Thyroid function, morphology and autoimmunity in young patients with insulin-dependent diabetes mellitus

Hansen, Dorte Gilså; Bennedbæk, Finn Noe; Hansen, Lise; Høier‐Madsen, Mimi; Jacobsen, BB; Hegedűs, László

doi:10.1530/eje.0.1400512

Cited by 64 publications

(60 citation statements)

References 26 publications

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“…No entanto, nem todos os estudos concordam na magnitude deste aumento. É possível que fatores como raça, ingesta de iodo e até o uso de ensaios cada vez mais sensíveis possam explicar esta diferença (8).…”

Section: Resultsunclassified

“…(8), estudando 105 pessoas com diabetes com menos de 18 anos de idade, encontraram títulos aumentados de anticorpos antitireoideanos em 16,2% dos pacientes. Cinqüenta por cento das mulheres e 35% dos homens diabéticos apresentavam algum tipo de anormalidade morfológica tireoideana à ultra-sonografia, comparado a apenas 8% das mulheres e 13% dos homens do grupo controle.…”

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Prevalência de doença tireoideana em pacientes com diabetes tipo 1

Ramos

Costa

Benício

et al. 2003

Arq Bras Endocrinol Metab

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RESUMOIntrodução: O diabetes mellitus tipo 1 (DM1) freqüentemente se acompanha de outras doenças autoimunes, principalmente doença autoimune da tireóide (DAT). Objetivo: Determinar a prevalência de DAT em pacientes com DM1 e investigar possível relacionamento com outros fatores. Métodos: Em 126 pessoas com DM1, foram mensurados TSH, T 4 livre, anticorpo anti-peroxidase e hemoglobina A1c. Resultados: DAT foi encontrada em 26 pacientes (20,6%), sendo 11 (8,7%) com hipotireoidismo clínico, 6 (4,8%) com hipotireoidismo subclínico e 9 (7,1%) com tireoidite sem disfunção tireoideana. Em um paciente (0,8%), a DAT (hipertireoidismo) precedeu o DM1. Houve relação entre DAT e idade atual e no diagnóstico do DM1. Não foram encontradas significâncias para sexo, grupo racial, duração do DM, paridade e local de moradia. Conclusões: A prevalência de DAT é bastante alta para justificar seu rastreamento e está relacionada com a idade atual e a idade do diagnóstico do DM1. (DM1) is frequently associated with other immune diseases, especially autoimmune thyroid disease (ATD). Objective: To determine the prevalence of ATD in subjects with DM1 and to investigate possible association with other factors. Methods: TSH, free T 4 , antiperoxydase antibody, and hemoglobin A1c were measured in 126 DM1 patients. Results: ATD was found in 26 (20.6%) patients being 11 (8.7%) with overt hypothyroidism, 6 (4.8%) with subclinical hypothyroidism and 9 (7.1%) with thyroiditis without thyroid dysfunction. In one patient (0.8%), ATD (hyperthyroidism) preceded DM1. ATD was associated with current age and age at diagnosis of DM1. No associations of ATD with sex, race, duration of DM1, parity, and home place were observed. Conclusions: The prevalence of ATD in DM1 patients is high enough to justify screening and is related to current age and to the age at the diagnosis of DM1. Keywords: Type 1 diabetes mellitus; Thyroid diseases; Hypothyroidism; Prevalence A TUALMENTE, O MELHOR ATENDIMENTO aos pacientes com diabetes mellitus tipo 1 (DM1), aliado aos avanços diagnósticos, tem possibilitado a detecção precoce de outras endocrinopatias autoimunes nestes indivíduos, algumas ainda na fase pré-clínica. Essa associação de endocrinopatias autoimunes num mesmo indivíduo (síndrome poliglandular) aparentemente não tem relação com o controle do DM1 e sim com o status imunogenético do paciente e/ou com fatores ambientais. Nas síndromes poliglandulares autoimunes, pode haver associação de DM1 com doenças autoimunes da artigo original

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Section: Resultsunclassified

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Prevalência de doença tireoideana em pacientes com diabetes tipo 1

Ramos

Costa

Benício

et al. 2003

Arq Bras Endocrinol Metab

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“…Our prevalence of thyroid autoantibodies at clinical onset of type 1 diabetes was similar to findings in some previous studies [26,27], but in other studies a prevalence as high as 15.8-29% has been reported. However, in these studies, the patients were tested at follow-up and not at the time of diagnosis [1,13,14,[28][29][30], which may explain the higher prevalence. Furthermore, only few children are diagnosed with AITD at the onset of type 1 diabetes [23,26,31], while the risk of AITD increases during follow-up of patients with type 1 diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…It is of interest that GADA was associated with DQ2 and IAA and IA-2A with DQ8, while DQ2 was associated with a decreased risk for IA-2A [12]. Autoantibodies against TPO (TPOAb) and TG (TGAb) were also associated with HLA-DQ genotype [13,14], although their relationships with specific HLA-DQ haplotypes were less obvious and would need further clarification in larger studies.…”

Section: Introductionmentioning

confidence: 99%

Thyroid autoimmunity in relation to islet autoantibodies and HLA-DQ genotype in newly diagnosed type 1 diabetes in children and adolescents

et al. 2013

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Aims/hypothesis The aim of this work was to investigate, in children newly diagnosed with type 1 diabetes: (1) the prevalence of autoantibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TGAb); and (2) the association between TPOAb, TGAb or both, with either islet autoantibodies or HLA-DQ genes. Methods Blood samples from 2,433 children newly diagnosed with type 1 diabetes were analysed for TPOAb and TGAb in addition to autoantibodies against arginine zinc transporter 8 (ZnT8RA), tryptophan zinc transporter 8 (ZnT8WA), glutamine zinc transporter 8 (ZnT8QA), glutamic acid decarboxylase (GADA), insulin (IAA), insulinoma-associated protein-2 (IA-2A), HLA-DQA-B1 genotypes, thyroid-stimulating hormone (TSH) and free thyroxine (T4). Results At type 1 diabetes diagnosis, 12% of the children had thyroid autoantibodies (60% were girls; p<0.0001). GADA was positively associated with TPOAb (p<0.001) and with TGAb (p<0.001). In addition, ZnT8A was associated with both TPOAb (p=0.039) and TGAb (p=0.015). DQB1*05:01 in any genotype was negatively associated with TPOAb (OR 0.55, 95% CI 0.37, 0.83, p value corrected for multiple comparisons (p c )=0.012) and possibly with TGAb (OR 0.55, 95% CI 0.35, 0.87, p c =0.07). Thyroid autoimmunity in children newly diagnosed with type 1 diabetes was rarely (0.45%) associated with onset of clinical thyroid disease based on TSH and free T4. Conclusions/interpretation GADA and ZnT8A increased the risk for thyroid autoimmunity at the time of clinical diagnosis of type 1 diabetes, while HLA-DQB1*05:01 reduced the risk. However, the associations between thyroid autoimmunity and HLA-DQ genotype were weak and did not fully explain the co-occurrence of islet and thyroid autoimmunity.

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“…It is suggested that there is a strong relationship between Graves' disease and type 1 DM, since coexistence of AITD and type 1 DM is classified as PGA type III [3]. It has been reported that approximately 20% of patients with type 1 diabetes develop AITD, compared to a risk of 1% to 7% in the general population [4,5]. Conversely, the titer of anti-glutamic acid decarboxylase antibodies in patients with AITD can be significantly higher than in healthy controls [6].…”

Section: Discussionmentioning

confidence: 99%

A Case of Polyglandular Autoimmune Syndrome Type III Complicated with Autoimmune Hepatitis

et al. 2006

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Abstract.A 58-year-old woman complaining of finger tremor was referred to our hospital. The diagnosis of Graves' disease was made based on increased free triiodothyronine (18.88 pg/ml) and free thyroxine (7.47 ng/dl), low TSH (<0.005 µIU/ml) and increased TSH receptor binding antibody activity (70.9%). Serum level of AST (62 U/l) and ALT (93 U/l) were increased and liver biopsy revealed linkage of adjacent portal areas by lymphoplasmacytic infiltrates and fibrosis with piecemeal necrosis. Although antinuclear antibody was negative, these findings indicated that she had autoimmune hepatitis (AIH) according to the criteria of the International Autoimmune Hepatitis Scoring System. Slowly progressive type 1 diabetes mellitus (DM) was confirmed by a diabetic response pattern due to 75 g-oral glucose tolerance test, and seropositivity towards anti-glutamic acid decarboxylase (725 U/ml) and islet cell (80 JDF Units) antibodies. This case exhibited an extremely rare combination of three different autoimmune diseases, including Graves' disease, slowly progressive type 1 DM and AIH, and had no known sensitive human leukocyte antigen (HLA) typing or haplotype for these disorders. Alhough it is common for patients with Graves' disease to exhibit abnormal liver function, it is important to make an accurate diagnosis of AIH because of this life-threatening disorder.

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Thyroid function, morphology and autoimmunity in young patients with insulin-dependent diabetes mellitus

Cited by 64 publications

References 26 publications

Prevalência de doença tireoideana em pacientes com diabetes tipo 1

Prevalência de doença tireoideana em pacientes com diabetes tipo 1

Thyroid autoimmunity in relation to islet autoantibodies and HLA-DQ genotype in newly diagnosed type 1 diabetes in children and adolescents

A Case of Polyglandular Autoimmune Syndrome Type III Complicated with Autoimmune Hepatitis

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