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BMC Endocrine Disorders

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Open Access 01-12-2020 | Ketoacidosis | Research article

Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/diabetic ketosis

Authors: Peng Shao, Shujuan Guo, Guimei Li, Daogang Qin, Sen Li, Ying Luan

Published in: BMC Endocrine Disorders | Issue 1/2020

Abstract

Background

Euthyroid sick syndrome (ESS) frequently arises in children admitted with diabetic ketoacidosis/diabetic ketosis (DKA/DK). This study evaluates the interplay of various metabolic factors with occurrence of deranged thyroid function tests in children suffering from DKA/DK.

Methods

98 DKA and 96 DK pediatric patients were selected from hospital records. Those on thyroxine replacement, with overt hypothyroidism, or with positive anti-thyroperoxidase (TPO) antibody were excluded. Tests for liver function, renal function, lipid profile, serum osmolarity, thyroid function, c-peptide levels, and glycosylated hemoglobin were done on all patients. Children were divided into euthyroid (n = 88) and ESS groups (n = 106).

Results

The ESS group had a higher level of white blood cell count (WBC), plasma glucose (PG), beta-hydroxybutyric acid (β-HB), triglyceride (TG), anion gap (AG), glycosylated hemoglobin (HbA1c) and a lower level of HCO₃⁻, prealbumin (PA), and albumin (ALB) compared with the euthyroid group (P < 0.05). Free T3 (FT3) levels were significantly correlated to β-HB, HCO₃⁻, AG, PA, and HbA1c (r = − 0.642, 0.681, − 0.377, 0.581, − 0.309, respectively; P < 0.01). Free T4 (FT4) levels were significantly correlated to β-HB, HCO₃⁻, and ALB levels (r = − 0.489, 0.338, 0.529, respectively; P < 0.01). TSH levels were significantly affected by HCO₃⁻ only (r = − 0.28; P < 0.01). HCO₃⁻ level was the most important factor deciding euthyroid or ESS on logistic regression analysis (OR = 0.844, P = 0.004, 95%CI = 0.751–0.948).

Conclusions

Lower levels of free thyroid hormones and occurrence of ESS were associated with a higher degree of acidosis in children with DKA/DK.

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Title: Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/diabetic ketosis
Authors: Peng Shao
Shujuan Guo
Guimei Li
Daogang Qin
Sen Li
Ying Luan
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Ketoacidosis
Type 1 Diabetes
Published in: BMC Endocrine Disorders / Issue 1/2020
Electronic ISSN: 1472-6823
DOI: https://doi.org/10.1186/s12902-020-00616-2

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