Autoimmune thyroiditis in patients with type 1 diabetes mellitus: A long-term follow-up study

Stratigou, Theodora; Koutroumpi, Stavroula; Vlassopoulou, Barbara; Tsagarakis, Stylianos; Ioannidis, George

doi:10.1016/j.dsx.2018.11.048

Cited by 12 publications

(8 citation statements)

References 21 publications

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“…The heterogeneity in rates of AITD might be the variability in study design, ethnicity, assays, and definition of the disease ( 28 ). In a study of 491 children with T1D, the onset of AITD was recorded as the date of TSH abnormalities in addition to positivity of thyroid autoantibodies; while other studies defined AITD solely from presence of thyroid autoantibodies despite clinically silent disease ( 10 , 29 ). We stringently defined patients with AITD as either GD or HD being having thyroid autoimmunity with clinical and laboratory evidence of hyper-/hypothyroidism might have rendered the lower prevalence of AITD.…”

Section: Discussionmentioning

confidence: 99%

Graves disease is more prevalent than Hashimoto disease in children and adolescents with type 1 diabetes

Wang

Huang²,

Lin³

et al. 2023

Front. Endocrinol.

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IntroductionAutoimmune thyroid disease (AITD) is the most common associated autoimmune disorder in type 1 diabetes (T1D). Early detection of AITD is crucial to optimize glycemic control, growth, and intellectual development. In this prospective cohort study, we sought to characterize the prevalence, incident ages and risk factors of AITD in children and adolescents with T1D.Materials and methodsPatients with T1D diagnosed at ≤ 18 years at MacKay Children’s Hospital, Taipei, from 1990 to 2019 underwent annual screening for AITD. Institutional Review Board-approved data on age, sex, and disease profile are collected. Statistical analysis was performed by using independent sample t test for continuous variables, chi-squared test for categorical variables, and Kaplan-Meier estimates of cumulative incidence of AITD were calculated. A p value of <0.05 was considered statistically significant.ResultsWe prospectively followed up 808 patients with T1D, 761 patients were included in the study. Of these patients, 197 (25.9%) of them had thyroid autoimmunity, meaning positivity of thyroid autoantibodies. Females had a higher prevalence of thyroid autoimmunity than males (59.9%, p = 0.012). Altogether, 5.5% patients developed AITD (4.1% had Graves disease; 1.4% had Hashimoto disease), at a mean age of 17.8 ± 8.5 years. The cumulative incidence of AITD at 30 years of disease duration was 0.29 in the total group and was significantly higher in females (0.39, n = 397) than in males (0.15, n = 364, p<0.001).DiscussionIn Taiwan, the prevalence of AITD in pediatric population with T1D increases with age, a longer disease duration and female sex. For early detection of autoimmune thyroid disease in Taiwanese children and adolescents with T1D, an annual AITD screening program should be implemented.

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Section: Discussionmentioning

confidence: 99%

Graves disease is more prevalent than Hashimoto disease in children and adolescents with type 1 diabetes

Wang

Huang²,

Lin³

et al. 2023

Front. Endocrinol.

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“…Anti-TPO antibodies positivity was reported to have a higher prevalence in population with obese [ 31 ] and type 1 diabetes mellitus [ 32 ], and autoimmune thyroid dysfunction was associated with serum metabolomic changes, suggesting possible correlations between anti-TPO antibodies positivity and metabolic disorder. A panel of 10 anti-TPO antibodies positivity related cord blood metabolites were identified in the present study, including 5 up-regulated and 5 down-regulated metabolites (Fig.…”

Section: Discussionmentioning

confidence: 99%

Cord blood metabolomics reveals gestational metabolic disorder associated with anti-thyroid peroxidase antibodies positivity

Han

Yang

Wang

et al. 2022

BMC Pregnancy Childbirth

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Background Thyroid disease is one of the common endocrine disorders affecting the pregnant women, in which thyroid autoimmunity can alter the progress and the outcome of pregnancy. Women with euthyroid status but anti-thyroid peroxidase (anti-TPO) antibodies positivity before pregnancy are prone to subclinical gestational hypothyroidism. However, the connections between anti-TPO antibodies positivity and gestational hypothyroidism remain largely unknown. The aim of the present study is to investigate the differences of fetal metabolic profile at birth according to maternal anti-TPO status. Methods We performed 1H-NMR metabolomics on cord blood of a nested case control cohort of 22 pregnant women with matched thyroid hormone levels and demographic data, including 11 women with euthyroid status but anti-thyroid antibodies positivity (into the anti-TPO antibodies positivity group) and 11 matched women as controls with euthyroid status and negative anti-thyroid antibodies (into the control group). Results Distinct metabolic profiles were observed between the anti-TPO antibody positivity group and the nested control group, from which a total of 10 metabolites with between-group altered abundances were structurally identified. Five out of the 10 metabolites were up-regulated in the anti-TPO antibodies positivity group, including D-Glucose, L-Glutamine, 3-Hydroxybutyric acid, Myo-Inositol, Creatinine. The other 5 metabolites were down-regulated in the anti-TPO antibodies positivity group, including L-Leucine, L-Lysine, L-Glutamic acid, L-Tyrosine, and L-Phenylalanine. All the 10 metabolites have been previously reported to be correlated with hypothyroidism. Metabolite set enrichment analysis and pathway analysis suggested that amino acid metabolism pathways (especially the phenylalanine metabolism) were associated with anti-TPO antibodies positivity. Conclusion The results of this study suggested that fetal metabolic disorder is correlated with anti-TPO antibodies positivity, representing by abundance alteration of hypothyroidism associated metabolites and the related disturbance of amino acid metabolism pathways.

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“…The prevalence of autoimmune thyroiditis among children with DM with normal IgA level in various studies was 11.3% [ 23 ], 14.4% [ 24 ] to 27.1% [ 21 ] depending on the age and duration of DM. In adults, this frequency ranged from 28.9% [ 13 ] to 35.4% [ 25 ]. Our results showed a slightly lower prevalence of autoimmune thyroiditis in children with DM only, which may be correlated with their age and the duration of DM, but the trend of its higher frequency in SIgAD patients persisted.…”

Section: Discussionmentioning

confidence: 99%

Selective immunoglobulin A deficiency in children with diabetes mellitus: Data from a medical center in Ukraine

2022

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The aim of this study was to estimate the prevalence of selective immunoglobulin A deficiency (SIgAD) among children with type 1 diabetes mellitus (DM) in Ternopil region (western Ukraine). Serum IgA levels were measured in 240 patients aged 4–17 years with DM and in 324 children of a control group of the same age. Normal IgA level was observed in 210 (87.5%) patients, increased—in 18 (7.5%), decreased (lower than the age reference value)—in 12 (5.0%) patients with DM. The mean IgA level in patients with DM was 152.11±73.78 mg/dL. SIgAD criteria were met by 7 (2.9%) children with DM, but none of the children of the control group met the SIgAD criteria. Female / male ratio among the patients with SIgAD was 1/6. There was no history of recurrent infections in these patients. No correlation between IgA and HbA1c levels was detected. Autoimmune thyroiditis was observed in 42.9% of patients with DM and SIgAD, and in 3.5% of patients with DM and normal or increased IgA levels. Thus, the prevalence of selective IgA deficiency in children with DM in Ternopil region (Ukraine) is 2.9% (1:34). This study shows that patients with low IgA levels need further re-examination of IgA levels to exclude SIgAD. Children with SIgAD and DM should be monitored for autoimmune manifestations that may affect the course and consequences of the disease.

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Autoimmune thyroiditis in patients with type 1 diabetes mellitus: A long-term follow-up study

Cited by 12 publications

References 21 publications

Graves disease is more prevalent than Hashimoto disease in children and adolescents with type 1 diabetes

Graves disease is more prevalent than Hashimoto disease in children and adolescents with type 1 diabetes

Cord blood metabolomics reveals gestational metabolic disorder associated with anti-thyroid peroxidase antibodies positivity

Selective immunoglobulin A deficiency in children with diabetes mellitus: Data from a medical center in Ukraine

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