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胰岛素依赖型糖尿病(IDDM)患者常对不同于胰岛细胞的组织产生自身抗体。Mirikian 等早已报道过,在很多新发病例及其亲属中有抗垂体细胞的抗体,提示疾病初起时可能不止涉及一种激素。临床家已记取,在甲状腺和肾上腺有发生自身免疫病的可能性,而这些情况会严重影响糖耐量、胰岛素需要量和糖尿病的控制。Riley 等甄别30岁以下的 IDDM 患者,其中17%可检出甲状腺微粒体抗体(TMAs)。在117例 TMA阳性的 IDDM 患者中,64例甲状腺临床和生化均正常,47例被诊断为甲状腺疾病。在12～30个月的研究期间,初期检出3例甲状腺疾病,其中1例甲亢和2例甲减,另有3例发生短暂的甲减表现。在全部病例中,甲亢通常在糖尿病之前或初发时出现;而甲减则倾向于后来才发生(可迟至29年以后)。在 TMAs阳性的糖尿病患者家属中,70%可检出甲状腺疾病或
Patients with insulin-dependent diabetes mellitus (IDDM) often develop autoantibodies to tissues other than islet cells. Mirikian et al. Have reported earlier that in many newly diagnosed cases and their relatives there are antibodies against pituitary cells, suggesting that the disease may start with more than one hormone involved. Clinicians have recalled the possibility of autoimmune disease in the thyroid and adrenal glands, which can severely affect glucose tolerance, insulin requirements, and diabetes control. Riley and colleagues identified IDDM patients under 30 years of age, of whom 17% detected thymic microsomal antibodies (TMAs). Of 117 TMA-positive IDDM patients, 64 had normal thyroid and biochemical status and 47 had been diagnosed with thyroid disease. During the 12-30 months of study, three cases of thyroid disease were initially detected, of which one had hyperthyroidism and two had hypothyroidism, and the other three had a transient hypothyroidism. In all cases, hyperthyroidism usually occurs before or at the onset of diabetes; hypothyroidism tends to occur later (as late as 29 years). 70% of families with TMA-positive diabetes can detect thyroid disease or