Department of Endocrinology and Diabetology, The Children's Memorial Health Institute, Warsaw, Poland.
Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland.
Pediatr Diabetes. 2021 Mar;22(2):329-334. doi: 10.1111/pedi.13154. Epub 2020 Nov 26.
To assess the influence of thyroid hormones status and coexistence of autoimmune thyroiditis on optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) results in children with Type 1 diabetes (T1D).
In the prospective, observational study (n = 175) we analyzed the impact of thyroid hormones on OCT results and the differences between the matched groups of children with T1D (n = 84; age = 13.14 ± 3.6; diabetes duration = 5.99 ± 3.3 years) and the children with T1D and autoimmune thyroiditis (AT) (n = 20; age = 13.94 ± 3.6; diabetes duration = 6.7 ± 4 years). We analyzed the following parameters: fovea avascular zone (FAZ), foveal thickness (FT), parafoveal thickness (PFT), ganglion cell complex (GCC), loss volume (global-GLV, focal-FLV), capillary vessel density: superficial (whole-wsVD, foveal-fsVD, parafoveal-psVD), and deep (whole-wdVD, foveal-fdVD, parafoveal-pdVD. The differences between the groups were tested by the unpaired t-Student test, Mann-Whitney U test as appropriate, whereas p level .05 was recognized as significant.
We detected the significant correlations between thyroid-stimulating hormone (TSH) level and PFT (r = -0.14; p < .05), psVD (r = -0.18; p < .005). The level of free triiodothyronine (FT3) was correlated with psVD (r = -0.14; p < .05). We found significant correlation between free thyroxine (FT4) and fsVD (r = -0.17; p < .01). In the studied T1D and AT groups there were statistical differences in FT (p < .005), PFT (p < .03), GCC (p < .01), and GLV (p < .003). We did not observe any significant differences in the FAZ area between the groups.
In our patients the co-occurrence of T1D and AT worsens the status of retinal parameters. Further studies are necessary to observe these relations and their potential influence on the occurrence of diabetic retinopathy (DR).
评估甲状腺激素状态和自身免疫性甲状腺炎共存对 1 型糖尿病（T1D）儿童光学相干断层扫描（OCT）和光学相干断层扫描血管造影（OCTA）结果的影响。
在这项前瞻性、观察性研究（n=175）中，我们分析了甲状腺激素对 OCT 结果的影响，以及 T1D 儿童（n=84；年龄=13.14±3.6；糖尿病病程=5.99±3.3 年）和 T1D 伴自身免疫性甲状腺炎（AT）儿童（n=20；年龄=13.94±3.6；糖尿病病程=6.7±4 年）匹配组之间的差异。我们分析了以下参数：中心凹无血管区（FAZ）、中心凹视网膜厚度（FT）、旁中心凹视网膜厚度（PFT）、神经节细胞复合体（GCC）、容积丢失（整体-GLV、局灶性-FLV）、毛细血管血管密度：浅层（全-WSVD、中心凹-fsVD、旁中心凹-psVD）和深层（全-WDVD、中心凹-fdVD、旁中心凹-pdVD）。通过未配对 t 检验和曼-惠特尼 U 检验测试组间差异，p 值<.05 被认为具有统计学意义。
我们检测到促甲状腺激素（TSH）水平与 PFT（r=-0.14；p<.05）和 psVD（r=-0.18；p<.005）之间存在显著相关性。游离三碘甲状腺原氨酸（FT3）水平与 psVD 相关（r=-0.14；p<.05）。我们发现游离甲状腺素（FT4）与 fsVD 之间存在显著相关性（r=-0.17；p<.01）。在研究的 T1D 和 AT 组中，FT（p<.005）、PFT（p<.03）、GCC（p<.01）和 GLV（p<.003）存在统计学差异。两组间 FAZ 面积无显著差异。
在我们的患者中，T1D 和 AT 的共存会使视网膜参数状况恶化。需要进一步研究以观察这些关系及其对糖尿病性视网膜病变（DR）发生的潜在影响。
