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Endothelial dysfunction in children with newly diagnosed Graves' disease
Yasser Gamal1, Ahlam Badawy2, Ahmed M Ali2
1Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt. dryasser_gamal@aun.edu.eg.
European Journal of Pediatrics
|April 6, 2023
Summary
Children with newly diagnosed Graves' disease show signs of endothelial dysfunction, indicated by reduced flow-mediated dilatation (FMD) and increased von Willebrand factor (vWF). Early detection of this vascular issue in pediatric Graves' disease is crucial.
Area of Science:
- Pediatric Endocrinology
- Vascular Biology
- Cardiology
Background:
- Graves' disease (GD) is the leading cause of hyperthyroidism in children.
- Thyroid hormones impact vascular endothelium function.
- Endothelial dysfunction is an early indicator of cardiovascular risk.
Purpose of the Study:
- To evaluate endothelial function in children with newly diagnosed Graves' disease.
- To assess flow-mediated dilatation (FMD) and serum von Willebrand factor (vWF) levels.
- To determine the extent of endothelial dysfunction in pediatric GD patients.
Main Methods:
- A study involving 40 children with newly diagnosed GD and 40 healthy controls.
- Measurements included anthropometrics, lipids, glucose, insulin, hs-CRP, thyroid function tests (TSH, FT4, FT3), TRAbs, and vWF.
- Noninvasive ultrasound assessed carotid intima-media thickness and brachial artery FMD.
Main Results:
- Children with GD exhibited significantly lower FMD and higher vWF and hs-CRP levels compared to controls (P<0.001).
- Multivariate analysis revealed vWF correlated significantly with TSH, FT3, TRAb, and FMD% (P<0.01).
- These findings indicate impaired endothelial function in pediatric Graves' disease.
Conclusions:
- Newly diagnosed pediatric Graves' disease is associated with endothelial dysfunction.
- Impaired FMD and elevated vWF levels are key indicators in these children.
- Prompt treatment of GD is supported by these findings, highlighting the need for early intervention.
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