Disorders of carbohydrate metabolism in hyperthyroidism in children and adolescent

Shakhlo Muratova; Anvar Alimov

doi:10.1530/endoabs.73.EP214

Relevance

Excess thyroid hormone as a result of thyroid hyperstimulation affects all types of metabolism, including carbohydrate metabolism

Purpose

To assess the incidence of carbohydrate metabolism disorders in children and adolescents with hyperthyroidism.

Materials and methods

Hormonal analysis of thyroid status (TSH, free and total T3, free and total T4, TSHRAb, TPOAb), and biochemical studies (glycemia, glycated haemoglobin, total cholesterol, urea, creatinine, hepatic transaminases) in 79 children and adolescents who received inpatient and outpatient treatment at the RSSPMC after Ya. Kh. Turakulovin the period from 2007 to 2020.

Results


	Units	Baseline	Day		Month
	Units	Baseline	1st	14th	4	7 (3 months after the end of therapy)
DHEA-S	μmol/l	0.003	5.04	5.72	5.74	0.003
SHBG	nmol/l	102.5	–		108.1	102.2
Total testosterone	nmol/l	0.17			0.975	0.17
Free testosterone	pmol/l	1.6			7.7	1.6
Estradiol	pmol/l	415.7			396.57	423.6
Osteocalcin	ng/ml	26.18			21.18	18.29
β-Cross laps		0.64			0.33	0.36
Colecalciferol		24.3			28.3	22.6
AMH		1.10			1.17	1.48
Inhibin B	pg/ml	59			52	60.7
LH	U/l	27.6			14.4	23.9
FSH	U/l	31.5			15.6	32.3
Glucose	mmol/l	4.64			4.04	4.34
Cholesterol	mmol/l	5.68			5.03	5.06
Insulin	μU/ml	4.18			6.51	5.3
HbA1c	%	5.5			5.5	5.8
Hair growth –axillary –pubic (Tanner scale)		No V			Yes V	No V
Ultrasound of the pelvic, mammary glands		n			n
Cytological examination of smears		n
Side effects		–			Slight greasiness of the face
Golombok-Rust Inventory of Sexual Satisfaction-Female
Frequency		5	–		5
Incommunicability		2			3	2
Dissatisfaction		4			3	4
Avoidance		2			0
Anorgasmia		3
Vaginismus		0
Touch					4	0
Hospital Anxiety and Depression Scale
Anxiety		7	–		4	6
Depression		3			2	1
Symptom checklist-90-revised
Somatization		0.75	–		0.5	0.67
Obsessive-Compulsive		0.5			0.8	0.8
Interpersonal Sensitivity		0.11			0.22	0.11
Depression		0.31			0.23	0.31
Anxiety		0.5			0.3	0.4
Hostility		0.33			0.17	0.5
Phobic Anxiety		0			0
Paranoid Ideation
Psychoticism
Positive Symptom Total		28			26	27
Global Severity Index		0.32			0.29	0.34
Positive Symptom Distress Index		1.04			1.00	1.15
SF-36 health status survey
Physical health		43.33	–		51.24	46.42
Physical Functioning		70			80	70
Role-Physical Functioning		0			50
Bodily pain		100			100
General Health		52			70	47
Mental health		45.93			51.93	45.22
Vitality		55			60
Social Functioning		75			75	62.5
Role-Emotional		100			100	66.67
Mental Health		52			76	68
Wechsler Memory Scale
Visual Reproduction		7	–		10	6
Paired Associates		12			15	14
Digits –forward –backward		6 5			6 5	7 4

In the period from 2007 to 2020, we examined 73 children with hyperthyroidism in the active phase at the age of 2–18 years, the control group consisted of 21 children of the same age without endocrine pathology, living in the Republic of Uzbekistan. The mean serum level of sugar, creatinine, ALT, AST in the group with hyperthyroidism was significantly higher than in the control group, the mean values of urea did not have a significant difference, the mean total cholesterol level in the group with hyperthyroidism was significantly lower than in the control group (Table 1). Among children and adolescents with hyperthyroidism, 6.85%(5) were simultaneously diagnosed with type 1 diabetes mellitus. In 11%(8) adolescents, fasting hyperglycemia and impaired glucose tolerance were revealed.

In 56 children and adolescents with hyperthyroidism, we analyzed the correlation between glycemic and other biochemical tests and thyroid status. A weak negative correlation between TSH and creatinine (r = 0.3, P < 0.05) and a direct correlation with fT4 (r = 0.3, P < 0.05), a high correlation of fT3 and glycemia (r = 0.8, P < 0.05) and weak with AST (r = 0.3, P < 0.01), as well as the level of fT4 with glycemia (r = 0.4, P < 0.05), ALT (r = 0.4, P < 0.01), AST (r = 0.4, P < 0.01) and creatinine (r = 0.3, P < 0.05). A weak direct correlation between TSHRAb and AST level was revealed (r = 0.4, P < 0.05).

Conclusions

This study shows the presence of carbohydrate metabolism disorders in hyperthyroidism in children and adolescents, demonstrated by diabetes mellitus (6.85%), fasting hyperglycemia and impaired tolerance to glucose (11%). A direct correlation was found between thyroid hormones and blood sugar.

Endocrine Abstracts

EP214