Prevalência de disfunção tireoidiana e anticorpos antitireoidianos em pacientes portadores de diabetes mellitus tipo 1 e em seus familiares de primeiro grau

Abstract

Type 1 Diabetes Mellitus results in the destruction of pancreatic β cells, mediated by a cellular auto-immune process, leading to an insulin production deficiency. Frequently it is also associated to other auto-immune diseases such as Hashimoto's Thyroiditis, Celiac Disease, Pernicious Anemia, Adrenalits and Ooforits. Autoimmune Thyroid Disease (AITD) is most frequently found in patients who have diabetes. Prevalence varies between 3 to 50% and is higher in family members of diabetic patients then in the general population. The objective of the present study was to investigate the prevalence of autoimmune thyroid disease in patients with type 1 diabetes mellitus in the city of Uberlândia and to evaluate possible differences of clinical action and evolution of diabetes mellitus among diabetic patients who also did not have AITD. This worked aimed, as well, to study the prevalence of autoimmune thyroid disease and thyroid disfunction in first degree relatives of patients with type 1diabetes mellitus, moreover evaluating if differences exist in the prevalence in relatives who have diabetics with AITD to those relatives who have diabetics without AITD. One hundred and twenty four diabetic patients who supplied samples for clinical and laboratorial data such as age, anthropometric data, time of evolution of the illness, presence of acute and chronic complications, glycosilated hemoglobin, daily insulin dose, levels of TSH anti-thyroid antibodies were evaluated to verify action and evolution of diabetes among those with or without associated thyroid disease. Thyroid function and presence of auto-antibodies to thyroid were also evaluated in 54 first degree relatives of these diabetic patients, divided into a group of relatives of diabetics who presented AITD and a control group of relatives of diabetics without thyroid disease. Prevalence of AITD and hormonal dysfunction among the diabetic patients 35.5% and 19.3% respectively. As for the evaluation of the diabetic evolution and its clinical action, no differences in groups with and without AITD were found. However prevalence of AITD and hormonal dysfunction (63.6% and 27.3%, respectively) was found to be higher in the group of family members of diabetics with AITD than in the group of the family members of diabetics without AITD (21.9% and 9,4%), respectively. Prevalence of autoimmune thyroid disease in diabetics and their relatives, in Uberlândia, is high. Screening of the thyroid function is therefore justified in these cases, especially in those first degree relatives of diabetics with autoimmune thyroid disease.