Frequency and nature of thyroid pathology in children and adolescents with type 1 diabetes mellitus and its influence on sexual development

Abstract

Objective — to assess the frequency and nature of thyroid gland pathology in children and adolescents with type 1 diabetes mellitus (DM 1) and to determine its impact on somatic and sexual development. Materials and methods. Investigation involved 117 children and adolescents with DM 1, aged from 9 to 18 years (54 boys and 63 girls), who were under observation in the clinic of the Institute of Children and Adolescents Health Care. All children underwent thyroid gland (TG) ultrasound examination. The assessments included physical and sexual development of patients, the state of carbohydrate metabolism according to the glycosylated hemoglobin (HbA1c) levels. Creation of the database and statistical processing of the results were carried out using the packages of Microsoft Excel and SPSS 17.0 statistical methods. Results and discussion. Thyropathies were diagnosed in 41.0 % of DM 1 patients (from the, 20.5 % had diffuse nontoxic goiter, 17.1 % autoimmune thyroiditis (AIT), 3.4 % nodules, cysts). AIT was mostly often determined in girls (22.2 %), and diffuse nontoxic goiter in boys (31.5 %). Among boys with harmonious physical development, 51.6 % had thyroid pathology. In case of sexual development abnormalities, almost half of girls (46.7 %) and a third of boys (33.3 %) had thyropathies. Thyropathies were significantly more often identified in adolescents with the DM 1 onset in childhood (71.4 %) and early puberty (80.0 %), duration of diabetes from 5 to 10 years (48.3 %), and suboptimal compensation (63.3 % in boys and 50.0 % in girls). Conclusions. The high frequency of thyroid pathology has been established among children and adolescents in whom DM 1 developed at the age of 4—5 years (71.4 %). It has been shown that the increased AIT risk exists in both girls and boys. A significant percentage of thyropathies among children in the early puberty period (80.0 %) was established. The obtained results confirmed the need for careful monitoring of the thyroid gland in children and adolescents with DM1, especially in the period of puberty.