Journal of Clinical Pediatrics >
Correlation analyses between thyroids function and diabetic ketoacidosis severity in T1DM children
Received date: 2021-09-13
Online published: 2022-05-13
Objective To explore the correlation between serum thyroid hormone and diabetic ketoacidosis (DKA) severity of children in type 1 diabetes mellitus (T1DM). Methods We retrospectively analyzed 167 T1DM children who were diagnosed with T1DM from January 2015 to December 2020. The clinical characteristics, laboratory indicators and thyroid function status of the four groups including non DKA, mild, moderate and severe DKA in T1DM were compared, and the related factors affecting serum free triiodothyronine (FT3） level were analyzed. Results Among 167 patients with newly diagnosed T1DM, there were 81 males and 86 females, with a median age of 6.5 (4.0-9.9) years and a median course of disease of 14 (7-28) days. There were 104 cases in non DKA group, 20 cases in mild DKA group, 16 cases in moderate DKA group and 27 cases in severe DKA group. The FT3, total triiodothyronine (TT3), total thyroxine (TT4), pH and HCO-3 in DKA groups were significantly lower than those in non DKA group, while the levels of anion gap and blood glucose were significantly higher than those in non DKA group, and the levels of WBC and the percentage of neutrophil in severe DKA group were significantly higher than those in other groups (P<0.05). There were 92 cases of normal thyroid function, 52 cases of non-thyroidal illness syndrome (NTIS), 10 cases of subclinical hypothyroidism, 6 cases of subclinical hyperthyroidism, 3 cases of hypothyroidism and 4 cases of hyperthyroidism. The severity of diabetes with DKA is associated with different thyroid function (P<0.01). The incidence of normal thyroid function in non DKA group was higher and the incidence of NTIS was lower. The multivariate regression analysis showed that FT3 was negatively correlated with anion gap, blood glucose (P<0.01). Conclusions FT3, TT3 and TT4 in DKA groups were lower than those in non DKA group. The incidence of NTIS in DKA group was significantly higher than that in non DKA group. Determination of thyroid hormone levels can provide a reliable basis for clinical judgment of thyroid diseases and diabetes mellitus.
Key words： type 1 diabetes; diabetic ketoacidosis; thyroid hormone; thyroid function; child
Mingyu JIANG , Xiaoqin YIN , Pin LI . Correlation analyses between thyroids function and diabetic ketoacidosis severity in T1DM children[J]. Journal of Clinical Pediatrics, 2022 , 40(5) : 339 -344 . DOI: 10.12372/jcp.2022.21e1315
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