ALTERED ADRENAL AND THYROID-FUNCTION IN CHILDREN WITH INSULIN-DEPENDENT DIABETES-MELLITUS

In 129 children, aged 12.6 +/- 3.8 years, affected by type 1 diabetes mellitus, the levels of dehydroepian- drosterone sulfate (DHEAS), cort isol, T-3, fT(3), T4, fT4, rT(3), TSH, cholesterol, and triglycerides were evaluated and compared with those of a control group of 458 healt hy age-matched children. The results were also correlated with hemoglo bin HbA(1C). The DHEAS-standard deviation score (DHEAS-SDS; -0.36 +/- 0.77) was significantly different from zero in diabetic children, whil e the cortisol serum level was higher than in control subjects (485 +/ - 94 vs 359 +/- 132 nmol/l). Moreover, the DHEAS-SDS and DHEAS-SDS/cor tisol ratio correlated negatively with HbA(1C). Diabetic patients also showed lower T-3 values (2.22 +/- 0.4 vs 2.32 +/- 0.3 nmol/l) and a h igher rT(3)/T-3 ratio (0.17 +/- 0.09 vs 0.15 +/- 0.05) than controls. There was a negative correlation between T-3 and HbA(1C). Cholesterol (4.77 +/- 1.08 vs 4.51 +/- 0.76 mmol/l) and triglycerides (0.82 +/- 0. 53 vs 0.63 +/- 0.37 g/L) levels were higher in diabetic children and p ositively correlated with HbA(1C), but not with DHEAS-SDS. We can ther efore conclude that diabetes, particularly if poorly controlled, tends to induce a dissociation of cortisol and DHEAS secretion and a low T- 3 syndrome, similar to that seen in other illnesses.