RESUMO
BACKGROUND: Type 1 diabetes (T1D) is an autoimmune disease and the leading form of diabetes among young white people. 1,5-Anhydroglucitol (1,5-AG), a nontraditional biomarker of postprandial glycemic control (after 1 - 3 days to 2 weeks), may be useful in T1D screening. We studied serum 1,5-AG concentration as a potential biomarker for T1D screening and diagnosis in adults and children. METHODS: In this case-control study, adults (n = 121; age, 19 - 61 years) and children (n = 19; age, 8 - 14 years) with T1D were matched with healthy subjects (n = 242) according to gender and age. Serum 1,5-AG levels were measured enzymatically (GlycoMark Inc., NY, USA). RESULTS: Patients showed no symptoms of overt kidney disease, assessed by serum creatinine concentrations. The median (25th - 75th percentile) 1,5-AG concentrations for the control group compared with the T1D group were 155 (128 - 183) vs. 21 (14 - 34) µmol/L in adults and 190 (158 - 237) vs. 20 (12 - 30) µmol/L in children (p < 0.001 for both). Receiver operating characteristic curves showed that 1,5-AG cutoffs of ≤ 113 and ≤ 79 µmol/L for adult men and women, respectively, and ≤ 57 µmol/L for children of both genders had > 95% sensitivity and specificity for both groups. CONCLUSIONS: Our results suggest that serum 1,5-AG concentration may be useful as an adjunct measure of hyperglycemia for diagnosing T1D and has the potential to screen for T1D in high-risk subjects.
Assuntos
Biomarcadores/sangue , Desoxiglucose/sangue , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/diagnóstico , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Creatinina/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Fatores de Risco , Adulto JovemRESUMO
Thyroid tumors are rare in childhood and adolescence. A retrospective analysis was done of fifteen patients (8 female) with thyroid carcinoma attended in the Pediatric Endocrinology Unit of the HC-UFPR, from February 1988 to March 2003. The most frequent initial complaint was an anterior cervical nodule. Ten patients were papillary carcinoma (PTC) bearers, four had medullary carcinoma (MTC; three of them with MEN-2B) and one had follicular carcinoma. Two patients with MEN-2B have de novo proto-oncogene RET mutation (Met918Thr). Fine needle aspiration (FNA) was performed in ten patients and was malignancy positive in only five of them. All patients underwent total thyroidectomy. Adjuvant radioiodine (131I) therapy was made in ten patients. Two patients died from unrelated diseases. Nine patients presented no clinical or laboratorial evidence of disease; one (PTC) developed recurrence 5 years after initial treatment and three (1 PTC, 2 MTC) have disease evidence yet. Our prognosis and clinical manifestations data are according to the literature. However, MTC prevalence (27%), sex distribution and FNA results differ from the majority of published casuistics, that can be attributed to the number of cases reported here.
Assuntos
Neoplasias da Glândula Tireoide , Adolescente , Criança , Feminino , Seguimentos , Humanos , Masculino , Proto-Oncogene Mas , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgiaRESUMO
Tumores tireoideanos são raros na infância e adolescência. Foram revisados os prontuários de quinze pacientes (8 do sexo feminino) com idades entre 5,8 e 15,2 anos, atendidos na Unidade de Endocrinologia Pediátrica (UEP) do HC-UFPR entre fevereiro de 1988 e março de 2003. Nódulo cervical anterior foi a queixa inicial mais freqüente. Dez pacientes eram portadores de carcinoma papilífero (CP), quatro apresentavam carcinoma medular (CMT; dos quais, três com NEM-2B) e um, carcinoma folicular. Dois pacientes com NEM-2B apresentam mutação de novo (Met918Thr) do proto-oncogene RET. PAAF, efetuada em dez pacientes, foi positiva para neoplasia em cinco deles. Todos os pacientes foram submetidos a tireoidectomia total. Terapia adjuvante com 131I foi realizada em dez pacientes. Dois pacientes faleceram por doença não relacionada ao tumor. Nove pacientes não apresentam evidência clínica ou laboratorial do tumor; um (CP) apresentou recidiva 5 anos após o tratamento inicial e três (1 CP, 2 CMT) ainda têm evidência da doença. Nossos dados estão de acordo com a literatura em relação ao prognóstico e manifestações clínicas. Entretanto, a prevalência de CMT (27 por cento), a distribuição por sexo e os resultados da PAAF diferem da maioria das casuísticas publicadas, o que pode ser atribuído ao número de casos aqui relatado.