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Anthropometric, clinical and biochemical parameters were evaluated in all patients. Insulin requirement was calculated in patients with APS-3 and T1DM, while levothyroxine requirement was calculated in APS-3 and AH.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Patients with APS-3 showed higher age (<jats:italic>p<\/jats:italic>\u2009=\u20090.001), age of onset of diabetes (<jats:italic>p<\/jats:italic>\u2009=\u20090.006) and TSH (<jats:italic>p<\/jats:italic>\u2009=\u20090.004) and lower total insulin as U\/day (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and U\/Kg (<jats:italic>p<\/jats:italic>\u2009=\u20090.001), long-acting insulin as U\/day (<jats:italic>p<\/jats:italic>\u2009=\u20090.030) and U\/kg (<jats:italic>p<\/jats:italic>\u2009=\u20090.038) and irisin (<jats:italic>p<\/jats:italic>\u2009=\u20090.002) compared to T1DM. Patients with APS-3 had higher waist circumference (<jats:italic>p<\/jats:italic>\u2009=\u20090.008), duration of thyroid disease (<jats:italic>p<\/jats:italic>\u2009=\u20090.020), levothyroxine total daily dose (<jats:italic>p<\/jats:italic>\u2009=\u20090.025) and mcg\/kg (<jats:italic>p<\/jats:italic>\u2009=\u20090.006), triglycerides (<jats:italic>p<\/jats:italic>\u2009=\u20090.007) and VAI (<jats:italic>p<\/jats:italic>\u2009=\u20090.010) and lower age of onset of thyroid disease (<jats:italic>p<\/jats:italic>\u2009=\u20090.007) than AH.<\/jats:p>\n                <jats:p>At multivariate analysis, levothyroxine treatment and VAI were associated with insulin and levothyroxine requirement in APS-3, respectively. VAI was independently associated with insulin requirement in T1DM. Circulating irisin levels were independently associated with levothyroxine requirement in AH.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Patients with APS-3 show lower insulin requirement and higher levothyroxine requirement than T1DM and AH alone, respectively. Levothyroxine treatment and VAI affect insulin and levothyroxine requirement, respectively, in APS-3. In T1DM, adipose tissue dysfunction, indirectly expressed by high VAI, is associated with an increased insulin requirement, while circulating irisin levels influence the levothyroxine requirement in AH.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s40618-020-01421-3","type":"journal-article","created":{"date-parts":[[2020,10,24]],"date-time":"2020-10-24T14:02:35Z","timestamp":1603548155000},"page":"1387-1394","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Levothyroxine and insulin requirement in autoimmune polyglandular type 3 syndrome: a real-life study"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8088-4947","authenticated-orcid":false,"given":"V.","family":"Guarnotta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Pillitteri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Gambino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Radellini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Vigneri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6052-8438","authenticated-orcid":false,"given":"G.","family":"Pizzolanti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1731-9395","authenticated-orcid":false,"given":"C.","family":"Giordano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,24]]},"reference":[{"key":"1421_CR1","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/s40618-017-0740-9","volume":"41","author":"GJ Kahaly","year":"2018","unstructured":"Kahaly GJ, Frommer L (2018) Polyglandular autoimmune syndromes. 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