Thyroid Hormone Replacement and Growth of Children with Subclinical Hypothyroidism and Diabetes

Chase, H. Peter; Garg, Samita; Cockerham, Richard; Wilcox, W.D.; Walravens, P.

doi:10.1111/j.1464-5491.1990.tb01393.x

Cited by 63 publications

(61 citation statements)

References 8 publications

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“…Nevertheless, the clinical significance of autoimmune thyroiditis in children and adolescents with type 1 diabetes is still unclear. Chase et al (17) reported reduced growth rates in children with diabetes and subclinical hypothyroidism, particularly in those with TSH values Ͼ50 mU/l. After treatment with Lthyroxine, growth velocity increased in prepubertal patients.…”

Section: Resultsmentioning

confidence: 99%

Thyroid Autoimmunity in Children and Adolescents With Type 1 Diabetes

Kordonouri

Klinghammer²,

Lang³

et al. 2002

Diabetes Care

267

160

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OBJECTIVE -To investigate thyroid autoimmunity in a very large nationwide cohort of children and adolescents with type 1 diabetes.RESEARCH DESIGN AND METHODS -Data were analyzed from 17,749 patients with type 1 diabetes aged 0.1-20 years who were treated in 118 pediatric diabetes centers in Germany and Austria. Antibodies to thyroglobulin (anti-TG) and thyroperoxidase (anti-TPO) were measured and documented at least once in 7,097 patients. A total of 49.5% of these patients were boys, the mean age was 12.4 years (range 0.3-20.0 years), and the mean duration of diabetes was 4.5 years (range 0.0 -19.5 years). A titer exceeding 100 units/ml or 1:100 was considered significantly elevated.RESULTS -In 1,530 patients, thyroid antibody levels were elevated on at least one occasion, whereas 5,567 were antibody-negative during the observation period. Patients with thyroid antibodies were significantly older (P Ͻ 0.001), had a longer duration of diabetes (P Ͻ 0.001), and developed diabetes later in life (P Ͻ 0.001) than those without antibodies. A total of 63% of patients with positive antibodies were girls, compared with 45% of patients without antibodies (P Ͻ 0.001). The prevalence of significant thyroid antibody titers increased with increasing age; the highest prevalence was in the 15-to 20-year age group (anti-TPO: 16.9%, P Ͻ 0.001; anti-TG: 12.8%, P Ͻ 0.001). Thyroid-stimulating hormone (TSH) levels were higher in patients with thyroid autoimmunity (3.34 U/ml, range 0.0 -615.0 U/ml) than in control subjects (1.84 U/ml, range 0.0 -149.0 U/ml) (P Ͻ 0.001). Even higher TSH levels were observed in patients with both anti-TPO and anti-TG (4.55 U/ml, range 0.0 -197.0 U/ml).CONCLUSIONS -Thyroid autoimmunity seems to be particularly common in girls with diabetes during the second decade of life and may be associated with elevated TSH levels, indicating subclinical hypothyroidism.

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Section: Resultsmentioning

confidence: 99%

Thyroid Autoimmunity in Children and Adolescents With Type 1 Diabetes

Kordonouri

Klinghammer²,

Lang³

et al. 2002

Diabetes Care

267

160

View full text Add to dashboard Cite

show abstract

“…Our data are in good agreement with the clinical reports when hypothyroidism is observed in diabetic patients. These patients frequently have autoimmune thyroiditis with an elevated TSH level, and in some cases the increase of TSH level is significant [7,35]. Thus, for the evaluation of human DM1-associated thyroid disorders the mild DM1 model seems more suitable than the acute DM1 model.…”

Section: Endocrine Researchmentioning

confidence: 99%

The Influence of Intranasal Insulin on Hypothalamic-Pituitary-Thyroid Axis in Normal and Diabetic Rats

et al. 2015

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The functions of hypothalamic-pituitary-thyroid axis are attenuated in type 1 diabetes mellitus due to insulin deficiency. The use of intranasally administered insulin is of considerable interest for treatment of diabetes and cognitive disorders, but its effect on the thyroid system has not been investigated yet. We studied the influence of long-term treatment with intranasal insulin on the hypothalamic-pituitary-thyroid axis of nondiabetic rats and diabetic animals with streptozotocin models of acute and mild type 1 diabetes mellitus. This treatment was carried out for 28 days in acute (daily does of 0.3, 0.6, and 1.5?IU of insulin per rat) and for 135 days in mild diabetes (daily dose of 0.45?IU/rat). Nondiabetic rats were treated in a similar manner. Intranasal insulin in both models of diabetes resulted in the improvement of thyroid status; manifested as increase of thyroid hormones levels and restoration of response to thyroliberin. In acute diabetes, a daily dose of 0.6?IU/rat was the most effective. Twenty eight days treatment of nondiabetic rats with intranasal insulin at a dose of 0.3?IU/rat resulted in a significant increase of free and total thyroxine levels. Longer treatment of rats with mild diabetes and nondiabetic animals significantly increased thyrotropin level. Thus, long-term intranasal insulin treatment restored the hypothalamic-pituitary-thyroid axis function in type 1 diabetes, but led to a significant increase in the thyrotropin level, which must be considered when designing a strategy for the use of intranasal insulin in clinical applications.

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“…Measuring thyroid autoantibodies is used to identify thyroid autoimmunity, and measurement of TSH may be the most sensitive way to identify patients with thyroid dysfunction (190,194). Subclinical hypothyroidism has been associated with an increased risk of symptomatic hypoglycemia (195) and with reduced linear growth (196). …”

Section: Thyroid Diseasementioning

confidence: 99%