Altered adrenal and thyroid function in children with insulin-dependent diabetes mellitus.
In 129 children, aged 12.6 +/- 3.8 years, affected by type 1 diabetes mellitus, the levels of dehydroepiandrosterone sulfate (DHEAS), cortisol, T3, fT3, T4, fT4, rT3, TSH, cholesterol, and triglycerides were evaluated and compared with those of a control group of 458 healthy age-matched children. The results were also correlated with hemoglobin HbA1C. The DHEAS-standard deviation score (DHEAS-SDS; -0.36 +/- 0.77) was significantly different from zero in diabetic children, while the cortisol serum level was higher than in control subjects (485 +/- 94 vs 359 +/- 132 nmol/l). Moreover, the DHEAS-SDS and DHEAS-SDS/cortisol ratio correlated negatively with HbA1c. Diabetic patients also showed lower T3 values (2.22 +/- 0.4 vs 2.32 +/- 0.3 nmol/l) and a higher rT3/T3 ratio (0.17 +/- 0.09 vs 0.15 +/- 0.05) than controls. There was a negative correlation between T3 and HbA1C. Cholesterol (4.77 +/- 1.08 vs 4.51 +/- 0.76 mmol/l) and triglycerides (0.82 +/- 0.53 vs 0.63 +/- 0.37 g/L) levels were higher in diabetic children and positively correlated with HbA1c, but not with DHEAS-SDS. We can therefore conclude that diabetes, particularly if poorly controlled, tends to induce a dissociation of cortisol and DHEAS secretion and a low T3 syndrome, similar to that seen in other illnesses.
Radetti
G
G
Department of Pediatrics, Regional Hospital of Bolzano, Italy.
Paganini
C
C
Gentili
L
L
Barbin
F
F
Pasquino
B
B
Zachmann
M
M
D000293:Adolescent; D000311:Adrenal Glands / Q000502:physiology / Q000503:physiopathology*; D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D012016:Reference Values; D013961:Thyroid Gland / Q000502:physiology / Q000503:physiopathology*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014280:Triglycerides / Q000097:blood; D014284:Triiodothyronine / Q000097:blood; D014285:Triiodothyronine, Reverse / Q000097:blood
D001786:Blood Glucose; D014280:Triglycerides; D014284:Triiodothyronine; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate; D014285:Triiodothyronine, Reverse; D013972:Thyrotropin; D002784:Cholesterol; D013974:Thyroxine; D006854:Hydrocortisone