Open Access青少年和青壮年1型糖尿病患者的精神障碍与甲状腺激素治疗有关吗?
Author(s) -
Eckert Alexander,
Galler Angela,
Papsch Matthias,
Hess Melanie,
Holder Martin,
Döing Carsten,
BierkampChristophersen Dirk,
Hammer Elke,
Pappa Angeliki,
Lanzinger Stefanie
Publication year - 2021
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.13145
Subject(s) - medicine , levothyroxine , type 1 diabetes , depression (economics) , thyroid disorder , diabetes mellitus , odds ratio , thyroid disease , thyroid , thyroid peroxidase , thyroiditis , bipolar disorder , pediatrics , endocrinology , lithium (medication) , economics , macroeconomics
Background To evaluate the association between thyroid autoimmunity and psychiatric disorders (depression, anxiety, eating disorder, schizophrenia or attention‐deficit/hyperactivity disorder) among adolescents and young adults with type 1 diabetes (11‐25 years). Methods We compared 9368 type 1 diabetes patients with thyroid autoimmunity (3789 of them treated with levothyroxine) with 62 438 type 1 diabetes patients without any thyroid disease from a multicentre diabetes patient follow‐up registry (DPV) in terms of psychiatric disorders. Thyroid autoimmunity was defined as documented diagnosis of Hashimoto thyroiditis or positive antibodies against thyroid peroxidase or thyroglobulin. Multivariable logistic regression models were used to calculate odds ratios for the respective psychiatric disorders in type 1 diabetes patients with thyroid autoimmunity (overall and stratified by levothyroxine therapy) compared to type 1 diabetes patients without thyroid diseases (reference). Results Of the 9368 patients with thyroid autoimmunity, 62% were female with a median (Q1‐Q3) age of 16.3 (14.2‐17.6) years. Thyroid autoimmunity (with or without levothyroxine therapy) revealed a slight, but significant higher chance for depression (odds ratio [OR], 1.35, 95% confidence interval [CI], 1.19, 1.52), eating disorder (OR, 1.25, CI, 1.03, 1.51), attention‐deficit/hyperactivity disorder (OR, 1.22, CI, 1.07, 1.39) and schizophrenia (OR, 1.63, CI, 1.04, 2.56). In individuals with prescribed levothyroxine therapy because of thyroid dysfunction significantly higher odds for depression (OR, 1.63, CI, 1.34, 1.99), anxiety (OR, 1.60, CI, 1.18, 2.18), and attention‐deficit/hyperactivity disorder (OR, 1.71, CI, 1.38, 2.12) were observed compared to reference. Thyroid autoimmunity without required levothyroxine therapy revealed no differences to the reference group. Conclusions Patients on levothyroxine had significantly higher odds for psychiatric disorders, but thyroid autoimmunity in terms of high antibody levels only did not show higher odds for any psychiatric disorder.