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Determinants of deranged thyroid function parameters in children admitted for management of diabetic

Peng Shao1,2, Shujuan Guo1,2, Guimei Li3

  • 1Department of Pediatrics, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong, China.

BMC Endocrine Disorders
|September 3, 2020
PubMed

Insights

Euthyroid sick syndrome (ESS) in children with diabetic ketoacidosis/ketosis (DKA/DK) is linked to higher acidosis. Lower free thyroid hormone levels correlate with increased severity of DKA/DK.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Thyroid Function Tests

Background:

  • Euthyroid sick syndrome (ESS) is common in children with diabetic ketoacidosis/ketosis (DKA/DK).
  • Understanding metabolic factors influencing thyroid function in DKA/DK is crucial.

Purpose of the Study:

  • To investigate the relationship between metabolic derangements and thyroid dysfunction in pediatric DKA/DK patients.
  • To identify key metabolic markers associated with ESS in this population.

Main Methods:

  • A retrospective study of 194 pediatric patients with DKA/DK.
  • Exclusion of patients on thyroxine, with hypothyroidism, or positive anti-thyroid peroxidase antibodies.
  • Comprehensive metabolic and thyroid function tests were performed.

Main Results:

  • The ESS group exhibited higher white blood cell count, plasma glucose, beta-hydroxybutyric acid, triglycerides, anion gap, and HbA1c.
  • Lower HCO3-, prealbumin, and albumin levels were observed in the ESS group.
  • Free T3 and Free T4 levels significantly correlated with metabolic parameters, with HCO3- being the strongest predictor of ESS.

Conclusions:

  • Increased acidosis is associated with lower free thyroid hormone levels and ESS in pediatric DKA/DK.
  • Metabolic factors, particularly bicarbonate levels, play a significant role in the development of ESS in children with DKA/DK.
Abstract

Keywords:
ChildrenDiabetesMetabolic changesThyroid functionType 1 diabetes

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