Tip 1 diyabetli hastalarda otoimmün tiroid hastalığı sıklığı
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Date
2020-04-01
Authors
Ünal, Edip
Demiral, Meliha
Öcal, Murat
Baysal, Birsen
Mehmet, Nuri Özbek
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Bu çalışmada, kliniğimizde tip 1 diyabetes mellitus (T1DM) tanısıyla izlenen çocuk ve ergen hastalarda otoimmün tiroid hastalığı (OİTH) sıklığının belirlenmesi ve diğer parametrelerle olan ilişkisinin değerlendirilmesi amaçlanmıştır. Son 10 yıldır tip 1 DM tanısıyla izlenen 722 hastanın dosyası retrospektif olarak incelendi. Hastaların yaş, cinsiyet, ortalama HbA1c, tiroid uyarıcı hormon (TSH), serbest tiroksin (sT4), antitiroid peroksidaz (anti-TPO) ve anti-tiroglobülin(anti-Tg) düzeyi, vücut ağırlığı standart deviasyon skoru (SDS), boy SDS ve vücut kitle indeksi (VKİ) SDS değerleri kaydedildi. Çalışmaya alınan 722 hastanın 607’sine en az bir kez tiroid otoantikorları bakılmış ve 72’sinde (% 11,9) anti-TPO ve/veya anti-Tg pozitifliği saptanmıştı. Bu hastaların 57’isi (% 79,2) ötiroid, 7’isinde ( % 9,7) aşikar hipotiroidi, 5’inde ( % 6,9) subklinik hipotiroidi ve 3’ünde ( % 4,2) hipertiroidi mevcuttu. Hashimoto tiroiditli(HT) olguların 48’i (% 66,7) pubertal iken, 24’ü (% 33,3) prepubertal idi. OİTH’li olguların 50’si ( % 69,4) kız, 22’isi ( % 30,6) erkek idi. Ayrıca OİTH tespit edilen 72 hastanın 12’sinde ( % 16,6) çölyak hastalığı(ÇH) mevcut idi. Ki-kare analizine göre OİTH kızlarda (p: 0,01) ve ÇH’si olanlarda ( p: 0,02) daha fazla görülmekteydi. Yaş ve diyabet süresi uzadıkça OİTH prevalansı artmaktaydı. T1DM’li hastalarda yaş ve diyabetin süresi arttıkça HT sıklığı artmaktadır. Hashimoto tiroiditi özellikle kız cinsiyette ve pubertal dönemde daha sık görülmektedir. Tip 1 DM’li hastalarda çölyak varlığı HT riskini artırmaktadır. Tiroid disfonksiyonun metabolik kontrol, büyüme ve gelişme üzerindeki olumsuz etkilerinin önlenmesi açısından belli aralıklarla tiroid fonksiyon testleri ve otoantikorların bakılması gerekmektedir.
In this study, it was aimed to determine the frequency of autoimmune thyroid disease (OITH) in children and adolescent patients who were followed-up with type 1 diabetes mellitus(T1DM) and to evaluate its relationship with other parameters. The files of 722 patients who have been followed up with the diagnosis of T1DM for the last 10 years were reviewed retrospectively. Age, gender, mean HbA1c, thyroid stimulating hormone(TSH), free thyroxine(fT4), anti-thyroid peroxidase(anti-TPO) and antithyroglobulin(anti-Tg) level, weight standard deviation score(SDS), height SDS and body mass index(BMI) SDS values were recorded. Of the 722 patients, 607 had thyroid autoantibodies examined at least once and 72(11.9%) had anti-TPO and/or anti-TG positivity. Of these patients, 57(79.2%) had euthyroid, 7(9.7%) had obvious hypothyroidism, 5(6.9%) had subclinical hypothyroidism and 3(4.2%) had hyperthyroidism. While 48(66.7%) of the patients with Hashimato thyroiditis(HT) were pubertal, 24(33.3%) were prepubertal. Fifty (69.4%) of the OITH cases were female and 22(30.6%) were male. In addition, 12(16.6%) of 72 patients with OITH had celiac disease (CD). According to the chi-square analysis, OITH was more common in girls(p: 0.01) and those with CD(p: 0.02). As the age and duration of diabetes prolonged, the prevalence of OITH increased. As a result; In patients with T1DM the frequency of HT increases with increasing age and duration of diabetes. Hashimato thyroiditis is more common in female gender and pubertal period. The presence of celiac increases the risk of HT in patients with T1DM. In order to prevent the negative effects of thyroid dysfunction on metabolic control, growth and development, thyroid function tests and autoantibodies should be checked periodically.
In this study, it was aimed to determine the frequency of autoimmune thyroid disease (OITH) in children and adolescent patients who were followed-up with type 1 diabetes mellitus(T1DM) and to evaluate its relationship with other parameters. The files of 722 patients who have been followed up with the diagnosis of T1DM for the last 10 years were reviewed retrospectively. Age, gender, mean HbA1c, thyroid stimulating hormone(TSH), free thyroxine(fT4), anti-thyroid peroxidase(anti-TPO) and antithyroglobulin(anti-Tg) level, weight standard deviation score(SDS), height SDS and body mass index(BMI) SDS values were recorded. Of the 722 patients, 607 had thyroid autoantibodies examined at least once and 72(11.9%) had anti-TPO and/or anti-TG positivity. Of these patients, 57(79.2%) had euthyroid, 7(9.7%) had obvious hypothyroidism, 5(6.9%) had subclinical hypothyroidism and 3(4.2%) had hyperthyroidism. While 48(66.7%) of the patients with Hashimato thyroiditis(HT) were pubertal, 24(33.3%) were prepubertal. Fifty (69.4%) of the OITH cases were female and 22(30.6%) were male. In addition, 12(16.6%) of 72 patients with OITH had celiac disease (CD). According to the chi-square analysis, OITH was more common in girls(p: 0.01) and those with CD(p: 0.02). As the age and duration of diabetes prolonged, the prevalence of OITH increased. As a result; In patients with T1DM the frequency of HT increases with increasing age and duration of diabetes. Hashimato thyroiditis is more common in female gender and pubertal period. The presence of celiac increases the risk of HT in patients with T1DM. In order to prevent the negative effects of thyroid dysfunction on metabolic control, growth and development, thyroid function tests and autoantibodies should be checked periodically.
Description
Keywords
Otoimmün tiroid hastalığı, Autoimmune thyroid disease, Tip 1 diyabet, Type 1 diabetes, Child and adolescent, Çocuk ve adölesan
Citation
Ünal, E. (2020). "Tip 1 diyabetli hastalarda otoimmün tiroid hastalığı sıklığı". Güncel Pediatri Dergisi, 18(2),251-262.