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Autoimmune thyroid disease in Indian children with type 1 diabetes mellitus
P S Menon1, B Vaidyanathan, M Kaur
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi. psmenon@hotmail.com
Insights
Indian children with type 1 diabetes have a high prevalence of thyroid antibodies, indicating a need for screening. Autoimmune thyroid disease screening is crucial for early detection and management in pediatric diabetes patients.
Area of Science:
- Endocrinology
- Pediatrics
- Immunology
Background:
- Type 1 diabetes mellitus (T1DM) is an autoimmune condition.
- Autoimmune thyroid disease (AITD) is the most common comorbidity in T1DM.
- Early detection of AITD in children with T1DM is essential for preventing complications.
Purpose of the Study:
- To determine the prevalence of AITD in Indian children with T1DM.
- To assess the presence of thyroid peroxidase antibodies (TPO) and thyroglobulin antibodies (TGA).
- To evaluate the association between T1DM and AITD in a pediatric population.
Main Methods:
- Study included 35 Indian children with T1DM and 32 healthy controls.
- Thyroid peroxidase antibodies (TPO) measured by ELISA; thyroglobulin antibodies (TGA) by passive hemagglutination.
- Thyroid function tests and glycemic control assessed, with repeat assays at 6 months and 1 year.
Main Results:
- TPO antibodies found in 54.3% of T1DM patients vs. 10% of controls (p=0.0002).
- TGA found in 31.4% of T1DM patients vs. 0% of controls (p=0.0016).
- One patient diagnosed with Hashimoto's thyroiditis; antibody prevalence unaffected by gender or diabetes duration.
Conclusions:
- High prevalence of thyroid antibodies in Indian children with T1DM suggests a significant association.
- Screening for thyroid antibodies is recommended for all diabetic children.
- Positive antibody results necessitate careful follow-up for potential AITD development.
Abstract:
The objective of the present study was to determine the prevalence of autoimmune thyroid disease in Indian children with type 1 diabetes mellitus by the assay of antibodies to thyroid peroxidase and thyroglobulin. The study population consisted of 35 children with type 1 diabetes mellitus and 32 healthy age- and sex-matched control children. Thyroid peroxidase antibodies (TPO) were determined by ELISA and thyroglobulin antibodies (TGA) by passive hemagglutination. Thyroid function tests and tests of glycemic control were also performed. These assays were repeated after six months and one year. TPO were observed in 19 (54.3%) patients compared to three (10%) controls, and TGA in 11 (31.4%) patients and none of the controls. Both these observations were statistically significant with p=0.0002 for TPO and 0.0016 for TGA. The prevalence of these antibodies was not different in boys and girls and did not change with the duration of diabetes. All patients who were positive for TGA were also positive for TPO. Thyroid function tests were abnormal in one patient who was found to have Hashimoto's thyroiditis. There is a definite need to screen all diabetic children for thyroid antibodies and carefully follow up those patients in whom these antibodies are positive.