The interlink between thyroid autoimmunity and type 1 diabetes and the impact on male and female fertility

Sanja Medenica; Vukasin Stojanovic; Umberto Capece; Rossella Mazzilli; Milica Markovic; Virginia Zamponi; Tanja Vojinovic; Silvia Migliaccio; Giuseppe Defeudis; Francesca Cinti

doi:10.1007/s42000-024-00563-w

The interlink between thyroid autoimmunity and type 1 diabetes and the impact on male and female fertility

Hormones (Athens). 2024 May 15. doi: 10.1007/s42000-024-00563-w. Online ahead of print.

Authors

Affiliations

¹ Department of Endocrinology, Internal Medicine Clinic, Clinical Center of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
² Emergency Medicine Center of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
³ UOS Centro Malattie Endocrine e Metaboliche, UOC Endocrinologia e Diabetologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
⁴ Endocrinology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant' Andrea Hospital, Rome, Italy.
⁵ Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
⁶ Faculty of Medicine, University od Montenegro, Podgorica, Montenegro.
⁷ Department of Movement, Human and Health Sciences, University Foro Italico of Rome, Rome, 00135, Italy.
⁸ Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy.
⁹ Department of Movement, Human and Health Sciences, University Foro Italico of Rome, Rome, 00135, Italy. defeudisg@gmail.com.
¹⁰ Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy. defeudisg@gmail.com.
¹¹ Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy. defeudisg@gmail.com.

PMID: 38748060
DOI: 10.1007/s42000-024-00563-w

Abstract

The aim of this review is to discuss the several interconnections between thyroid autoimmunity and type 1 diabetes in terms of epidemiology, immunoserology, genetic predisposition, and pathogenic mechanisms. We will also analyze the impact of these conditions on both male and female fertility. A literature search was carried out using the MEDLINE/PubMed, Scopus, Google Scholar, ResearchGate, and Clinical Trials Registry databases with a combination of keywords. It was found that the prevalence of thyroid autoantibodies in individuals with type 1 diabetes (T1DM) varied in different countries and ethnic groups from 7 to 35% in both sexes. There are several types of autoantibodies responsible for the immunoserological presentation of autoimmune thyroid diseases (AITDs) which can be either stimulating or inhibiting, which results in AITD being in the plus phase (thyrotoxicosis) or the minus phase (hypothyroidism). Different types of immune cells such as T cells, B cells, natural killer (NK) cells, antigen presenting cells (APCs), and other innate immune cells participate in the damage of the beta cells of the islets of Langerhans, which inevitably leads to T1D. Multiple genetic and environmental factors found in variable combinations are involved in the pathogenesis of AITD and T1D. In conclusion, although it is now well-known that both diabetes and thyroid diseases can affect fertility, only a few data are available on possible effects of autoimmune conditions. Recent findings nevertheless point to the importance of screening patients with immunologic infertility for AITDs and T1D, and vice versa.

Keywords: Autoimmunity; Fertility; Immunoserology; Thyroid autoantibodies; Thyroid disorders; Type 1 diabetes mellitus.

Publication types

Review