Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/diabet
- PDF / 815,035 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 18 Downloads / 155 Views
RESEARCH ARTICLE
Open Access
Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/ diabetic ketosis Peng Shao1,2, Shujuan Guo1,2, Guimei Li1* , Daogang Qin2, Sen Li3 and Ying Luan2
Abstract Background: Euthyroid sick syndrome (ESS) frequently arises in children admitted with diabetic ketoacidosis/ diabetic ketosis (DKA/DK). This study evaluates the interplay of various metabolic factors with occurrence of deranged thyroid function tests in children suffering from DKA/DK. Methods: 98 DKA and 96 DK pediatric patients were selected from hospital records. Those on thyroxine replacement, with overt hypothyroidism, or with positive anti-thyroperoxidase (TPO) antibody were excluded. Tests for liver function, renal function, lipid profile, serum osmolarity, thyroid function, c-peptide levels, and glycosylated hemoglobin were done on all patients. Children were divided into euthyroid (n = 88) and ESS groups (n = 106). Results: The ESS group had a higher level of white blood cell count (WBC), plasma glucose (PG), betahydroxybutyric acid (β-HB), triglyceride (TG), anion gap (AG), glycosylated hemoglobin (HbA1c) and a lower level of HCO3−, prealbumin (PA), and albumin (ALB) compared with the euthyroid group (P < 0.05). Free T3 (FT3) levels were significantly correlated to β-HB, HCO3−, AG, PA, and HbA1c (r = − 0.642, 0.681, − 0.377, 0.581, − 0.309, respectively; P < 0.01). Free T4 (FT4) levels were significantly correlated to β-HB, HCO3−, and ALB levels (r = − 0.489, 0.338, 0.529, respectively; P < 0.01). TSH levels were significantly affected by HCO3− only (r = − 0.28; P < 0.01). HCO3− level was the most important factor deciding euthyroid or ESS on logistic regression analysis (OR = 0.844, P = 0.004, 95%CI = 0.751–0.948). Conclusions: Lower levels of free thyroid hormones and occurrence of ESS were associated with a higher degree of acidosis in children with DKA/DK. Keywords: Diabetes, Thyroid function, Metabolic changes, Type 1 diabetes, Children
Background Type 1 diabetes (T1DM) is a common autoimmune disorder associated with other autoimmune diseases such as coeliac disease and autoimmune hypothyroidism.
* Correspondence: [email protected] 1 Department of Pediatrics, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong, China Full list of author information is available at the end of the article
Although no age group is exempt, children under 18 are most affected. In children with T1DM due to insulin deficiency, blood ketone levels are higher than normal. Very high ketone levels can trigger a life-threatening condition named diabetic ketoacidosis (DKA), which is manifested by nausea, vomiting, stomach pain, breathing trouble, and loss of consciousness [1, 2]. Infection, stress, inappropriate diet/malnutrition, or medications can all
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution
Data Loading...
