摘要
目的研究1型糖尿病(T1DM)患儿甲状腺功能状态,并探讨胰岛自身抗体阳性是否可预测自身免疫性甲状腺疾病的发生。方法选取2005年1月-2008年9月在中国医科大学附属盛京医院住院新发且资料完整的71例T1DM患儿,进行2～4 a的随访,对其年龄、性别、家族史及内分泌相关检查结果进行分析。对胰岛自身抗体[谷氨酸脱羧酶抗体(GADA)、胰岛细胞抗体(ICA)、胰岛素自身抗体(IAA)、胰岛素瘤相关蛋白2抗体(IA-2)]及甲状腺自身抗体[甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)]检测结果进行分析。结果胰岛自身抗体的检测阳性率:ICA为12.7%(9/71例),IAA为36.6%(26/71例),GADA为54.9%(39/71例),IA-2为46.5%(33/71例)。甲状腺自身抗体检测阳性率:TPOAb阳性率为11.3%(8/71例),TGAb阳性率为8.5%(6/71例),APOAb、TGAb任一抗体阳性率为12.7%(9/71例)。10岁以上患儿甲状腺抗体阳性率高(P=0.031)。甲状腺抗体阳性患儿更易发生甲状腺功能异常(促甲状腺激素:5.6%vs 0,P<0.05)。GADA阳性组甲状腺功能异常率及抗体的阳性率较GADA阴性组偏高,但无统计学差异(TPOAb:8.5%vs 2.8%,P>0.05;TGAb:5.6%vs 2.8%,P>0.05),ICA、IAA阳性组与阴性组比较差异无统计学意义。IA-2阳性组TSH阳性率与IA-2阴性组比较有统计学差异(促甲状腺激素:5.6%vs 0,P<0.05)。71例患儿经过2～4 a随访,无新发甲状腺疾病。结论 IA-2阳性的T1DM患儿可能更易发生甲状腺功能异常。10岁以上T1DM患儿有必要动态监测甲状腺功能。
Objective To determine the thyroid function of the children with type 1 diabetes mellitus（ T1DM）, and to evaluate whether the presence of islet autoantibodies may predict the development of autoimmune thyroid diseases. Methods Children （ n = 71 ） with newly diagnosed T1DM at Shengjing Hospital of China Medical University between Jan. 2005 and Sep. 2008 were analyzed,included their age, sex, family history and thyroid function, with the follow - up time of 2 - 4 years. Islet autoantibodies [ glutamic acid decarboxylase autoantibody （GADA） , islet cell antibody（ICA） , insulin autoantibody （IAA） , insulinoma associated protein 2 （IA -2 ） ] and anti-thyroid antibodies [ thy-roid peroxidase antibody （TPOAb） , thyroglobulin antibody（TGAb） ] were tested. Results The positive rate of islet autoantibodies was：ICA 12.7% （9/71 cases） ,IAA 36.6% （26/71 cases） ,GADA 54.9% （39/71 cases） ,IA-2 46.5% （33/71 cases）. The positive rate of anti - thyroid antibodies among the children was ： TPOAb 11.3 % （ 8/71 cases）, TGAb 8.5 % （ 6/71 cases） , either of the anitbodies positivity was 12.7% （9/71 cases）. The positive rate of anti-thyroid antibodies was higher in the children above 10 years old （P = 0. 031 ）. The patients with positive anti - thyroid antibodies were more likely to develop autoimmune thyroiditis [ thyroid stimulating hormone （TSH） ： 5.6% vs. O, P 〈 0.05 1. The patients with GADA positive had a higher prevalence rate of anti - thyroid antibodies than those with GADA negative, however,there was no significant difference between them（TPOAb ：8.5 % vs 2.8% ,P 〉 0.05 ;TGAb：5.6% vs 2.8% , P 〉 0.05 ） ;there was no significant difference between the ICA, IAA positive group and the ICA, IAA negative group. There was significant difference in TSH be-tween the positive IA - 2 and negative IA - 2 group （ TSH ： 5.6% vs. 0, P 〈 0.05 ）. During 2 - 4 years follow - up, no thyroid diseases oc-curred. Conclusions IA - 2 positive patients are at higher risk to develop autoimmune thyroid diseases. It is necessary for patients with TI DM above 10 years old to screen thyroid function.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2012年第20期1572-1575,共4页
Journal of Applied Clinical Pediatrics
