Pediatric Intensive Care Unit, Health Sciences University, Dr. Behçet Uz Children's Diseases and Surgery Training and Research Hospital, İzmir, Türkiye.
Pediatric Endocrinology, Health Sciences University, Dr. Behçet Uz Children's Diseases and Surgery Training and Research Hospital, İzmir, Türkiye.
J Pediatr Endocrinol Metab. 2024 Apr 4;37(5):400-404. doi: 10.1515/jpem-2024-0022. Print 2024 May 27.
The aim of our study was to investigate the changes in thyroid hormone levels during and after acute metabolic disorder in patients with diabetic ketoacidosis (DKA).
Eighty five patients diagnosed with DKA were included in the study. Patients with control thyroid function test (TFT) values at admission (the first blood sample) and 1 month later were included in the study. Thyroid function tests obtained during diabetic ketoacidosis and at the first month follow-up were compared. Euthyroidism and euthyroid sick syndrome were defined and grouped according to current guidelines. The mild and moderate groups, according to DKA classification, were combined and compared with the severe group.
A significant increase was observed between the first admission and the control TFT values 1 month later. However, there was no significant difference found in TFT between mild/moderate and severe groups taken at the time of DKA. Difference between two groups, euthyroid sick syndrome and euthyroid, was examined and the result that was different from the literature was the difference between TSH levels. We found that low FT4 levels were associated with higher HgbA1c, although the correlation was weak.
Thyroid hormone levels may not reflect a thyroid disease during severe DKA attack. Therefore, it is unnecessary to check thyroid function tests.
本研究旨在探讨糖尿病酮症酸中毒（DKA）患者在急性代谢紊乱期间和之后甲状腺激素水平的变化。
本研究纳入了 85 例确诊为 DKA 的患者。纳入标准为入院时（第一次采血）和 1 个月后甲状腺功能检查（TFT）值正常的患者。比较 DKA 期间和首次随访时的甲状腺功能检查结果。根据现行指南定义并分组正常甲状腺功能和正常甲状腺病态综合征。根据 DKA 分类，将轻度和中度组合并与重度组进行比较。
第一次入院时与 1 个月后控制 TFT 值相比，观察到显著增加。然而，在 DKA 时，轻度/中度和重度组之间的 TFT 没有发现显著差异。检查了两组之间，即正常甲状腺病态综合征和正常甲状腺之间的差异，结果与文献不同的是 TSH 水平的差异。我们发现尽管相关性较弱，但 FT4 水平较低与 HgbA1c 较高有关。
在严重 DKA 发作期间，甲状腺激素水平可能不能反映甲状腺疾病。因此，没有必要检查甲状腺功能检查。
