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目的:研究儿童糖尿病(diabetes mellitus,DM)合并自身免疫性甲状腺疾病(autoimmune thyroid disease,AI-TD)患者的临床特征,为该类疾病的治疗提供临床依据。方法:选择37例DM合并AITD儿童,其中1型糖尿病(T1DM)患者27例,2型糖尿病(T2DM)患者10例,并以32例健康体检者为对照组进行比较,分别检测甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(TG-Ab)、促甲状腺激素受体抗体(TR-Ab)的水平,同时检测糖尿病组患者的谷氨酸脱羧酶抗体(GAD-Ab);分析DM与AITD的并发情况。结果:T1DM合并AITD的患者中,桥本氏病占59.3%,Graves病占40.7%;T2DM合并AITD的患者中,桥本氏病占60.0%,Graves病占40.0%;T1DM组任一甲状腺抗体(包括TPO-Ab、TG-Ab和TR-Ab)阳性检出率为44.4%,明显高于T2DM组和对照组(P<0.05);GAD-Ab阳性的T1DM组患者任一甲状腺抗体阳性检测率为52.6%,明显高于GAD-Ab阴性的T1DM患者(P<0.05)。结论:不同类型糖尿病对于AITD的分型无明显影响,与T2DM和健康人群比较,T1DM患者更容易并发AITD,其中GAD-Ab阳性的患者并发AITD的比例要高于GAD-Ab阴性的患者。
Objective: To study the clinical features of diabetes mellitus (DM) patients with autoimmune thyroid disease (AI-TD) and provide the clinical evidence for the treatment of such diseases. Methods: Thirty-seven DM patients with AITD were selected. Twenty-seven patients with type 1 diabetes mellitus (T1DM) and 10 patients with type 2 diabetes mellitus (T2DM) were enrolled in this study. Thirty-two DM patients were selected as control group. Thyroperoxide (TPO-Ab), thyroglobulin antibody (TG-Ab) and thyroid-stimulating hormone receptor antibody (TR-Ab) were detected in patients with diabetes mellitus. Analyze the concurrency between DM and AITD. Results: Among patients with T1DM and AITD, Hashimoto’s disease accounted for 59.3% and Graves ’disease accounted for 40.7%. Hashimoto’s disease accounted for 60.0% and Graves’ disease accounted for 40.0% in patients with T2DM and AITD. Any of the thyroid antibodies (Including TPO-Ab, TG-Ab and TR-Ab) was 44.4%, which was significantly higher than that in T2DM group and control group (P <0.05). The positive rate of any thyroid antibody in GAD-Ab positive T1DM patients The rate was 52.6%, significantly higher than GAD-Ab-negative T1DM patients (P <0.05). CONCLUSIONS: There is no significant difference in the type of AITD between different types of diabetes mellitus. Patients with T1DM are more likely to have AITD than those with T2DM and healthy people. The proportion of patients with GAD-Ab positive AITD is higher than those with negative GAD-Ab.