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儿童 1 型糖尿病合并自身免疫性甲状腺炎患者颈总动脉搏动性变差:一项初步研究。

Common carotid pulsatility is deteriorated by autoimmune thyroiditis in children with type 1 diabetes mellitus - A pilot study.

机构信息

Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, Gdansk, Poland.

Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdańsk, Gdansk, Poland.

出版信息

Physiol Rep. 2020 Aug;8(15):e14518. doi: 10.14814/phy2.14518.

Abstract

Autoimmune thyroiditis (AIT) frequently coexists with type 1 diabetes (DM1) and additionally increases the extent of microcirculatory complications due to DM1. We hypothesized that in pediatric patients with DM1, impairment of macrocirculation could be further augmented by a coexisting autoimmune process. Therefore, we investigated the influence of AIT on large arteries in DM1 pediatric patients. Our group consisted of 19 DM1, 19 DM1 + AIT patients and 29 control subjects. The groups were comparable regarding age and gender. The DM1 and DM1 + AIT patients were matched for age at onset of DM1 and diabetes duration. Macrocirculation was described using pulsatility indices (PIs) determined for common carotid (CCA) and peripheral arteries of upper and lower limbs. CCA resistance index (RI) and ABI were also assessed. Children with DM1 + AIT had only significantly lower CCA_PI and CCA_RI in comparison with controls whereas in the absence of AIT such difference was not found. The diabetes duration and age of onset did not correlate with carotid indices. Total cholesterol level was higher both in DM1 + AIT and DM1 groups than in the control group. For low density lipoproteins cholesterol, a significant difference was found between DM1 + AIT and control groups. Age-independent impact of AIT on CCA_PI was confirmed by multivariate analysis. Common carotid pulsatility is deteriorated by autoimmune thyroiditis independently of age in children with type 1 diabetes mellitus.

摘要

自身免疫性甲状腺炎(AIT)常与 1 型糖尿病(DM1)并存,并因 DM1 而增加微循环并发症的程度。我们假设,在患有 1 型糖尿病的儿科患者中,共存的自身免疫过程可能会进一步损害大动脉。因此,我们研究了 AIT 对 1 型糖尿病儿科患者大动脉的影响。我们的小组由 19 名 1 型糖尿病患者、19 名 1 型糖尿病伴 AIT 患者和 29 名对照组组成。这些组在年龄和性别方面具有可比性。1 型糖尿病和 1 型糖尿病伴 AIT 患者在 DM1 的发病年龄和糖尿病病程方面相匹配。使用肱动脉(CCA)和上下肢外周动脉的搏动指数(PI)描述大循环。还评估了 CCA 阻力指数(RI)和 ABI。与对照组相比,患有 1 型糖尿病伴 AIT 的儿童仅 CCA_PI 和 CCA_RI 显著降低,而在不存在 AIT 的情况下未发现这种差异。糖尿病病程和发病年龄与颈动脉指数无相关性。总胆固醇水平在 1 型糖尿病伴 AIT 和 1 型糖尿病组均高于对照组。低密度脂蛋白胆固醇水平在 1 型糖尿病伴 AIT 组和对照组之间存在显著差异。多变量分析证实了 AIT 对 CCA_PI 的独立于年龄的影响。在患有 1 型糖尿病的儿童中,自身免疫性甲状腺炎独立于年龄对颈总动脉搏动有恶化作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f258/7399375/516983e63890/PHY2-8-e14518-g001.jpg

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