Piątkowska Ewa, Szalecki Mieczysław
The Third Department of Pediatrics (Endocrinology and Diabetology), Regional Children's Hospital, Kielce, Poland.
Pediatr Endocrinol Diabetes Metab. 2011;17(4):173-7.
In children and adolescents with type 1 diabetes coexist some other autoimmune diseases such as autoimmune thyroiditis, celiac disease, Addison's disease or others.
was to assess the incidence and risk factors for autoimmune thyroiditis in children and adolescents with type 1 diabetes at the moment of diagnosis.
The study included 382 children, who in the years 2001 to 2010 were diagnosed with type 1 diabetes. The concentrations of antibodies against thyroid peroxidase (anti- TPO), TSH and FT4 were measured and thyroid ultrasound examinations were performed. Children who had not initially shown the presence of anti-TPO had the test repeated at yearly intervals for 2-8 years.
At the time of diagnosis of diabetes, elevated anti-TPO titres were found in 14.4% of patients, more often in girls than in boys, p<0.01. Children with a positive anti-TPO titre were on average older than those whose anti-TPO levels were within the normal range, p<0.05. The incidence of elevated titers of anti-TPO increased with age, 20,5% of children above 10 years old had positive anti-TPO, compared to 8.3% of children less than 10 years old, p <0.001. At the time of the onset of diabetes, hypothyroidism was diagnosed in 14.5% of children with elevated anti-TPO, and in 2.1% of the whole group. 4.5% of patients whose levels of anti-TPO were initially normal, within the next 1-8 years had positive antibody titers.
Due to the high incidence of the disease, it is necessary to carry out screenings for autoimmune thyroiditis in children with diabetes at the time of diagnosis and redo them in accordance with the recommendations.
1型糖尿病儿童和青少年常合并其他自身免疫性疾病,如自身免疫性甲状腺炎、乳糜泻、艾迪生病等。
评估1型糖尿病儿童和青少年在诊断时自身免疫性甲状腺炎的发病率及危险因素。
研究纳入了382例在2001年至2010年期间被诊断为1型糖尿病的儿童。检测了抗甲状腺过氧化物酶抗体(抗-TPO)、促甲状腺激素(TSH)和游离甲状腺素(FT4)的浓度,并进行了甲状腺超声检查。最初抗-TPO阴性的儿童在2至8年内每年重复检测。
糖尿病诊断时,14.4%的患者抗-TPO滴度升高,女性多于男性,p<0.01。抗-TPO滴度阳性的儿童平均年龄高于抗-TPO水平正常的儿童,p<0.05。抗-TPO滴度升高的发生率随年龄增加,10岁以上儿童中有20.5%抗-TPO阳性,而10岁以下儿童为8.3%,p<0.001。糖尿病发病时,抗-TPO升高的儿童中有14.5%被诊断为甲状腺功能减退,而整个研究组中这一比例为2.1%。抗-TPO水平最初正常的患者中有4.5%在接下来的1至8年内抗体滴度转为阳性。
鉴于该疾病的高发病率,有必要在糖尿病儿童诊断时进行自身免疫性甲状腺炎筛查,并根据建议再次进行筛查。