Thyroid autoimmunity among type 2 diabetes mellitus: assessing anti-thyroid peroxidase (anti-TPO) antibodies


  • Narendra Kumar Sah Department of Biochemistry, Maharishi Markandeshwar, Medical College & Hospital, Kumarhatti-Solan,173229, H.P., India
  • Saurabh Kumar Deo Department of Biochemistry, Adesh Medical College & Hospital, Mohri, Kurukshetra, 136135, Haryana, India
  • Harpreet Kaur Walia Department of Biochemistry, Maharishi Markandeshwar, Medical College & Hospital, Kumarhatti-Solan,173229, H.P., India
  • Alka Singh Department of Biochemistry, Maharishi Markandeshwar, Medical College & Hospital, Kumarhatti-Solan,173229, H.P., India
  • Suvarna Prasad Department of Biochemistry, Maharishi Markandeshwar Institute of Medical Sciences & Research, Mullana-Ambala, 133203, Haryana, India
  • Kiranjeet Kaur Department of Biochemistry, Maharishi Markandeshwar, Medical College & Hospital, Kumarhatti-Solan,173229, H.P., India



Thyroid peroxidase, thyroid autoimmunity, anti-TPO antibodies


Introduction and Aim: Thyroid disorder, the most abundant endocrine disorder in the globe ranks second after diabetes mellitus. Because of immune resistance to thyroid gland, it leads to the development of hyperthyroidism and hypothyroidism. Autoantibodies against thyroid peroxidase (TPO) - a critical enzyme in the thyroid hormone biogenesis is responsible for thyroid autoimmunity and is increasingly found among type 2 diabetes mellitus (T2DM). So, the present study was designed to assess the serum anti-TPO antibodies among type 2 diabetes mellitus in hospital setting.


Materials and Methods: 100 clinically diagnosed type 2 diabetes mellitus was included with 50 age and sex matched apparently healthy controls in the age range 35-70 years. Mean age (in Years) of male and female T2DM cases had 57.40±5.93 and 55.96±7.39 respectively. Also, the male and female controls had mean age as 56.24±8.74 and 54.20±8.90 respectively.


Results: The mean glycated hemoglobin (HbA1c) value among T2DM male and female cases was found to be 8.53±2.02% and 8.66±1.90% respectively. The mean value of serum TSH was found to be highly significant statistically among T2DM as compared to healthy controls, whereas mean value of serum anti-TPO antibodies was significant statistically among T2DM as compared to healthy controls. The occurrence of anti-TPO antibodies among T2DM was found to be 13 out of 100 (13%) in the present study.


Conclusion: The association between serum TSH and anti-TPO antibodies among T2DM patients was found to be highly significant statistically. Thus, the existence of higher anti-TPO antibodies among T2DM points out the future development of functional thyroid problem in such patients.


Sah, N. K., Kaur, H., I, Sheikh., Sodhi, K. S., Singh, J., Bhaskar, N., et al., Microalbuminuria as an independent risk factor of cardiovascular disease in type 2 diabetes mellitus. Journal of Pharmaceutical and Biomedical Sciences. 2013; 32(32): 1324-1328.

Baruah, M. P., Kalra, S., Unnikrishnan, A. G., Raza, S. A., Somasundaram, S., John, M., et al., Management of hyperglycemia in geriatric patients with diabetes mellitus: South Asian consensus guidelines. Indian Journal of Endocrinology and Metabolism. 2011? 15: 75-90.

Heuck, C. C., Kallner, A., Kanagasabapathy, A. S., Riesen, W. Diagnosis and monitoring of the disease of the thyroid. WHO Document; 2012: 8-9.

Collins, J., Gough, S. Autoimmunity in thyroid disease. European Journal of Nuclear Medicine and Molecular Imaging. 2002; 29: 417-424.

Nielsen, C. H., Hegedüs, L., Leslie, R. G. Autoantibodies in autoimmune thyroid disease promote immune complex formation with self-antigens and increase B cell and CD4+ T cell proliferation in response to self-antigens. European Journal of Immunology. 2004; 34: 263-272.

Matejková-Behanová, M., Zamrazil, V., Vondra, K., Vrbíková, J., Kucera, P., Hill, M., et al., Autoimmune thyroiditis in non-obese subjects with initial diagnosis of Type 2 diabetes mellitus. Journal of Endocrinological Investigation. 2002; 25: 779-784.

Toulis, K., Tsekmekidou, X., Potolidis, E., Didangelos, T., Gotzamani-Psarrakou, A., Zebekakis, P., et al., Thyroid autoimmunity in the context of type 2 diabetes mellitus: implications for vitamin D. International Journal of Endocrinology. 2015; 2015: 1-5.

Pietropaolo, M., Barinas-Mitchell, E., Pietropaolo, S. L., Kuller, L. H., Trucco, M. Evidence of islet cell autoimmunity in elderly patients with type 2 diabetes. Diabetes. 2000; 49: 32-38.

Turner, R., Stratton, I., Horton, V., Manley, S., Zimmet, P., Mackay, I.R., et al., UKPDS 25: autoantibodies to islet-cell cytoplasm and glutamic acid decarboxylase for prediction of insulin requirement in type 2 diabetes. UK Prospective Diabetes Study Group. Lancet. 1997; 350: 1288-1293.

Gambelunghe, G., Forini, F., Laureti, S., Murdolo, G., Toraldo, G., Santeusanio, F., et al., Increased risk for endocrine autoimmunity in Italian type 2 diabetic patients with GAD65 autoantibodies. Clinial Endocrinology. (Oxf.). 2000; 52: 565-573.

Groop, L., Miettinen, A., Groop, P. H., Meri, S., Koskimies, S., Bottazzo, G. F. Organ-specific antigens as markers for beta-cell destruction in patients with type II diabetes. Diabetes. 1988; 37: 99-103.

Schroner, Z., Lazurova, I., Petrovicova, J. Autoimmune thyroid diseases in patients with diabetes mellitus. Bratislavske Lekarske Listy. 2008; 109(3): 125-129.

Nathan, D. M., Singer, D. E., Hurxthal, K., Goodson, J. D. The clinical information value of the glycosylated hemoglobin assay. The New England Journal of Medicine. 1984; 310(6): 341-346.

Burtis, C. A., Ashwood, E. R., Bruns, D. E. Teitz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th edition. New Delhi: Saunders; 2008.

Akbar, D. H., Ahmed, M. M., Al-Mughales, J. Thyroid dysfunction and thyroid autoimmunity in Saudi type 2 diabetics. Acta Diabetologica. 2006; 43: 14-18.

Uppal, V., Vij, C., Bedi, G.K., Vij, A., Banerjee, B.D. Thyroid disorders in patients of type 2 diabetes mellitus. Indian Journal of Clinical Biochemistry. 2013; 28(4): 336-341.

Acharya, A., Shah, P. B., Chitkara, E., Shrestha, S. Evaluation of thyroid hormones level in patients with type 2 diabetes mellitus as compared to normal individuals in Nepal. International Journal Health Sciences and Research. 2017; 7(1): 79-85.

Ramesh, V., Geetha, R., Anitha, D., Swamy, N. R. V. K., Panneerselvam, T. T. The study of thyroid dysfunction among type 2 diabetic patients. International Journal of Current Research and Academic Review. 2015; 3(9): 14-18.

Islam, S., Yesmine, S., Khan, A. S., Alam, N. H. A comparative study of thyroid hormone levels in diabetic and nondiabetic patients. Southeast Asian Journal of Tropical Medicine and Public Health. 2008; 39(5): 913-916.

Elebrashy, I. N., Meligi, A. E., Rashed, L., Salam, R. F., Youssef, E., Fathy, S. A. Thyroid dysfunction among type 2 diabetic female Egyptian subjects. Therapeutics and Clinical Risk Management. 2016; 12: 1757-1762.

Nwokolo, H. I., Meludu, S. C., Dioka, C. E., Onah, C. E., Ikemefuna, F. O., Obiageli, B., et al., The prevalence of thyroid dysfunction and thyroid autoantibodies among type 2 diabetic patients in Nnewi, Southeastern Nigeria. Journal of Medical Science and Clinical Research. 2014; 2(4): 646-653.

Billic-Komarica, E., Beciragic, A., Junuzovic, D. The importance of HbA1c control in patients with subclinical hypothyroidism. Materia Socio Medica. 2012; 24(4): 212-219.

Afkhami-Ardekani, M., Rashidi, M., Shojaoddiny-Ardekani, A. Prevalence of thyroid autoantibodies in type 2 diabetic patients. Iranian Journal of Diabetes and Obesity. 2012; 4(1): 1-6.

Chehade, J. M., Gladysz, M., Mooradian, A. D. Dyslipidaemia in type 2 diabetes: Prevalence, pathophysiology, and management. Drugs. 2013; 3(4): 327-339.

Primo, M. E., Niepomniszcze, H., Poskus, E., Sala, M. S., Guaita, S. S., Sica, M. P., et al., Frequency of pancreatic beta-cell autoimmunity markers in patients with autoimmune thyroid disease. Medicina Buenos Aires. 2008; 68(1): 37-42.




How to Cite

Sah NK, Deo SK, Walia HK, Singh A, Prasad S, Kaur K. Thyroid autoimmunity among type 2 diabetes mellitus: assessing anti-thyroid peroxidase (anti-TPO) antibodies. Biomedicine [Internet]. 2021Dec.31 [cited 2022Jan.20];41(4):720-3. Available from:



Original Research Articles