Evaluation of adrenomedullin levels in adolescents with Hashimoto's thyroiditis: association with clinical and laboratory findings.

OBJECTIVES

Hashimoto thyroiditis (HT) is an autoimmune disorder that may be associated with systemic inflammation. Adrenomedullin (ADM) is a peptide known to be elevated in inflammatory conditions, but its role in pediatric HT has not been extensively studied. To investigate serum ADM levels and their relationship with clinical and laboratory parameters in adolescents with HT.

METHODS

This cross-sectional study included 46 adolescents with HT and 41 age-, sex-, and BMI-matched healthy controls. Serum ADM, thyroid function tests, anti-thyroid antibodies, IL-6, and CRP levels were measured. Clinical features including goiter and symptom status were recorded. Correlation and multivariate logistic regression analyses were performed to evaluate associations and predictive factors.

RESULTS

ADM levels were significantly higher in the HT group than in controls (p=0.016). TSH, anti-TPO, anti-TG, and IL-6 levels were also elevated, while free T4 and CRP did not differ significantly. ADM correlated with TSH and thyroid functional status but not with IL-6 or CRP. Goiter was present in 28 % of patients, with all patients with goiter showing elevated ADM. Multivariate analysis identified TSH, free T4, and ADM as significant predictors of HT. Receiver operating characteristic analysis showed moderate diagnostic performance for ADM (AUC=0.651).

CONCLUSIONS

Serum adrenomedullin levels were elevated in adolescents with Hashimoto thyroiditis compared with matched controls and were associated with thyroid dysfunction and local inflammatory activity. Although ADM showed only moderate diagnostic performance, this exploratory first study in pediatric HT suggests a potential role in disease pathophysiology and warrants confirmation in larger prospective cohort studies.