title: How does autoimmune thyroiditis in children with type 1 diabetes mellitus influence glycemic control, lipid profile and thyroid volume?
abstract: OBJECTIVE
  To investigate whether autoimmune thyroiditis (AIT) in children with type 1 diabetes mellitus (DM1) has any influence on glycemic control, lipid profile or thyroid volume.
  
  
  METHODS
  A total of 330 patients with DM1 and AIT (DM1+AIT group) were compared with 309 children with DM1 without AIT (control group). Patients were treated in four Polish academic pediatric diabetes centers from 2008 to 2012: Warsaw, Lodz, Katowice and Gdansk. All patients underwent measurements of thyroid-stimulating hormone (TSH), free thyroxine, anti-thyroid peroxidase (anti-TPO) antibody, anti-thyroglobulin (anti-TG) antibody and HbA1c levels, and thyroid ultrasound examination.
  
  
  RESULTS
  Among AIT+DM1 patients, 62% (n=205) were female, whereas in the control group 60.8% (n=188) were male (p<0.0001). Children with AIT+DM1 had lower a BMI-SDS (mean difference of -0.5, 95% CI -0.68 to -0.33; p<0.0001), had a higher SDS thyroid volume (0.27, 95% CI 0.03-0.51; p=0.014) and needed less insulin (-0.15, 95% CI -0.20 to -0.11 U/kg body weight per day; p<0.0001) in comparison with the control group. AIT patients had higher HbA1c levels (0.66, 95% CI 0.36%-0.96%, p<0.0001), lower HDL-cholesterol levels (-3.68, 95% CI -1.41 to -5.94 mg/dL, p=0.002) and higher triglyceride levels (7.16, 95% CI 1.22-13.10 mg/dL, p=0.02). Patients with positive anti-TPO and anti-TG antibodies were older (by 1.95 years, 95% CI 0.98-2.92 years, p=0.006) and had longer DM1 duration (by 1.64 years, 95% CI 0.76-2.52 years, p=0.006). Presence of anti-TPO antibodies was associated with higher TSH levels (odds ratio 2.34, 95% CI 1.36-4.04; p=0.007).
  
  
  CONCLUSIONS
  AIT accompanying DM1 is associated with worse glycemic control and lipid profile as well as a lower daily insulin requirement. The female gender is more likely to develop AIT and hypothyroidism.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Korzeniowska
authors.forename: Anna
authors.initials: A
authors.lastname: Ramotowska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szypowska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szadkowska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Fendler
authors.forename: Barbara
authors.initials: B
authors.lastname: Kalina-Faska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Młynarski
authors.forename: Przemyslawa
authors.initials: P
authors.lastname: Jarosz-Chobot
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Myśliwiec
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008055:Lipids / Q000097:blood*; D008297:Male; D009929:Organ Size; D012737:Sex Factors; D013961:Thyroid Gland / Q000473:pathology*; D013967:Thyroiditis, Autoimmune / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000473:pathology*
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008055:Lipids