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How does autoimmune thyroiditis in children with type 1 diabetes mellitus influence glycemic control, lipid profile

Katarzyna Korzeniowska, Anna Ramotowska, Agnieszka Szypowska

    Journal of Pediatric Endocrinology & Metabolism : JPEM
    |September 12, 2014
    PubMed

    Insights

    Autoimmune thyroiditis (AIT) in children with type 1 diabetes mellitus (DM1) is linked to poorer glycemic control and lipid profiles. Female children are more prone to developing AIT and hypothyroidism alongside DM1.

    Area of Science:

    • Pediatric Endocrinology
    • Immunology
    • Metabolic Disorders

    Background:

    • Type 1 diabetes mellitus (DM1) is an autoimmune condition requiring lifelong management.
    • Autoimmune thyroiditis (AIT) is a common comorbidity in patients with DM1.
    • The impact of co-occurring AIT on DM1 management in pediatric populations requires further elucidation.

    Purpose of the Study:

    • To determine the influence of autoimmune thyroiditis (AIT) on glycemic control in children with type 1 diabetes mellitus (DM1).
    • To assess the effect of AIT on lipid profiles in pediatric patients with DM1.
    • To investigate the relationship between AIT and thyroid volume in children with DM1.

    Main Methods:

    • A comparative study involving 330 children with DM1 and AIT (DM1+AIT group) and 309 children with DM1 without AIT (control group).
    • Data collected from four Polish academic pediatric diabetes centers between 2008 and 2012.
    • Measurements included thyroid function tests (TSH, free thyroxine), thyroid antibodies (anti-TPO, anti-TG), HbA1c, lipid profile, and thyroid ultrasound.

    Main Results:

    • Children with AIT+DM1 exhibited lower BMI-SDS, increased thyroid volume, and required less insulin compared to controls.
    • AIT patients presented with higher HbA1c levels, lower HDL-cholesterol, and elevated triglyceride levels.
    • Positive anti-TPO and anti-TG antibodies were associated with older age and longer DM1 duration; anti-TPO antibodies correlated with higher TSH levels.

    Conclusions:

    • Autoimmune thyroiditis accompanying type 1 diabetes mellitus is associated with poorer glycemic control and an unfavorable lipid profile.
    • Children with AIT and DM1 demonstrate a reduced daily insulin requirement.
    • Female gender is a significant risk factor for developing AIT and hypothyroidism in the context of DM1.
    Abstract

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