PREVENTION AND CORRECTION OF THYROID DYSFUNCTION IN ADOLESCENTS WITH TYPE 1 DIABETES AT PUBERTY STAGES
DOI:
https://doi.org/10.21856/j-PEP.2023.2.06Keywords:
type 1 diabetes, adolescents, thyroid dysfunctionAbstract
Aim of the study is to improve the methods of prevention and treatment of disorders of the functional state of the pituitary-thyroid system in adolescents with type 1 diabetes mellitus (T1DM).
Materials and methods. 114 patients with T1DM aged 9-16 years (main group) and 149 healthy peers (control group) were examined. In all adolescents, the levels of thyrotropin (TSH), free fractions of thyroid hormones (fT4 and fT3) were determined by the enzyme-linked immunosorbent assay and ratios (fT3/fT4 and TSH/fT4) were calculated. Analysis of the obtained values is carried out taking into account the level of sexual development of adolescents.
The results of the examination of adolescents were combined into an electronic data bank, the mathematical processing of which was carried out using the “SPSS Statistics 17.0“ and “Microsoft Excel-2007“ software. The critical significance level for testing statistical hypotheses was assumed to be 0.05.
Results. At the onset of puberty, adolescents in both groups experience an increase in TSH levels in the background of a decrease in fT4 levels and an increase in the TSH/fT4 ratio. The TSH/fT4 and fT3/fT4 ratios were significantly higher in patients with T1DM than in the control group.
In the case of an individual analysis, it was found that the signs of thyroid insufficiency were most often diagnosed during early puberty among adolescents of both groups (60.0% in patients with T1DM and 43.9% in the control group, p <0.05). At all stages of puberty, the incidence of patients with hypothyroidism was significantly higher among adolescents with T1DM than in the control group (prepubertal: 16.0% vs. 6.6%, p<0.05, early puberty: 23.5% vs. 0%, p<0.05, puberty: 8.9% vs. 2.9%, p<0.05). The inclusion of potassium iodide (IodomarinÒ 100 or IodomarinÒ 200) and levothyroxine (L-Thyroxin Berlin-Chemie) in the treatment regimen for the prevention and treatment of thyroid dysfunction is justified.
Conclusions. In adolescents with T1DM, the proportion of patients with signs of thyroid dysfunction significantly increases due to an increase in TSH levels in the background of a decrease in fT4 and an increase in fT3. Most often, signs of thyroid insufficiency are diagnosed during early puberty. Prevention and correction of thyroid dysfunction is a mandatory part of the rehabilitation program for children and adolescents with T1DM.
References
Weber G, Vigone MC, Stroppa L, Chimello G. J Pediatr Endocrinol Metab 2003;16(2): 253-257.
Mamenko ME, Erokhina OІ. Ukr Med Almanakh 2008;11(6): 113-115.
Turchina SI. Probl Endocr Pathol 2010;34(4): 19-25. https://doi.org/10.21856/j-PEP.2010.4.03.
Turchina SI. Suchasna Pediatrija 2010;33(5): 201-204.
Turchina SI, Nachetova TA, Kashkalda DA. Sovremennaya Pediatriya 2016;76(5): 113-116. https://doi. оrg/10.15574/SP.2016.76.113.
Turchina SI, Dynnik VO. Reprod Endocrinol 2019;49: 29-33. . https://doi. оrg/10.18370/2309-4117.2019.49.29-33
Biondi B, Kahaly GJ, Robertson RP. Endocr Rev 2019;40(3): 789-824. https://doi. оrg/ 10.1210/er.2018-00163.
Budrejko OA. Cukrovij diabet 1 tipu u ditej i pidlitkiv: osoblivosti perebigu ta mozhlivosti optimizaciyi terapiyi, Kiyiv, 2011: 40 p.
Fatourechi A, Ardakani HM, Sayarifard F, Sheikh M. Clin Pediatr Endocrinol 2017;26(2): 73-80. https://doi. оrg/10.1297/cpe.26.73.
Shliakhova N, Chumak S. Physical Rehabilitation and Recreational Health Technologies 2022;7(3): 104-110. https://doi. оrg/10.15391/prrht.2022-7.21.
Turchina SI, Nikitina LD, Kostenko TP, Shljahova NV. Proceedings of the 16th International Scientific and Practical Conference 2022 Аpr 26-29, Athens, 2022: 386-389. https://doi. оrg/ 10.46299/ISG.2022.1.16.
Kostenko TP. Ukr Zurn Dytjachoi' Endokrynol 2022;43-44(3-4): 21-26. https://doi. оrg/10.30978/UJPE2022-3-4-21.
Assessment of iodine deficiency disorders and monitoring their elimination: А guide for programme managers, World Health Organization, 2007: 180 р., available at: http://whqlibdoc.who.int/publications/2007/9789241595827 eng.pdf, accessed 13 Oct 2016.
Child Endocrinology: Protocols on medical assistance to children for the specialty, Kyiv, 2006: 94 p.
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