Thyroid function and stress hormones in children with stress hyperglycemia
The purpose of the study is to determine the prevalence of stress hyperglycemia and to investigate how thyroid and stress hormones alter during stress hyperglycemia in children admitted to pediatric emergency wards. A prospective cross-sectional study was conducted in children, less than 19 years old, who were admitted to pediatric emergency wards of Nemazee and Dastgheib Hospitals, Shiraz, Southern Iran. Those patients taking steroids, beta-agonists or intravenously administered glucose before venipuncture, and patients with diabetes mellitus (DM) or thyroid diseases were excluded. Children with blood glucose ≥150 mg/dL during admission were regarded as cases. The controls were age- and- sex- matched, euglycemic children. Stress hormones including cortisol, insulin, growth hormone, and prolactin were measured, and thyroid function was tested with a radioimmunoassay (RIA) method in all cases and controls. The resuts showed that among 1,054 screened children, 39 cases (3.7 %) had stress hyperglycemia and 89 controls were included in the study. The occurrence of hyperglycemia was independent of sex, but it occurred mostly in children under 6 years old. Hyperglycemia occurred more frequently in patients with a positive family history of DM (odds ratio = 3.2, 95 % CI = 1.3–7.9, and P = 0.009). There were no significant differences between cases and controls regarding any hormones except higher cortisol, and lower total T3 and T4 in cases compared with controls. Neither of cases developed diabetes in the 24-month follow-up period. These findings led us to the conclusion that stress hyperglycemia is occasionally seen in critically ill patients. Among the stress hormones measured, only cortisol increased during hyperglycemia. It seems that hyperglycemia is not an important risk factor for future diabetes.
KeywordsDiabetes Hyperglycemia Stress hormones Thyroid function
Non thyroidal illness syndrome
Oral glucose tolerance test
Sick euthyroid syndrome
Statistical package for the social sciences
Thyroid stimulating hormone
The authors would like to express their special thanks to Dr. H. Tabesh for carrying out the statistical analysis, Mrs. M. Farahmandi for typing the manuscript, and K. Shashok (Author AID in the Eastern Mediterranean) and Sh. Parand of the Hematology Research Center, for English editing the manuscript. This manuscript is relevant to the thesis of Reza Taj-aldini with project number 86-3714.
Conflict of interest
None of the authors has financial disclosures or any conflict of interest to be declared.
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