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How does autoimmune thyroiditis in children with type 1 diabetes mellitus influence glycemic control, lipid profile and thyroid volume?

  • Katarzyna Korzeniowska EMAIL logo , Anna Ramotowska , Agnieszka Szypowska , Agnieszka Szadkowska , Wojciech Fendler , Barbara Kalina-Faska , Wojciech Młynarski , Przemyslawa Jarosz-Chobot and Malgorzata Myśliwiec
Published/Copyright: September 11, 2014
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 28 Issue 3-4

Abstract

Aim: To investigate whether autoimmune thyroiditis (AIT) in children with type 1 diabetes mellitus (DM1) has any influence on glycemic control, lipid profile or thyroid volume.

Methods: A total of 330 patients with DM1 and AIT (DM1+AIT group) were compared with 309 children with DM1 without AIT (control group). Patients were treated in four Polish academic pediatric diabetes centers from 2008 to 2012: Warsaw, Lodz, Katowice and Gdansk. All patients underwent measurements of thyroid-stimulating hormone (TSH), free thyroxine, anti-thyroid peroxidase (anti-TPO) antibody, anti-thyroglobulin (anti-TG) antibody and HbA1c levels, and thyroid ultrasound examination.

Results: Among AIT+DM1 patients, 62% (n=205) were female, whereas in the control group 60.8% (n=188) were male (p<0.0001). Children with AIT+DM1 had lower a BMI-SDS (mean difference of –0.5, 95% CI –0.68 to –0.33; p<0.0001), had a higher SDS thyroid volume (0.27, 95% CI 0.03–0.51; p=0.014) and needed less insulin (–0.15, 95% CI –0.20 to –0.11 U/kg body weight per day; p<0.0001) in comparison with the control group. AIT patients had higher HbA1c levels (0.66, 95% CI 0.36%–0.96%, p<0.0001), lower HDL-cholesterol levels (–3.68, 95% CI –1.41 to –5.94 mg/dL, p=0.002) and higher triglyceride levels (7.16, 95% CI 1.22–13.10 mg/dL, p=0.02). Patients with positive anti-TPO and anti-TG antibodies were older (by 1.95 years, 95% CI 0.98–2.92 years, p=0.006) and had longer DM1 duration (by 1.64 years, 95% CI 0.76–2.52 years, p=0.006). Presence of anti-TPO antibodies was associated with higher TSH levels (odds ratio 2.34, 95% CI 1.36–4.04; p=0.007).

Conclusion: AIT accompanying DM1 is associated with worse glycemic control and lipid profile as well as a lower daily insulin requirement. The female gender is more likely to develop AIT and hypothyroidism.

Keywords: autoimmune thyroiditis; glycemic control; thyroid autoantibodies; thyroid volume; type 1 diabetes mellitus
Corresponding author: Katarzyna Korzeniowska, MD, PhD, Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, Dębinki Street 7, 80-952 Gdańsk, Poland, Phone: +48 583492890, Fax: +48 583492848, E-mail:

Acknowledgments

Wojciech Fendler and Wojciech Mlynarski received funding from the TEAM programme of the Foundation for Polish Science, funded by the European Union.

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Received: 2013-12-3
Accepted: 2014-8-14
Published Online: 2014-9-11
Published in Print: 2015-3-1

©2015 by De Gruyter

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  1. Frontmatter
  2. Highlight: Diabetes
  3. Diabetes mellitus in children and adolescents – a global epidemic which has become neglected
  4. Maturity-onset diabetes of the young (MODY): an update
  5. Relationship of plasma level of chemerin and vaspin to early atherosclerotic changes and cardiac autonomic neuropathy in adolescent type 1 diabetic patients
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  7. Profile of mood states in adult type 1 diabetes mellitus men and women with disease onset in childhood and in adulthood
  8. Evaluation of fetuin-A and carotid intima-media thickness in adolescent type 1 diabetic patients
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https://doi.org/10.1515/jpem-2013-0455
Keywords for this article
autoimmune thyroiditis; glycemic control; thyroid autoantibodies; thyroid volume; type 1 diabetes mellitus

Articles in the same Issue

  1. Frontmatter
  2. Highlight: Diabetes
  3. Diabetes mellitus in children and adolescents – a global epidemic which has become neglected
  4. Maturity-onset diabetes of the young (MODY): an update
  5. Relationship of plasma level of chemerin and vaspin to early atherosclerotic changes and cardiac autonomic neuropathy in adolescent type 1 diabetic patients
  6. How does autoimmune thyroiditis in children with type 1 diabetes mellitus influence glycemic control, lipid profile and thyroid volume?
  7. Profile of mood states in adult type 1 diabetes mellitus men and women with disease onset in childhood and in adulthood
  8. Evaluation of fetuin-A and carotid intima-media thickness in adolescent type 1 diabetic patients
  9. An increasing incidence of type 1 diabetes mellitus in Romanian children aged 0 to 17 years
  10. Resistin and right ventricular function in children with recently diagnosed type-1 diabetes mellitus: a case control study
  11. Assessment of human cartilage glycoprotein 39 (YKL-40), preptin, and nitric oxide in adolescent patients with type 1 diabetes and its relation to cardiorenal affection
  12. The effect of a home-based strength training program on type 2 diabetes risk in obese Latino boys
  13. From cerebral salt wasting to diabetes insipidus with adipsia: case report of a child with craniopharyngioma
  14. Three years of liraglutide treatment offers continuously optimal glycemic control in a pediatric patient with maturity-onset diabetes of the young type 3
  15. Diabetic euglycemic ketoacidosis in newly diagnosed type 1 diabetes mellitus during Ramadan fasting
  16. Transient neonatal hyperinsulinism with adaptation disorders: a report of three cases
  17. Acute mononeuropathy in a child with newly diagnosed type 1 diabetes mellitus
  18. Alternating hypoglycemia and hyperglycemia in a toddler with a homozygous p.R1419H ABCC8 mutation: an unusual clinical picture
  19. Cognitive functioning, metabolic control, and treatment type in youth with type 1 diabetes
  20. Images in pediatric endocrinology
  21. Benefit of testosterone in pediatric genital trauma
  22. Original articles
  23. Attenuated salivary cortisol response after exercise test in children with asthma
  24. Reliability of pubertal maturation self-assessment in a school-based survey
  25. Detection of inborn errors of metabolism using GC-MS: over 3 years of experience in southern China
  26. Assessing biological maturity: chronological age and the pubertal development scale predict free testosterone in adolescent males
  27. Evaluation of puberty by verifying spontaneous and stimulated gonadotropin values in girls
  28. Longitudinal changes in C-reactive protein, proform of eosinophil major basic protein, and pregnancy-associated plasma protein-A during weight changes in obese children
  29. Caries in adolescents in relation to their skeletal status
  30. Endothelial and metabolic disorders in adolescence: low birth weight is not an isolated risk factor
  31. Comparison of cortisol samples in the first two weeks of life in preterm infants
  32. Mutations in BTD gene causing biotinidase deficiency: a regional report
  33. Patient reports
  34. Late-onset hypercalcemia in Williams-Beuren syndrome: importance of early and frequent screening and intervention
  35. Hepatoblastoma presenting as precocious puberty: a case report
  36. Three cases of Wolfram syndrome with different clinical aspects
  37. L-asparaginase induced hypoglycemia in a case of acute lymphoblastic leukemia: a patient report
  38. Pyogenic granuloma, an unusual presentation of peripubertal vaginal bleeding. Case report and review of the literature
  39. Octreotide-associated cholestasis and hepatitis in an infant with congenital hyperinsulinism
  40. Two novel mutations in the homogentisate-1,2-dioxygenase gene identified in Chinese Han Child with Alkaptonuria
  41. Pituitary abscess in an adolescent girl: a case report and review of the literature
  42. Neonatal thyrotoxicosis with severe supraventricular tachycardia: case report and review of the literature
  43. Consumptive hypothyroidism associated with parotid infantile hemangioma
  44. Novel mutations in the SLC25A13 gene in a patient with NICCD and severe manifestations
  45. Short communications
  46. Tetrahydrobiopterin deficiency among Serbian patients presenting with hyperphenylalaninemia
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