Abstract
TSH and T3 responses to TRH (7mcg/kg i.v.) were evaluated in 28 diabetic children (9 males, 19 females; age range 3.5-18 yr) with stable HbA1c range between 4.5 and 10.1% and in 16 non-diabetic controls (C) (5 males, 11 females; age range 5-17 yr). TRH test was performed at 8.00 a.m. before insulin therapy and serum samples were obtained at 0', 20', 30', 60' and 120' for TSH and at O' and 120' for T3 measurements (RIA). Basal TSH was lower in 8 ketotic children (KC) than in 20 hyperglycemic non-ketotic subjects (HNK) (1.5±0.3 mIu/ml vs 2.7±0.9; p<0.01), while no difference was found between HNK and C. TSH response in HNK was similar to C; it was lower in KC than in HNK (Δ9.2±3.2 mIU/ml vs 17.0±5.4; p<0.05. Peak 10.9±3.3 mIu/ml vs 20.2±7.5; p<0.01. Area 743±248 vs 1577±987; p<0.05). Basal T3 was lower in HNK than in C (1.33±0.5 ng/ml vs 2.05±0.31; p<0.025); no difference was found between HNK and KC. T3 response was lower in HNK than in C (1.8±0.5 ng/ml vs 2.9±0.45; p<0.001); it was lower in KC than in HNK (1.27±0.36 ng/ml vs 1.8±0.5; p<0.05).
Our data show that diabetic ketoacidosis reduces TSH and, consequently, T3 responses to TRH; besides, hyperglycemic non-ketotic subjects have normal TSH, but low T3 response. These observations confirm that children with type I diabetes mellitus, as adults, present “low T3 syndrome”, both in ketotic and non-ketotic status. After releasing hormone stimulus there is low T3 response in diabetic subjects, while in ketoacidosis this phenomenon could be due also to reduced TSH response. In hyperglycemic non-ketotic children a real depression of peripheral metabolism of T3 is found, correlated with metabolic control.
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Chiarelli, F., Tumini, S., Verrotti, A. et al. 158 TSH AND T3 RESPONSES TO TRH IN CHILDREN WITH TYPE I INSULIN-DEPENDENT DIABETES MELLITUS (IDDM). Pediatr Res 20, 1060 (1986). https://doi.org/10.1203/00006450-198610000-00213
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DOI: https://doi.org/10.1203/00006450-198610000-00213
