Dyslipidemia and thyroid dysfunction in children and adolescents with type 1 diabetes mellitus: relationship to metabolic control and body mass index

Objetivo: Determinar la frecuencia de dislipidemia y disfunción tiroidea en niños y adolescentes con DM1, procedentes de la consulta de diabetes del Hospital JM de Los Ríos, y establecer su asociación con el control metabólico y el índice de masa corporal. Métodos: Estudio retrospectivo y descriptivo. Se seleccionaron 253 historias de pacientes con DM1, durante un período de 3 años (2004-2006). Se recolectaron los siguientes datos: edad, sexo, tiempo de evolución de la diabetes, índice de masa corporal (IMC), control metabólico (HbA1c), presencia de anticuerpos antitiroideos, perfil tiroideo y lipídico. Resultados: El 53,4% eran del sexo femenino y 46,6% masculino, 22 (8,7%) preescolares, 80 (31,6%) escolares y 151 (59,7%) adolescentes. El 22,8% tenía buen control metabólico, 77,2% mal control. A mayor edad, el control metabólico empeoraba (p=0,02). Hubo una correlación positiva significativa de la HbA1c, con el IMC y la duración de la DM1. El perfil lipídico se encontró alterado en 69,6% y su frecuencia fue significativamente mayor en los pacientes en mal control. Se observaron valores significativamente más altos de Ct, C-LDL, Tg y relación Tg/C-HDL en los diabéticos mal controlados. Los valores de Ct y de C-LDL fueron significativamente más altos en el grupo con obesidad, en comparación con los normopeso y sobrepeso. Los anticuerpos antitiroideos resultaron positivos en el 12,7%. El 6% presentaron hipotiroidismo y no hubo asociación con la frecuencia de dislipidemia ni el control metabólico. Conclusiones: La frecuencia de dislipidemia e hipofunción tiroidea en los niños y adolescentes con DM1 fue similar a la reportada en la literatura. Se demostró una clara asociación de la dislipidemia con el mal control metabólico y la obesidad. Se recomienda la realización de lipidograma y función tiroidea en pacientes con DM1.24-29jmendoya@hotmail.comObjetive: To determine the prevalence of thyroid dysfunction and dyslipidemia in children and adolescents with type 1 diabetes mellitus (1DM), from the Children’s Hospital JM de Los Ríos, and its association with metabolic control and body mass index. Methods: A descriptive and retrospective study was done. Data were obtained from the medical records of patients with 1DM, who attended during a period of 3 years (2004 to 2006). The following data were collected: age, sex, duration of diabetes, body mass index (BMI), metabolic control (HbA1c), presence of antithyroid antibodies, thyroid and lipid profile. Results: The 53.4% were female, 46,6% male, twenty two (8.7%) preschoolers, 80 (31.6%) school children and 151 (59.7 %) adolescents. A good metabolic control was observed in 22.8% and poor control in 77.2% of the patients. It was noted that the older the worse metabolic control (p=0.02). There was a significant ositive correlation of HbA1c values with BMI and duration of DM1. The 69,6% had some form of dyslipidemia and the frequency of atherogenic lipid profile was significantly higher in patients poorly controlled. Significantly higher values of Ct, C-LDL, triglycerides and Tg/HDL-C ratio were observed in diabetics in poor metabolic control. The values of TC and LDL-C were significantly higher in the obese group compared with normal and overweight subjects. Antithyroid antibodies were positive in 12.7% of the patients. The 6% were hypothyroid and there was not association with the frequency of dyslipidemia or the metabolic control. Conclusion: The frequency of dyslipidemia and hypothyroidism in children and adolescents with 1DM was similar to that reported in the literature. It was demonstrated a clear association of dyslipidemia with poor metabolic control and obesity. We recommend the determination of lipids and thyroid function in patients with type 1 DM