Factors associated with thyroid dysfunction in children with newly diagnosed type 1 diabetes mellitus.
Factors associated with thyroid dysfunction in children with newly diagnosed type 1 diabetes mellitus.
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DOI：
10.23736/s0026-4946.19.05484-7
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发表时间：
2019-05
期刊：
影响因子：
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通讯作者：
Weixia Yang;F. Sheng
中科院分区：
文献类型：
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作者：
Weixia Yang;F. Sheng
背景本研究旨在探讨儿童1型糖尿病（T1DM）甲状腺功能障碍（TD）的可能相关因素。方法对87例T1DM患儿的临床资料进行分析，并检测胰腺和甲状腺抗体。在基线和治疗开始后10天检测甲状腺功能。结果13例（14.9%）患者在纠正急性代谢紊乱后出现甲状腺功能异常。亚临床甲减的患病率（10.3%）高于临床甲减（3.4%）和临床甲亢（1.2%）。TD患者的胰腺抗体和甲状腺抗体均阳性，与甲状腺功能正常者比较差异有显著性（P<0.01，P<0.05）。TD家族史在TD患者中的发生率显著高于甲状腺功能正常者（P<0.01）。32例DKA患儿入院时游离三碘甲状腺原氨酸、总三碘甲状腺原氨酸、游离甲状腺素、总甲状腺素均在甲减范围内，治疗10天后均恢复正常（P=0.02和P<0.01）。pH值与游离三碘甲状腺原氨酸水平呈显著正相关（P<0.05）。结论T1DM患者TD与家族因素、自身免疫和急性代谢应激有关，应定期进行甲状腺筛查。
BACKGROUND This study aims to investigate the possible factors associated with thyroid dysfunction (TD) in children with type 1 diabetes mellitus (T1DM). METHODS 87 children with T1DM were evaluated in terms of their clinical profile as well as tested for pancreatic and thyroid antibodies. Thyroid function were tested at baseline and 10 days after treatment onset. RESULTS Thyroid dysfunction was present in 13 (14.9%) patients after correction of acute metabolic disorders. The prevalence of subclinical hypothyroidism (10.3%) was found to be higher than that of clinical hypothyroidism (3.4%) and clinical hyperthyroidism (1.2%). Both pancreatic and thyroid antibody were detected positive in TD patients, which was significantly different from that with euthyroidism (P<0.01, P<0.05). The frequency of TD family history was significantly higher in subjects with TD rather than with euthyroidism (P<0.01). The levels of free and total triiodothyronine, free and total thyroxine were in the hypothyroid range at the time of admission, all of which increased to normal range after 10 days of therapy in 32 DKA children (P=0.02 and P<0.01). There was a significant correlation between pH and free triiodothyronine levels (P<0.05). CONCLUSIONS TD is related to family factors, autoimmunity, and acute metabolic stress in the T1DM and regular thyroid screening should be performed.