Distribution of Thyroid Autoantibodies in Saudi Children with type 1 Dm and their effect on Glycemic Control
Elhashimi E. Hassan1, Ehab A. M. Elagab2, Hassan B. Mohammed1, Ahmed El-basher Abdelgader1, Amar B. Elhusseinand Mohammed Ayed Huneif3

1Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia.

2Department of Pathology, College of Medicine, Najran University, Najran, Saudi Arabia.

3Department of Pediatrics, College of Medicine, Najran University, Najran, Saudi Arabia.

Corresponding Author  E-mail: alhashimihassan@hotmail.com

Abstract: Associations of subclinical autoimmune thyroiditis with type 1DM were frequently studied, but their role on the glycemic state was not well investigated. Nevertheless, very little data are available from KSA, despite an increase in incidence of disease. This study aimed to investigate the prevalence of subclinical autoimmune thyroiditis in patients with type 1DM and to evaluate their effect on HbA1c (Glycated hemoglobin) level as glycemic marker. The study comprised 132 Saudi children with type 1 diabetes mellitus, and 72 matched healthy control in age and sex. Patients diagnosis based on WHO criteria. The study excluded patients with thyroid disease, renal disease, liver disease, and anemia. HbA1c was measured using chromatography technique. The sera were used to assay the TSH (Thyroid stimulating hormone) concentrations using ELC (Electrochemiluminescent) technology while GAD antibodies (Anti thyroglobulin antibodies), TPO antibodies (Anti-thyroid peroxidase antibodies) & TG antibodies (Anti thyroglobulin antibodies) were measured by ELISA (Enzyme-Linked Immunosorbent Assay) from abcam –UK. The data were analyzed by SPSS. The study showed a higher distribution of anti-GAD, and thyroid autoantibodies (anti-TPO and anti-TG) among type1 DM patients 56.8%, 36.4% and 19.7% in contrast to lower distribution in controls 5.6%, 9.7% and 4.2% respectively. Furthermore a group of patients whom had positive autoimmune thyroid antibodies associated with a significant raising of HbA1c in compare to other patients group with negative auto thyroid antibodies P value ˂0.001 On the other hand, about 9.8% of diabetic patient showed high-level TSH and only 1.4 % in healthy group. Nevertheless, it seemed to be insignificantly associated with HbA1C. This study reported that the distributions of auto thyroid antibodies among type 1 DM patients were high in Saudi children. Perhaps theses autoantibodies may have indirect effect on glycemic control; a subject for further study. Furthermore, according to our finding it recommends to do serial thyroid profile investigation including thyroid auto- antibodies for type 1DM as a subclinical thyroiditis are not very rare.

Keywords: Anti-glutamic acid decarboxylase (Anti GAD); Anti thyroglobulin antibodies (Anti-TG); anti-thyroid peroxidase antibodies (Anti-TPO); Glycated hemoglobin (HbA1c); Thyroid stimulating hormone (TSH)

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