%). Lymphocyte infiltration into the follicular adenoma or papillary carcinoma correlated with the severity of combined thyroiditis. CONCLUSION: An association between chronic lymphocytic thyroiditis and papillary carcinoma was confirmed in the Japanese, and white and African American populations. The possibility of autoimmune thyroiditis as a predisposing factor for papillary thyroid carcinoma, is suggested.

Adenoma↗
PubMed1994

Reduction of thyroid hormone levels and alteration of thyroid function by four representative UDP-glucuronosyltransferase inducers in rats.

Male Sprague-Dawley rats (250-275 g) were fed diets containing four representative UDP-glucuronosyltransferase (UDP-GT) inducers, phenobarbital (PB), 3-methylcholanthrene (3MC), and pregnenolone-16 alpha-carbonitrile (PCN), as well as a polychlorinated biphenyl (PCB) mixture for 21 days to determine their effect on thyroid hormone levels and thyroid gland function. On Days 3, 7, 14, and 20, blood was collected and serum levels of free and total thyroxine (T4), free and total triiodothyronine (T3), and thyroid-stimulating hormone (TSH) were determined by radioimmunoassay. On Day 21, following treatment with Na131I, the thyroid glands were removed and weighed, and the amount of 131I incorporated was determined. The livers were removed and microsomes were isolated for determination of T4 UDP-GT activity. UDP-GT activity toward T4 was increased by PB, 3MC, PCN, and PCB approximately 190, 290, 260, and 550%, respectively, per kilogram of body weight. PB, 3MC, and PCN reduced serum total and free T4 30-40%, whereas PCB produced a 80-90% reduction. Total T3 levels were slightly reduced by treatment with PB, PCN, and PCB, but none of the treatments decreased free T3 levels. Serum T4 levels (total and free) were found to correlate with UDP-GT activity toward T4. The reductions in thyroid hormone levels led to an increase in TSH levels by PB, 3MC, PCN, and PCB (approximately 50, 50, 210, and 40%, respectively) on Day 20. The elevation of TSH led to an increase in thyroid gland weight by PCN (60%) and PCB (30%) and an increase in thyroidal 131I uptake by PB (60%), PCN (160%), and PCB (100%). Thus, while reasonable correlations between T4 glucuronidation and reduction of serum T4 can be made, only qualified correlations between reduction of T4 and increase in TSH and increase in TSH and stimulation of the thyroid can be made. In conclusion, three classes of microsomal enzyme inducers, represented by PB, 3MC, PCN, as well as PCB, increase UDP-GT activity toward T4 and decrease T4 levels. It appears that induction of UDP-GT plays a role in the effect of these chemicals on the thyroid gland.

Administration, Oral↗
PubMedDate not supplied

Measurement of thyroid cell surface antibodies by radioassay using human cultured thyroid cells.

The present report describes a sensitive and quantitative binding radioassay for measurement of thyroid cell surface antibodies (TCSAb). Enzyme-dispersed thyroid cells from surgical specimens of human normal thyroid tissue were used after 7 days of culture. 125I-labelled Graves' IgG was shown to bind to cultured thyroid cells. The binding was time-and temperature-dependent and increased linearly with the number of thyroid cells. Evidence for specificity was provided by the lack of binding of radioiodinated Graves' IgG to human fibroblasts and by the negligible binding of 125I-labelled normal IgG to thyroid cells. A dose-dependent inhibition of binding of 125I-labelled Graves' igG to thyroid cells was produced by the addition of graded amounts of the unlabelled original Graves' IgG preparation, but not by normal IgG. Assays for TCSAb were performed on IgG preparations from patients with and without thyroid autoimmune disorders using the original Graves' IgG preparation as reference standard. Results were expressed in terms of arbitrary units/100 microgram IgG, 1 unit corresponding to the minimum amount of the standard IgG producing a significant inhibition of binding. Negative tests were found in most normal subjects (15/18) while low TCSAb levels (less than or equal to 1.8 U/100 microgram IgG) were detected in 3 cases. Increased TCSAb levels were found in the majority of the patients wit Graves' disease (14/21), in most of the patients with idiopathic myxedema (9/10) and in all of those with Hashimoto's thyroiditis (10/10).

Autoantibodies↗
PubMed2006

Thyroid dysfunction and thyroid autoimmunity in Saudi type 2 diabetics.

Diabetes mellitus and thyroid disease are common endocrine disorders in the general population. To investigate the association between thyroid dysfunction, thyroid autoimmunity and Saudi type 2 diabetics, a random sample of 100 Saudi type 2 diabetics and 100 age- and sex-matched controls were studied. The mean age was 54 years for diabetics and 55 years for controls while the male:female ratios were 1:1.6 and 1:14 respectively. GAD65ab were found in 26% diabetics and 2% controls (p=0.001). Thyroid autoimmunity were detected in 10% diabetics vs. 5% controls (p=0.05), while thyroid dysfunction was found in 16% and 7% respectively (p=0.03). In GAD65ab-positive diabetics, thyroid autoimmunity was observed in 27% vs. 4% GAD65ab-negative diabetics (p=0.02) and thyroid dysfunction was reported in 42% and 7% respectively. We conclude that thyroid dysfunction and autoimmunity are common in Saudi type 2 diabetics. Further studies are needed on the cost effectiveness of thyroid screening in diabetics.

Autoimmunity↗