The euthyroid sick syndrome (ESS) also known as nonthyroidal illness syndrome is a condition characterized by a derangement in thyroid function tests, especially represented by low triiodothyronine (T3) and free T3 (FT3) concentrations. Participants with more severe T1DM onset presentation both in terms of metabolic derangement and kidney function impairment had an increased prevalence of ESS.Ĭhildren with ESS had a slower recovery from acute kidney injury compared with those without ESS.ĮSS spontaneously disappeared in all participants.
This is the first longitudinal study describing in detail the relationship between clinical/metabolic factors at type 1 diabetes mellitus (T1DM) onset and thyroid hormones, with particular attention to the relationship between diabetic ketoacidosis (DKA)-related kidney function impairment and euthyroid sick syndrome (ESS). ConclusionsĮSS is associated with T1DM onset severity and spontaneously disappears. Participants with euthyroidism showed earlier recovery from AKI than those with ESS. FT3 inversely correlated with serum triglycerides and creatinine, and urinary calcium/creatinine ratio and NGAL.
Only ATN, however, was associated with ESS at adjusted analysis. It was more prevalent in case of more severe T1DM presentation both in terms of metabolic derangement (DKA) and kidney function impairment (AKI, RTD and ATN). Of 161 participants, 60 (37.3%) presented ESS. RTD was defined by abnormal urinary beta-2-microglobulin and/or neutrophil gelatinase-associated lipocalin (NGAL) and/or tubular reabsorption of phosphate 2%. MethodsĪ total of 161 children with T1DM onset were included. To evaluate (i) the prevalence and association of euthyroid sick syndrome (ESS) with severity indexes of type 1 diabetes mellitus (T1DM) onset such as diabetic ketoacidosis (DKA) and kidney damage, (ii) relationship between clinical/metabolic parameters at T1DM onset and thyroid hormones, and (iii) ESS as a prognostic indicator of delayed recovery from kidney damage.
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