Ridha Muneera Fadhil, Al Zubaidi Munib Ahmed
Muneera Fadhil Ridha, Department of Pediatrics, University of Baghdad, College of Medicine, Baghdad, Iraq.
Munib Ahmed Al Zubaidi, Department of Pediatrics, University of Baghdad, College of Medicine, Baghdad, Iraq.
Pak J Med Sci. 2019 Jul-Aug;35(4):969-973. doi: 10.12669/pjms.35.4.192.
BACKGROUND & OBJECTIVE: As an autoimmune disease, Type-1 diabetes mellitus (DM) may be associated with other autoimmune disorders, the presence of thyroid antibodies could be negatively impact the diabetic control. Our objective was to investigate thyroid autoimmunity in a cohort of children and adolescents with Type-1 diabetes and the Influence of the presence of thyroid autoimmune abnormalities on the control of diabetes in group of Iraqi pediatric patients with Type-I D.M.
This study was conducted at the Medical City Complex, Children Welfare Hospital, Baghdad, Iraq. This study was carried out from the first of January 2016 till the end of September 2017. Data were analyzed from 150 patients with Type-1 diabetes, aged 1-18 years who were treated and are coming for regular follow up in the diabetic clinic. Thyroid functions tests, Antibodies to thyroglobulin (anti-TG) and thyroperoxidase (anti-TPO) were measured, documented and correlated with diabetic control according to glycated haemoglobin (HbA1c) level.
In the total of 150 patients, positive Antibodies to thyroglobulin (anti TG) were more in ≤3 years duration group of Diabetes mellitus(DM) and negative anti TG was less in the >3 years duration of DM group with statistically significant results (p=0.043), Regarding the distribution of thyroid antibodies (AB) according to HbA1c group, there was progressive positive anti thyroperoxidase (anti TPO) titer with glycemic status, good glycemic control had the lowest positive anti TPO titer and poor glycemic control group had the highest positive anti TPO titer and the result was statistically significant (p=0.048).
Thyroid autoimmunity may be associated with poor diabetic control and elevated TSH levels, indicating subclinical hypothyroidism that my affect the diabetic control.
作为一种自身免疫性疾病，1型糖尿病（DM）可能与其他自身免疫性疾病相关，甲状腺抗体的存在可能对糖尿病控制产生负面影响。我们的目的是调查一组1型糖尿病儿童和青少年的甲状腺自身免疫情况，以及甲状腺自身免疫异常的存在对伊拉克1型糖尿病儿科患者组糖尿病控制的影响。
本研究在伊拉克巴格达医疗城综合大楼儿童医院进行。本研究于2016年1月1日至2017年9月30日开展。分析了150例年龄在1至18岁之间、在糖尿病诊所接受治疗并定期随访的1型糖尿病患者的数据。检测、记录甲状腺功能测试、甲状腺球蛋白抗体（抗TG）和甲状腺过氧化物酶抗体（抗TPO），并根据糖化血红蛋白（HbA1c）水平将其与糖尿病控制情况进行关联分析。
在总共150例患者中，糖尿病病程≤3年组的甲状腺球蛋白抗体（抗TG）阳性率更高，而糖尿病病程>3年组的抗TG阴性率更低，结果具有统计学意义（p = 0.043）。关于根据HbA1c分组的甲状腺抗体（AB）分布，抗甲状腺过氧化物酶（抗TPO）滴度随血糖状态呈逐渐升高趋势，血糖控制良好组的抗TPO阳性滴度最低，血糖控制差组的抗TPO阳性滴度最高，结果具有统计学意义（p = 0.048）。
甲状腺自身免疫可能与糖尿病控制不佳和促甲状腺激素水平升高有关，提示亚临床甲状腺功能减退可能影响糖尿病控制。
