Screening for thyroid disease among children and adolescents with type 1 diabetes mellitus

Abstract

Altered thyroid hormones have been described in patients with diabetes especially those with poor glycemic control. The aim of this work was to evaluate; the presence of serum anti-thyroid peroxidase (serum anti-TPO) autoantibodies and the prevalence of autoimmune thyroid disease in children with type 1 diabetes mellitus. Patients and methodsFifty diabetic children coming for regular follow-up in the diabetes clinic of El-Shatby University Children’s Hospital were enrolled in the study and 20 healthy children matching in age and sex were taken as control. History taking, clinical examination, measurement of HbA1c, serum anti-TPO autoantibodies and serum TSH levels were carried out. Serum T4 and T3 were measured in samples with abnormal serum TSH level. ResultsSerum anti-TPO was positive in 12% of cases, and was negative in 100% of controls. Serum TSH level was abnormal in 50.0% of positive serum anti-TPO cases, in cases where serum anti-TPO was negative, 97.7% had normal serum TSH level, this difference was statistically significant P=0.004. Good metabolic control was found in 42% of all diabetic children, 19% of them had positive serum anti-TPO, fair control was seen in 36%, only 5% of them were positive for serum anti-TPO, 22% had poor control and 9.1% were positive for serum anti-TPO, these differences had no statistical significance P=0.550. ConclusionAlthough serum TSH screening is more sensitive for detecting thyroid abnormalities in children and adolescents with type1 diabetes, the presence of positive serum anti-TPO antibodies may be an earlier marker for thyroid disease, therefore, patients with positive antibodies should be monitored for serum TSH elevation at yearly intervals.