Levothyroxine in Euthyroid Autoimmune Thyroiditis and Type 1 Diabetes: A Randomized, Controlled Trial
| Autor: | Andreas Neu, Ina Knerr, Regine Hub, Waldemar Ertelt, Andrea Rapp, Bernhard O. Boehm, Andreas Schirbel, Wolfram Karges, Beate Karges, Thomas Wiesel, Albrecht Klinghammer, Klaus-Michael Debatin, Eberhard Heinze, Julia Aufschild, Rainer Muche |
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| Rok vydání: | 2007 |
| Předmět: |
Male
Thyroid Hormones endocrine system medicine.medical_specialty Adolescent endocrine system diseases Pediatric endocrinology Endocrinology Diabetes and Metabolism Clinical Biochemistry Thyroid Gland Levothyroxine Thyrotropin Iodide Peroxidase Thyroglobulin Biochemistry Thyroiditis law.invention Diabetes Complications Autoimmune thyroiditis Endocrinology Randomized controlled trial law Thyroid peroxidase Internal medicine Humans Medicine Euthyroid Prospective Studies Child Autoantibodies biology business.industry Biochemistry (medical) Thyroid Thyroiditis Autoimmune Infant medicine.disease Thyroxine Diabetes Mellitus Type 1 medicine.anatomical_structure Child Preschool biology.protein Female business medicine.drug |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 92:1647-1652 |
| ISSN: | 1945-7197 0021-972X |
| Popis: | Patients with type 1 diabetes (T1D) have an increased risk of autoimmune thyroiditis (AIT).Our objective was to determine whether levothyroxine (l-T(4)) treatment prevents the clinical manifestation of AIT in euthyroid subjects with T1D.We conducted a prospective, randomized, open, controlled clinical trial at six tertiary care centers for pediatric endocrinology and diabetes.Of 611 children and adolescents with T1D, 89 individuals (14.5%) were identified with positive thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb), or both. Of these, 30 patients (age, 13.3 +/- 2.1 yr) met the inclusion criteria and were randomized to receive l-T(4) (n = 16 patients) or no treatment (n = 14 patients).l-T(4) (1.3 microg/kg daily) was given for 24 months in the treatment group, followed by an additional observation period of 6 months in both groups.Thyroid gland volume (as determined by ultrasound), serum levels of TSH, thyroid hormones, TPOAb, and TgAb were assessed every 6 months for 30 months.Mean thyroid volume decreased in the treatment group after 24 months (-0.60 sd score) and increased in the observation group (+ 1.11 sd score; P = 0.0218). Serum thyrotropin, free T(4), TPOAb, and TgAb levels were not significantly different in both groups during the entire study period. Hypothyroidism developed in three individuals treated with l-T(4) and in four untreated patients (conversion rate, 9.3% per year).In this study in euthyroid patients with AIT and T1D, l-T(4) treatment reduced thyroid volume but had no effect on thyroid function and serum autoantibody levels. |
| Databáze: | OpenAIRE |
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