ESPE Abstracts

Introduction: Type 1 diabetes mellitus (DM) can be related with other autoimmune disorders. Thyroid dysfunction and autoimmune thyroiditis are frequently reported in DM. This study was performed to evaluate the prevalence and risk factors of thyroid dysfunction and autoimmune thyroiditis in children with new-onset DM.

Subjects and Methods: Children with DM and followed for more than 6 months in a single tertiary center were included in the study. Medical records were reviewed. Sex, onset age, initial HbA1c, presentation of diabetic ketoacidosis (DKA), serum T3, free T4, and TSH levels, positivity of anti-GAD, anti -insulin, and anti-IA2 antibody (Ab) as well as anti-thyroid peroxidase (TPO), anti-thyroglobulin (TG), and anti-TSH receptor Ab were analyzed to find the prevalence and risk factors of thyroid dysfunction and thyroid autoimmunity at the onset of DM. Chi-square, Fisher’s exact test, t-test, and logistic regression were used for statistics.

Results: A total of 103 subjects were included in the study (T1DM:T2DM 57:46). Initial presentation as DKA was found in 34% and it was more frequent in T1DM (T1DM:T2DM 56%:7%). Among 57 subjects with T1DM, low T3 and low free T4 were found in 51% and 19%, respectively and both were more frequently occurred in T1DM compared to T2DM. The presence of DKA was associated with low T3 and low free T4, respectively (P< 0.05). Thyroid autoimmunity was not associated with low T3 or low free T4. Anti-TPO Ab positivity and anti-TG Ab positivity at the onset of T1DM were 24% and 22%, respectively and both were 3% and 11% in T2DM. Anti-TPO Ab was significantly more frequent in T1DM compared to T2DM. Presence of anti-TPO Ab was associated with younger age of onset and positivity of GAD Ab or IA2 Ab in total DM. However, among T1DM, anti-TPO Ab positivity was not associated with onset age, GAD Ab or IA2 Ab positivity.

Conclusion: This study showed that low T3 or low free T4 was frequently observed at the onset of T1DM and it was associated with the presence DKA. Among T1DM children, anti-TPO Ab and anti-TG Ab were positive in 24% and 22%, respectively, and there was no correlation between the presence of anti-TPO Ab and anti-T1DM Ab in children with T1DM.