Risk Factors of Incidence of Hypothyroidism in Patients With Type 1 Diabetes
试验速览
- 阶段
- 不适用
- 入组人数
- 300
- 主要终点
- Screening the incidence of hypothyroidism in patients with type 1 diabetes
研究概览
简要总结
Therefore, for early detection of hypothyroidism in children with type 1 diabetes, it is suggested to measure anti-thyroid antibodies and thyroid stimulating hormone at disease onset and in yearly intervals after the age of 12 yr. Furthermore, the International Society for Pediatric and Adolescent Diabetes Consensus Clinical Guidelines recommend the screening of thyroid function by analysing circulating thyroid stimulating hormone at the diagnosis of diabetes and, thereafter every 2nd yr. in asymptomatic individuals without goitre and more frequent if goitre present .
详细描述
Type 1 diabetes is an organ-specific autoimmune disease characterized by the selective destruction of pancreatic β-cells. The histopathology of type 1 diabetes is defined by a decreased β-cell mass infiltration of mononuclear cells into the islets of Langerhans , this lesion was later called 'insulitis', and it is the hallmark of the disease .
Insulitis was observed in 70% of patients with acute onset type 1 diabetes and concluded that this disease was caused by a β-cell-specific autoimmune process .
Furthermore, in a study demonstrated cellular autoimmunity in patients with type 1 diabetes using the leukocyte migration test and speculated that cellular hypersensitivity was the counter part of lymphocytic infiltration in islets . Therefore, it is speculated that cell-mediated immunity could play an important part in the pathogenesis of type 1 diabetes .
As a view suggesting that type 1 diabetes is an autoimmune disease, there is some evidence that type 1 diabetes is often complicated with other autoimmune diseases or that anti-islet antibodies precede the clinical onset of the disease.
So, it is found that type 1 diabetes is frequently associated with other organ-specific autoimmune diseases, including hypothyroidism , pernicious anaemia, and idiopathic Addison's disease .The most common coexisting organ autoimmune disease is hypothyroidism (>90%), the prevalence of anti-thyroid autoantibodies in children with type 1 diabetes at disease onset is about 20% .
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 8 Years 至 15 Years（Child）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Children with type 1 diabetes aging between 8 - 15 y .
排除标准
- •Cases with hyperthyroidism .
- •Areas known to have endemic goitre due to nutritional iodine deficiency .
- •History of maternal hypothyroidism and / or congenital hypothyroidism .
- •Children known to be normoglycaemic with already presented thyroid dysfunction .
- •Children with multiple endocrinopathies .
- •Children under treatment with drugs inducing hypothyroidism like amiodarone , lithium .
- •Children under treatment with drugs affecting insulin secretion like steroids , growth hormone therapy .
结局指标
主要结局
Screening the incidence of hypothyroidism in patients with type 1 diabetes
时间窗: after 1-2 years after diagnosis of Diabetes
Measuring of thyroid stimulating hormone in patients with type 1 diabetes
次要结局
未报告次要终点
研究者
Romany Safwat
principal investigator
Assiut University