Thyroid autoimmunity in 72 children with type 1 diabetes mellitus: relationship with pancreatic autoimmunity and child growth

Abstract

The aim of this study was to assess the association between pancreatic and thyroid autoimmunity (TA) and determine impact of thyroid antibodies on statural growth. Seventy-two children with type 1 diabetes mellitus (TIDM) and no clinical evidence of thyroid disorders were evaluated: glycated haemoglobin (A1c), thyroid peroxidase antibodies (TPOAb), glutamic acid decarboxylase antibody (GADA), tyrosine phosphatase antibodies (IA2A), and thyroid-stimulating hormone (TSH). The score of standard deviation for height (SDS) was calculated. There were 72 patients, 38 (52.7%) boys and 34 (47.2%) girls, with a mean age of 10.89 +/- 4.26 years and a mean duration of T1DM of 3.41 +/- 2.56 years. TPOAb were present in 23.6% of patients; 12.5% of subjects were positive for GADA and 41.6% for IA2A. Patients with TA had more prevalent GADA and IA2A (23.5% vs. 9%, p < 0.001, and 58.8% vs. 36.3%, p < 0.001, respectively). A1c was higher in patients with TA (9.7% +/- 2.05% vs. 8.6% +/- 2.11%, p = 0.05). TA was associated with lower SDS (0.26 vs. 0.98, p = 0.043). TSH was higher in patients with TA (3.39 vs. 2.15 microU/mL, p < 0.05). Logistic regression analysis revealed that a negative SDS for height was independently associated with duration of diabetes (p = 0.049) and TSH (p = 0.027) but not with birth weight, A1c, and TPOAb. In conclusion, TA was found in 23.6% TIDM children. Patients with TA had significantly higher prevalence of GADA and IA2A and significantly higher A1c vs. patients without TA. Our data suggest significant association between TA and height in children with T1DM. SDS was independently associated with diabetes duration and TSH.

The Impact of Thyroid Autoimmunity on the Clinical and Diabetes Parameters of Patients with Latent Autoimmune Diabetes in Adults

“…A similar prevalence of GADA positivity (47 %) was observed in a study performed on insulin-treated type 2 diabetes mellitus inpatients, whereas only 10 % of the patients not treated with insulin were positive for GADA [30]. TA based on TPOAb measurements displayed a prevalence of 28.8 % in our study; this result was higher than that for classical type 1 diabetes mellitus [31,32]. Few studies have examined TA among LADA patients [16,17,19,33].…”

Prevalence of autoimmune thyroiditis in patients with type 1 diabetes: a long-term follow-up study

“…Many studies have demonstrated that several factors such as age, the female sex, duration of disease, and the presence of beta cell autoimmunity are associated with AIT in type 1 DM patients [ 9 , 10 , 13 , 20 - 22 ]. In our study, GADA positivity at the onset of type 1 DM was a predictor of AIT development.…”

“…Thyroid autoantibodies can be detected at the initial diagnosis or can be detected over time, after diagnosis [ 5 , 6 ]. Age at diagnosis, pubertal status, and the female gender have been associated with thyroid autoantibody in children and adolescents with type 1 DM [ 7 - 10 ]. In addition, recent studies have reported that the presence of glutamic acid decarboxylase antibodies (GADA) and human leucocyte antigen class II genes may influence the development or progression of AIT [ 11 , 12 ].…”

Organ-specific autoimmunity in relation to clinical characteristics in children with long-lasting type 1 diabetes

“…The recent extensive Ab screening study in patients with T1DM has raised awareness of the association of T1DM with organ-specific autoimmunity [29]. The reported prevalence of thyroid autoimmunity in young T1DM patients ranges between 3% and 50% [10,[30][31][32][33], while it is 3.4%-7% in the general paediatric population [34,35]. The association of T1DM and AITD is highly dependent on age, sex and ethnicity [36].…”