Calcaterra Valeria, De Santis Raffaella, Braghieri Davide, Zanelli Sara, Zuccotti Gianvincenzo
Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
Pediatric Department, "Vittore Buzzi" Children's Hospital, Milano, Italy.
Front Pediatr. 2024 Oct 29;12:1456545. doi: 10.3389/fped.2024.1456545. eCollection 2024.
Concurrent alterations in the metabolic profile and thyroid dysfunction, including non-thyroidal illness syndrome (NTIS) has been reported in multisystem inflammatory syndrome in children (MIS-C). Considering the influence of thyroid hormones (TH) on lipid metabolism, we explored the relationship between thyroid function and the atherogenic lipid profile in children with MIS-C at admission and during a 12-month follow-up.
we considered children admitted for MIS-C. Total and HDL cholesterol, triglycerides (TG), fasting plasma glucose, fasting plasma insulin as well as free T3 (FT3), free T4 (FT4), and TSH were assessed at diagnosis within 24 h of admission and during follow-up. TG/HDL ratio, no-HDL/HDL ratio and atherogenic index of plasma was also considered as atherogenic risk markers.
we monitored 56 children. On admission, pathological levels of FT3, FT4, TSH, TG, TC, HDL, TG/HDL ratio, no-HDL/HDL ratio, and AIP were detected. Correlation analyses revealed associations between FT3, FT4, and lipid markers and TSH with TG. During monitoring, while complete restoration of TH balance was achieved at 12 months, some patients still exhibited an altered lipid profile, without correlation between thyroid function and lipid markers.
we supported a relationship between thyroid function and an atherogenic lipid profile in children with MIS-C. This may result from interactions between adaptive and innate metabolic responses and genetic predisposition. Elucidating the relationship between TH and metabolic pathways during infections could help identify new biomarkers to prevent acute and fatal outcomes, improving patient prognosis and protecting long-term health.
儿童多系统炎症综合征(MIS-C)中已报道代谢谱与甲状腺功能障碍同时出现,包括非甲状腺疾病综合征(NTIS)。考虑到甲状腺激素(TH)对脂质代谢的影响,我们探讨了MIS-C患儿入院时及12个月随访期间甲状腺功能与动脉粥样硬化性脂质谱之间的关系。
我们纳入了因MIS-C入院的儿童。在入院24小时内诊断时及随访期间评估总胆固醇、高密度脂蛋白胆固醇、甘油三酯(TG)、空腹血糖、空腹血浆胰岛素以及游离T3(FT3)、游离T4(FT4)和促甲状腺激素(TSH)。TG/HDL比值、非HDL/HDL比值和血浆动脉粥样硬化指数也被视为动脉粥样硬化风险标志物。
我们监测了56名儿童。入院时,检测到FT3、FT4、TSH、TG、总胆固醇(TC)、高密度脂蛋白(HDL)、TG/HDL比值、非HDL/HDL比值和动脉粥样硬化指数(AIP)的病理水平。相关性分析显示FT3、FT4与脂质标志物以及TSH与TG之间存在关联。在监测期间,虽然12个月时TH平衡完全恢复,但一些患者仍表现出脂质谱改变,甲状腺功能与脂质标志物之间无相关性。
我们支持MIS-C患儿甲状腺功能与动脉粥样硬化性脂质谱之间存在关联。这可能是适应性和先天性代谢反应与遗传易感性之间相互作用的结果。阐明感染期间TH与代谢途径之间的关系有助于识别新的生物标志物,以预防急性和致命后果,改善患者预后并保护长期健康。