Background: Increased prevalence of autoimmune thyroid disease (ATD) in patients with type 1 diabetes mellitus (T1DM) has been extensively described. Since 1996, screening for thyroid disease has been implemented in children and adolescents with T1DM and is performed at least annually.
Objective and hypotheses: The aim of this study is to determine the natural history and incidence of ATD in T1DM pediatric patients and the relationship between positive anti-thyroid antibodies and potential risk factors, including age, gender and duration of diabetes.
Method: We designed an observational, transversal and analytic study, based on patient data from the Pediatric Diabetes Consultation in a Tertiary Hospital in Portugal. We studied a total of 104 patients (49 females and 55 males) aged 3.317.9 years (mean 12.5±4.4) with T1DM. TSH, free thyroxine (FT4), anti-peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies were measured.
Results: ATD was diagnosed in 17 patients (16.3%). The prevalence rates of anti-thyroid antibodies were: anti-TPO 16.3% (n=17), anti-TG 12.5% (n=13). The presence of serum anti-thyroid antibodies was significantly higher in females (76.5%). In the age group <10 years, 5.9% (n=1) had thyroid antibodies and in the age group ≥10 years, 94.1% (n=16). 35.3% (n=6) of ATD patients had hypothyroidism and were medicated with levothyroxine. 64.7% (n=11) of the 17 patients had T1DM for at least 5 years.
Conclusion: Thyroid autoimmunity was related with increasing age, female gender and longer diabetes duration. Our results confirmed the high prevalence of ATD in patients with T1DM. The screening of autoantibodies in type 1 diabetic patient, regardless of symptoms, could reveal cases of ATD.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology