ESPE Abstracts (2019) 92 P1-287

ESPE2019 Poster Category 1 Thyroid (1) (13 abstracts)

The Comparison of Natural Course Thyroid Autoimmunity in Children and Adults with Type 1 Diabetes: From the Diabetes Onset Up to Five Years of its Duration

Elżbieta Niechciał 1 , Anita Rogowicz-Frontczak 2 , Stanisław Piłaciński 2 , Piotr Fichna 1 & Dorota Zozulińska-Ziółkiewicz 2

1Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland. 2Department of Internal Medicine and Diabetology, Poznań University of Medical Sciences, Poznań, Poland

Introduction: Individuals with type 1 diabetes (T1D) are at higher risk of developing other autoimmune disease, including autoimmune thyroid diseases (AITD). The incidence of Hashimoto among people with T1D varies between 8 and 50%, depending on gender, age and ethnicity.

Aim: To evaluate prevalence of anti-thyroid peroxidase (anti-TPO) and its correlation to the presence of thyroid dysfunction in children and adults at diagnosis of T1D and in the five-year observation.

Methods: The study included 367 patients (218 children; 149 adults) at T1D onset. Anti-TPO level and thyroid function tests (T4,T3, and TSH) were performed within 5 days of the initial diagnosis of diabetes and during the five-year follow-up period.

Results: At T1D onset, anti-TPO was reported in 18.5% of patients, more frequently in adults than in children (26.2%vs.13.3%, P=0.001). In children, anti-TPO was observed mostly in girls (62.1vs. 37.9%, P=0.047), while there was no gender association in adults (females 56.4% vs. men 34.6%; P=0.754). Positive anti-TPO patients had higher occurrence of GADA (83.8%vs. 70%,P= 0.03) and higher level of its titer [median 38.7 (IQR:5.4-512.4)vs.6.2 (1.1-40.6),P<0.0001]. Whereas, in children higher titer of IAA was observed [6.5 (5.3-8.2)vs. 5.6 (5.0-6.9),(P=0.026)].

Hypothyroidism (HT) at diagnosis of T1D occurred more frequently in adults than in children (9 vs. 2,P=0.009), in 3 positive anti-TPO adults autoimmune hyperthyroidism was noted (elevated titers of anti-TSH-R). Positive anti-TPO adults had higher TSH concentration as opposed to negative anti-TPO group (3.6±0.9vs 1.7±0.9,P=0.026), such an relationship was not observed among children. HT was diagnosed in 41.4% anti-TPO positive children at T1D onset in the five-year follow-up period, significantly more often in girls than in boys (83.3%vs.16.7%). While, only next 15% of adults with initially positive anti-TPO developed HT during the study period. The mean time from T1D diagnosis to HT development was 2.8±1.7 years.

Conclusions: Anti-TPO tended to occur more frequently in adults with newly diagnosed T1D without gender association, whereas in children anti-TPO was observed significantly more often in females. The presence of a positive anti-TPO titer was related to a higher incidence of HT at T1D onset in adults. While, in children, the occurrence of a positive anti-TPO titer at T1D diagnosis was associated with a greater risk of developing HT in 5-year follow-up period. The results of the study confirm the validity of screening for AITD at the time of T1D diagnosis and further thyroid function assessment should be recommended.

Volume 92

58th Annual ESPE

Vienna, Austria
19 Sep 2019 - 21 Sep 2019

European Society for Paediatric Endocrinology 

Browse other volumes

Article tools

My recent searches

No recent searches.