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Title: Thyroid Disorder and Association of Insulin Antibodies with Thyroid Antibodies in Children with Type 1 Diabetes Mellitus
Authors: Muniba Jalil, Mohsina Noor Ibrahim, Sajid Ali, Sidra Saleem, Shahzadi Dilawar, Arit Parkash
Journal: Pakistan Journal of Medical Research (PJMR)
Publisher: Health Research Institute (HRI), NIH
Country: Pakistan
Year: 2023
Volume: 62
Issue: 1
Language: English
Keywords: Type 1 Diabetes MellitusHypothyroidismHyperthyroidismAutoinsuline antibodiesAntithyroid antibodies
Background: During past decade, type 1 diabetes (T1DM) disease burden has increased among all ages, but the rapid growth was seen in young children. It is quite common to have coexistence of other autoimmune disorders among children having T1DM.
Objective: To evaluate the frequency of thyroid dysfunction in children having T1DM and association of insulin antibodies with thyroid antibodies in TIDM.
Study type, settings & duration: This cross-sectional study was performed at Department of Endocrinology, National Institute of Child Health, Karachi from June to December 2021.
Methodology: Children of age 2-17 years with T1DM were enrolled for this the study. Patients’ socio-demographic and clinical profile was documented in a pre-designed proforma. SPSS version 21 was used for statistical analysis.
Results: Mean age of patients was 10.49±4.24 years. Out of 133 children, 59.4% were females. 18.79% were positive for Insulin autoantibody, while 16.5% were positive for IA-2 and 33.1% for generalized anxiety disorder (GAD). 22.6% of patients were positive for thyroid peroxidase (TPO) and 39.09% were positive for Tg-AB. A total of 84.2% of subjects had euthyroidism, 13.53% of subjects had hypothyroidism (subclinical or clinical) while 2.3% had hyperthyroidism. A significant association among the subjects with positive insulin autoantibodies and those with thyroglobulin antibodies was observed.
Conclusion: A positive association between Insulin and Thyroglobulin antibodies suggests that patients with positive insulin antibodies are more likely to have thyroglobulin antibodies. Therefore, it is imperative to test and manage these markers on a frequent and regular basis to avoid .......
To evaluate the frequency of thyroid dysfunction in children having Type 1 Diabetes Mellitus (T1DM) and the association of insulin antibodies with thyroid antibodies in T1DM.
This cross-sectional study was conducted at the Department of Endocrinology, National Institute of Child Health, Karachi from June to December 2021. Children aged 2-17 years with T1DM were enrolled. Socio-demographic and clinical profiles were documented. Statistical analysis was performed using SPSS version 21. Blood samples were analyzed for insulin autoantibodies (anti-insulin IgG, IA2, anti-GAD) and thyroid antibodies (anti-TPO, anti-Tg). TSH, T4, and T3 levels were estimated.
graph TD
A["Enroll Children aged 2-17 with T1DM"] --> B["Collect Socio-demographic and Clinical Data"];
B --> C["Collect Blood Samples"];
C --> D["Analyze for Insulin Antibodies IAA, IA2, GAD"];
C --> E["Analyze for Thyroid Antibodies TPO, Tg-AB"];
C --> F["Estimate TSH, T4, T3 Levels"];
D --> G["Statistical Analysis"SPSS v21""];
E --> G;
F --> G;
G --> H["Determine Thyroid Dysfunction Frequency"];
G --> I["Assess Association between Insulin and Thyroid Antibodies"];
H --> J["Conclusion"];
I --> J["Conclusion"];
The study highlights the common coexistence of autoimmune disorders in children with T1DM, suggesting a mutual genetic disposition. The findings are consistent with literature indicating a higher prevalence of thyroid disorders in T1DM patients, particularly hypothyroidism, and a greater likelihood in females. The association between insulin and thyroid antibodies suggests a potential shared autoimmune pathway.
Out of 133 children, 18.79% were positive for Insulin autoantibody, 16.5% for IA-2, and 33.1% for GAD. Thyroid antibodies showed positivity rates of 22.6% for TPO and 39.09% for Tg-AB. Euthyroidism was observed in 84.2% of subjects, hypothyroidism in 13.53%, and hyperthyroidism in 2.3%. A significant association was found between positive insulin autoantibodies and thyroglobulin antibodies. Females had a higher frequency of hypothyroidism and hyperthyroidism.
A positive association between insulin and thyroglobulin antibodies indicates that patients with positive insulin antibodies are more likely to have thyroglobulin antibodies. Regular testing and management of these markers are crucial for patients with T1DM to prevent health aggravation.
- Study duration: June to December 2021. (Confirmed by text)
- Total patients enrolled: 133. (Confirmed by text)
- Prevalence of hypothyroidism: 13.53%. (Confirmed by text)
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