American Journal of Internal Medicine

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Thyroid Dysfunction and Morphological Abnormalities in Patients with Type 1 Diabetes Mellitus

Received: 28 June 2015    Accepted: 07 July 2015    Published: 17 July 2015
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Abstract

Background: Type 1 diabetes mellitus is an autoimmune disease. Several studies have documented great variations in the prevalence of thyroid dysfunction and autoimmune thyroid disease (AITD) in type 1 diabetic patients. Undiagnosed thyroid dysfunction has negative impact on the metabolic control and will aggravate the cardiovascular disorders. Objectives: We aimed to investigate the presence of thyroid dysfunction and the associated morphological abnormalities in type 1 diabetes mellitus. Methods: 80 type 1 diabetic patients without overt thyroid disease attending the outpatient clinic of diabetes at Kasr Al Aini hospital, faculty of medicine, Cairo University were enrolled in the study. Thyroid functions (TSH, FT4, FT3), anti thyroid peroxidase (anti-TPO) and anti thyroglobulin (anti-TG) antibodies were measured in all patients. Thyroid ultrasound was performed in all patients and in 50 healthy control subjects. The data was analyzed and expressed in terms of mean ± SD. Pearson correlation was performed to establish the relationship between different variables. Results: 52 of 80 patients (65%) showed high TSH levels with mean (12.37±3.9 mIU/ml) and 25 patients (31.3%) showed positive anti-TG anti-TPO levels with mean (906 ± 184.3, 628 ±137.5 IU/ml) respectively. The high TSH levels were statistically significantly associated with high anti-TG levels and anti-TPO levels with (mean 570.23± 372.41, 366.52±281.34 IU/ml) respectively with P-value < 0.001. There was significant increase in the gland volume in diabetic patients with mean (3.4±1.5 ml) versus (2.9±0.9 ml) in the control group, P-value <0.046. Also 25% of patients showed heterogenous hypoechogenic gland texture versus 6 % in the control group which was statistically significantly different, P-value = 0.008 and 50% of the patients showed increase in gland vascularity versus 12% in the control group which was statistically significantly different with P-value <0.001. These morphological abnormalities were associated with high (TSH, anti-TPO and anti-TG) levels but weren’t significant. High TSH levels were strongly positively correlated with anti-TPO and anti-TG, r = (0.84, 0.83) respectively, P-value <0.001. Conclusions: Type 1 diabetic patients had high incidence of thyroid dysfunction and AITD associated with morphological abnormalities of the thyroid gland. So we recommend screening for thyroid dysfunction in all patients with type 1 DM to avoid additional cardiovascular risk factors.

DOI 10.11648/j.ajim.20150304.16
Published in American Journal of Internal Medicine (Volume 3, Issue 4, July 2015)
Page(s) 185-193
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Type 1 Diabetes Mellitus, Thyroid Dysfunction, Thyroid Antibodies, AITD

References
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Author Information
  • Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt

  • Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt

  • Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt

  • Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt

  • Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt

  • National Institute of Diabetes and Endocrinology, Cairo, Egypt

  • Biochemistry Department, Faculty of Medicine, Cairo University, Cairo, Egypt

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  • APA Style

    Heba-Allah Moustafa Kamal Al-Din, Rokaya Abd-Al Aziz Mohamed, Shereen Sadik El-Sawy, Noha Adly Sadik, Rasha Mohamed Abd El Samie, et al. (2015). Thyroid Dysfunction and Morphological Abnormalities in Patients with Type 1 Diabetes Mellitus. American Journal of Internal Medicine, 3(4), 185-193. https://doi.org/10.11648/j.ajim.20150304.16

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    Heba-Allah Moustafa Kamal Al-Din; Rokaya Abd-Al Aziz Mohamed; Shereen Sadik El-Sawy; Noha Adly Sadik; Rasha Mohamed Abd El Samie, et al. Thyroid Dysfunction and Morphological Abnormalities in Patients with Type 1 Diabetes Mellitus. Am. J. Intern. Med. 2015, 3(4), 185-193. doi: 10.11648/j.ajim.20150304.16

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    AMA Style

    Heba-Allah Moustafa Kamal Al-Din, Rokaya Abd-Al Aziz Mohamed, Shereen Sadik El-Sawy, Noha Adly Sadik, Rasha Mohamed Abd El Samie, et al. Thyroid Dysfunction and Morphological Abnormalities in Patients with Type 1 Diabetes Mellitus. Am J Intern Med. 2015;3(4):185-193. doi: 10.11648/j.ajim.20150304.16

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  • @article{10.11648/j.ajim.20150304.16,
      author = {Heba-Allah Moustafa Kamal Al-Din and Rokaya Abd-Al Aziz Mohamed and Shereen Sadik El-Sawy and Noha Adly Sadik and Rasha Mohamed Abd El Samie and Mahmoud Ahmed Khatab and Laila Ahmed Rashed},
      title = {Thyroid Dysfunction and Morphological Abnormalities in Patients with Type 1 Diabetes Mellitus},
      journal = {American Journal of Internal Medicine},
      volume = {3},
      number = {4},
      pages = {185-193},
      doi = {10.11648/j.ajim.20150304.16},
      url = {https://doi.org/10.11648/j.ajim.20150304.16},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajim.20150304.16},
      abstract = {Background: Type 1 diabetes mellitus is an autoimmune disease. Several studies have documented great variations in the prevalence of thyroid dysfunction and autoimmune thyroid disease (AITD) in type 1 diabetic patients. Undiagnosed thyroid dysfunction has negative impact on the metabolic control and will aggravate the cardiovascular disorders. Objectives: We aimed to investigate the presence of thyroid dysfunction and the associated morphological abnormalities in type 1 diabetes mellitus. Methods: 80 type 1 diabetic patients without overt thyroid disease attending the outpatient clinic of diabetes at Kasr Al Aini hospital, faculty of medicine, Cairo University were enrolled in the study. Thyroid functions (TSH, FT4, FT3), anti thyroid peroxidase (anti-TPO) and anti thyroglobulin (anti-TG) antibodies were measured in all patients. Thyroid ultrasound was performed in all patients and in 50 healthy control subjects. The data was analyzed and expressed in terms of mean ± SD. Pearson correlation was performed to establish the relationship between different variables. Results: 52 of 80 patients (65%) showed high TSH levels with mean (12.37±3.9 mIU/ml) and 25 patients (31.3%) showed positive anti-TG anti-TPO levels with mean (906 ± 184.3, 628 ±137.5 IU/ml) respectively. The high TSH levels were statistically significantly associated with high anti-TG levels and anti-TPO levels with (mean 570.23± 372.41, 366.52±281.34 IU/ml) respectively with P-value < 0.001. There was significant increase in the gland volume in diabetic patients with mean (3.4±1.5 ml) versus (2.9±0.9 ml) in the control group, P-value <0.046. Also 25% of patients showed heterogenous hypoechogenic gland texture versus 6 % in the control group which was statistically significantly different, P-value = 0.008 and 50% of the patients showed increase in gland vascularity versus 12% in the control group which was statistically significantly different with P-value <0.001. These morphological abnormalities were associated with high (TSH, anti-TPO and anti-TG) levels but weren’t significant. High TSH levels were strongly positively correlated with anti-TPO and anti-TG, r = (0.84, 0.83) respectively, P-value <0.001. Conclusions: Type 1 diabetic patients had high incidence of thyroid dysfunction and AITD associated with morphological abnormalities of the thyroid gland. So we recommend screening for thyroid dysfunction in all patients with type 1 DM to avoid additional cardiovascular risk factors.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Thyroid Dysfunction and Morphological Abnormalities in Patients with Type 1 Diabetes Mellitus
    AU  - Heba-Allah Moustafa Kamal Al-Din
    AU  - Rokaya Abd-Al Aziz Mohamed
    AU  - Shereen Sadik El-Sawy
    AU  - Noha Adly Sadik
    AU  - Rasha Mohamed Abd El Samie
    AU  - Mahmoud Ahmed Khatab
    AU  - Laila Ahmed Rashed
    Y1  - 2015/07/17
    PY  - 2015
    N1  - https://doi.org/10.11648/j.ajim.20150304.16
    DO  - 10.11648/j.ajim.20150304.16
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 185
    EP  - 193
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20150304.16
    AB  - Background: Type 1 diabetes mellitus is an autoimmune disease. Several studies have documented great variations in the prevalence of thyroid dysfunction and autoimmune thyroid disease (AITD) in type 1 diabetic patients. Undiagnosed thyroid dysfunction has negative impact on the metabolic control and will aggravate the cardiovascular disorders. Objectives: We aimed to investigate the presence of thyroid dysfunction and the associated morphological abnormalities in type 1 diabetes mellitus. Methods: 80 type 1 diabetic patients without overt thyroid disease attending the outpatient clinic of diabetes at Kasr Al Aini hospital, faculty of medicine, Cairo University were enrolled in the study. Thyroid functions (TSH, FT4, FT3), anti thyroid peroxidase (anti-TPO) and anti thyroglobulin (anti-TG) antibodies were measured in all patients. Thyroid ultrasound was performed in all patients and in 50 healthy control subjects. The data was analyzed and expressed in terms of mean ± SD. Pearson correlation was performed to establish the relationship between different variables. Results: 52 of 80 patients (65%) showed high TSH levels with mean (12.37±3.9 mIU/ml) and 25 patients (31.3%) showed positive anti-TG anti-TPO levels with mean (906 ± 184.3, 628 ±137.5 IU/ml) respectively. The high TSH levels were statistically significantly associated with high anti-TG levels and anti-TPO levels with (mean 570.23± 372.41, 366.52±281.34 IU/ml) respectively with P-value < 0.001. There was significant increase in the gland volume in diabetic patients with mean (3.4±1.5 ml) versus (2.9±0.9 ml) in the control group, P-value <0.046. Also 25% of patients showed heterogenous hypoechogenic gland texture versus 6 % in the control group which was statistically significantly different, P-value = 0.008 and 50% of the patients showed increase in gland vascularity versus 12% in the control group which was statistically significantly different with P-value <0.001. These morphological abnormalities were associated with high (TSH, anti-TPO and anti-TG) levels but weren’t significant. High TSH levels were strongly positively correlated with anti-TPO and anti-TG, r = (0.84, 0.83) respectively, P-value <0.001. Conclusions: Type 1 diabetic patients had high incidence of thyroid dysfunction and AITD associated with morphological abnormalities of the thyroid gland. So we recommend screening for thyroid dysfunction in all patients with type 1 DM to avoid additional cardiovascular risk factors.
    VL  - 3
    IS  - 4
    ER  - 

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