BSPED2024 Poster Presentations Diabetes 5 (8 abstracts)
Endocrine dysfunction following positive thyroid and adrenal antibodies in children with newly diagnosed type 1 diabetes
Orla Dempsey 1 , Jonathan Pinsker 2 , Angela K. Lucas-Herald 1,2 , Gavin Allison 2 , Karen Whyte 2 , Vaiva Kuehne 2 , Hilary Pearce 2 , Amita Sharma 2 , Rajeeb Rashid 3 , Ian Craigie 2 , Fiona Lamb 2 , Jane McNeilly 1,4 & M Guftar. Shaikh 1,2
1Developmental Endocrinology Research Group, University of Glasgow, Glasgow, United Kingdom; 2Department of Paediatric Diabetes, Royal Hospital for Children, Glasgow, United Kingdom; 3Department of Paediatric Diabetes, Glasgow, United Kingdom; 4Department of Clinical Biochemistry, Queen Elizabeth University Hospital, Glasgow, United Kingdom
Introduction: Individuals with Type 1 Diabetes (T1DM) are known to be at risk of development of further autoimmune diseases. This study aimed to identify the prevalence of thyroid and adrenal autoimmunity and dysfunction in children with T1DM.
Methods: A retrospective case review was conducted of all children who presented to the Royal Hospital for Children, Glasgow with newly diagnosed T1DM between 01/09/2017-01/09/2022. Data were obtained regarding thyroid peroxidase (TPO) and adrenal antibody status and subsequent thyroid and adrenal function from diagnosis to 24/05/2024 to provide a minimum of 18 months follow-up per patient.
Results: In total, 503 children presented with a new diagnosis of T1DM during the study time period. Data were available for 372 (53% female) with a median age of 9.6 (0.9, 16.1) at T1DM diagnosis. Median duration of follow up was 3 (1.5, 5) years). TPO antibodies were tested at the time of diabetes diagnosis in 349 (94%) and 61 (17%) were found to have raised TPO antibodies. Five children who were not tested for TPO antibodies at diagnosis were found to have positive antibodies on screening when tested later. Girls were more likely to have positive TPO antibodies (71.2%, P = 0.001). Only 10/66 (15%) went on to develop thyroid dysfunction (hypothyroidism in all). Of these, 8 had hypothyroidism at the time of initial raised TPO antibody detection and 2 developed hypothyroidism 2.3 and 2.4 years after TPO antibody detection. Adrenal antibody status was obtained at T1DM diagnosis in 368 (99%). Only 3 of these children were found to have positive adrenal antibodies. Two (67%) patients positive adrenal antibodies detected at T1DM diagnosis and 1 child had adrenal antibodies detected prior to diagnosis. Neither of the 2 children with positive antibodies at time of diagnosis have developed adrenal dysfunction with follow-up periods of 3 and 6 years respectively.
Conclusions: Hypothyroidism occurs in 10-20% of T1DM children with raised TPO antibodies with the majority of these having detectable TPO antibodies at the time of T1DM diagnosis. Adrenal autoantibodies are less prevalent in children with T1DM as is the development of adrenal dysfunction following a positive autoantibody status.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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