Prevalência do anti-TPO e anti-21-hidroxilase no paciente diabético tipo 1 / Prevalence of anti-thyroid peroxidase and anti-adrenal 21-hidroxylase in type 1 diabetes patients
Arq. bras. endocrinol. metab
; 53(4): 461-465, jun. 2009. tab
Article
in Portuguese
| LILACS
| ID: lil-520771
Responsible library:
BR1.1
RESUMO
Ainda não está definida a estratégia ideal para rastrear a doença de Addison em pacientes com diabetes melito tipo 1 (DMT1). Objetivo:
O objetivo deste estudo foi determinar a prevalência do anticorpo anti-21-hidroxilase (AC anti-21OH) em pacientes DMT1 de etnia diversificada e investigar sua associação à disfunção adrenal e autoimunidade tireoidiana.Métodos:
Quarenta indivíduos foram avaliados, submetidos à entrevista e à dosagem de AC antitireoperoxidase (anti-TPO), anti-21OH, TSH, T4 livre e cortisol. AC anti-21OH foi encontrado em 7,5% (n = 3)dos casos, sem disfunção adrenal associada.Resultados:
Positividade para anti-21OH não ocorreu exclusivamente em pacientes com anti-TPO (+). Este foi detectado em 25% dos casos e associado a níveis de TSH mais elevados (p = 0,034) e à idade mais avançada (p = 0,009).Conclusões:
Embora nossa frequência de anti-TPO (+) seja similar à da literatura, a presença de anti-21OH (+) foi superior. Entretanto, esses AC não foram associados à disfunção hormonal, o que parece não justificar o rastreamento universal da doença de Addison.ABSTRACT
There is still no consensus about the best strategy to screen Addisons disease (AD) in type 1 diabetes mellitus (T1DM) patients. Objective:
The aim of this study was to determine the frequency of anti-21-hydroxilase (anti-21OH) in a multiethnic T1DM population and investigate if its presence is associated with any adrenal dysfunction or thyroid autoimmunity.Methods:
Forty individuals underwent an interview and blood was drawn for anti- thyroperoxidase (anti-TPO), anti-21OH, TSH, free T4 and cortisol measurement.Results:
Anti-21OH was found in 7.5% (n = 3), none with adrenal dysfunction. This antibody was not exclusively seen in patients with anti-TPO (+). Anti-TPO was positive in 25% and associated with higher TSH levels (p = 0.034) and older age (p = 0.009).Conclusions:
Although the frequency of anti-TPO in this sample was similar to previous studies, a higher prevalence of anti-21-OH was found. However, no coexisting adrenal dysfunction was detected, which does not support universal screening for AD in this group.
Full text:
Available
Collection:
International databases
Database:
LILACS
Main subject:
Autoantibodies
/
Diabetes Mellitus, Type 1
/
Iodide Peroxidase
Type of study:
Prevalence study
/
Risk factors
/
Screening study
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
Portuguese
Journal:
Arq. bras. endocrinol. metab
Journal subject:
Endocrinology
/
Metabolism
Year:
2009
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Hospital de Aeronáutica dos Afonsos/BR
/
UFRJ/BR