Background: The nonthyroidal illness syndrome (NTIS) is a condition characterized by abnormal thyrotropin and thyroid homone levels and it’s frequently reported during severe illness. T1DM onset is an acute stressful event and could affect thyroid function. Objective and hypotheses: To study thyroid function at T1DM onset and after 1-90 days. Methods: We examined 149 patients (72 M and 77 F, mean age 7.7±4.1 yrs) diagnosed for T1DM from 2000 to 2011. 20 pts were anti-thyroid autoantibodies positive at T1DM diagnosis. The 129 pts without autoimmunity were subdivided in the following group: 63 had abnormalities in thyroid hormone levels (8 pts had hypertireotropinemia, 30 pts had low fT3 levels, 23 pts had both low fT3 and fT4 and 2 pts had suppressed TSH too) and the remaining 66 were normal. Results: Multiple regression analysis identified BE (R2=0.38; p<0.0001) and fructosamine (R2 change=0.12;p<0.0001) as major influencing variables on fT3 levels. Table 1 shows parameter at diabetes onset. Normal thyroid function (77 pts) Pathological thyroid function (72 pts) p Weight SDS -0.06±0.9 -0.52±0.9 <0.006 BMI SDS -0.28±1 -1.02±1.1 <0.0001 HbA1c (%) 11.14±2.3 12.5±2.1 <0.0001 Fructosamine (ìmol/l) 559.27±135.2 680.73±146.8 <0.0001 pH 7.32±0.1 7.22±1.3 <0.0001 Glycemia (mg/dl) 396.35±182.9 500±204.5 <0.001 BE -3.95±8.4 -12±10 <0.0001 Aldosteron (ng/dl) 271.55±238 760.3±751.4 <0.0001 Cortisol (ìg/dl) 155.76±84.6 240.3±133.6 <0.0001 ACTH (pg/ml) 21.04±15.5 21.8±45.9 <0.01 C-peptide (ng/ml) 0.73±0.5 0.46±0.3 <0.0001 In all subjects thyroid levels became normal after 1-90 days. Conclusions: Thyroid disfunction, in particulary NTIS, is frequent at T1DM diagnosis regardless of autoantibodies. Thyroid function is strictly related to seriousness of metabolic pattern. A delayed diagnosis could compromise not only metabolic balance but also thyroid function.
Prevalence and follow-up of thyroid disfunction at type 1 diabetes mellitus (T!DM) onset in pediatric population / Balsamo C; Cassio A; Zucchini S; Scipione M; Maltoni G; Rollo A; Martini A;Rinaldini D; Rizzello A. - In: HORMONE RESEARCH IN PAEDIATRICS. - ISSN 1663-2818. - STAMPA. - 78(Suppl1):(2012), pp. 255-255. (Intervento presentato al convegno 51th Annual Meeting of ESPE tenutosi a Leipzig, Germany nel September 2O-23, 2012).
Prevalence and follow-up of thyroid disfunction at type 1 diabetes mellitus (T!DM) onset in pediatric population
BALSAMO, CLAUDIA;CASSIO, ALESSANDRA;ZUCCHINI, STEFANO;SCIPIONE, MIRELLA;MALTONI, GIULIO;
2012
Abstract
Background: The nonthyroidal illness syndrome (NTIS) is a condition characterized by abnormal thyrotropin and thyroid homone levels and it’s frequently reported during severe illness. T1DM onset is an acute stressful event and could affect thyroid function. Objective and hypotheses: To study thyroid function at T1DM onset and after 1-90 days. Methods: We examined 149 patients (72 M and 77 F, mean age 7.7±4.1 yrs) diagnosed for T1DM from 2000 to 2011. 20 pts were anti-thyroid autoantibodies positive at T1DM diagnosis. The 129 pts without autoimmunity were subdivided in the following group: 63 had abnormalities in thyroid hormone levels (8 pts had hypertireotropinemia, 30 pts had low fT3 levels, 23 pts had both low fT3 and fT4 and 2 pts had suppressed TSH too) and the remaining 66 were normal. Results: Multiple regression analysis identified BE (R2=0.38; p<0.0001) and fructosamine (R2 change=0.12;p<0.0001) as major influencing variables on fT3 levels. Table 1 shows parameter at diabetes onset. Normal thyroid function (77 pts) Pathological thyroid function (72 pts) p Weight SDS -0.06±0.9 -0.52±0.9 <0.006 BMI SDS -0.28±1 -1.02±1.1 <0.0001 HbA1c (%) 11.14±2.3 12.5±2.1 <0.0001 Fructosamine (ìmol/l) 559.27±135.2 680.73±146.8 <0.0001 pH 7.32±0.1 7.22±1.3 <0.0001 Glycemia (mg/dl) 396.35±182.9 500±204.5 <0.001 BE -3.95±8.4 -12±10 <0.0001 Aldosteron (ng/dl) 271.55±238 760.3±751.4 <0.0001 Cortisol (ìg/dl) 155.76±84.6 240.3±133.6 <0.0001 ACTH (pg/ml) 21.04±15.5 21.8±45.9 <0.01 C-peptide (ng/ml) 0.73±0.5 0.46±0.3 <0.0001 In all subjects thyroid levels became normal after 1-90 days. Conclusions: Thyroid disfunction, in particulary NTIS, is frequent at T1DM diagnosis regardless of autoantibodies. Thyroid function is strictly related to seriousness of metabolic pattern. A delayed diagnosis could compromise not only metabolic balance but also thyroid function.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
