The Sardinian Autoimmunity Study: 3. Studies on Circulating Antithyroid Antibodies in Sardinian Schoolchildren: Relationship to Goiter Prevalence and Thyroid Function

Abstract

The relationship among iodine intake, goiter prevalence, and thyroid autoimmunity remains controversial. In the present article, we report the prevalence of antithyroid antibodies (ATA) in relation to iodine intake, frequency of goiter, and thyroid function in a large group of Sardinian schoolchildren living in areas with borderline iodine sufficiency, or mild to moderate iodine deficiency. A total of 8,040 schoolchildren (4,194 males, 3,846 females, ages 6-15 years) from 29 communities were examined between 1986-1994. Thyroid size was assessed by palpation, according to the Pan American Health Organization (PAHO) criteria. In all cases antimicrosomal (MAb) or antithyroid peroxidase antibodies (TPOAb) and thyrotropin (TSH) were assayed. Urinary iodine was determined in a subgroup of 820 children. ATA was detected in 235 (2.92%) sera (88 males, 2.12%; 147 females, 3.82%; chi2 = 20.41, p < 0.0001). ATA prevalence ranged between 0.0%-7.3% in the 29 communities without any geographical correlation with goiter prevalence and urinary iodine excretion. However, ATA was more frequently detected in goitrous children, especially in females. The presence of ATA was not age-dependent in males, whereas a significant increase of ATA was observed in females older than 11 years of age. Seventy-seven (0.96%) children showed borderline to slightly increased serum TSH (>5.2-32 mU/L). Increased serum TSH concentration was more frequently found in children with ATA, especially at higher titers. In summary, our study in Sardinian schoolchildren indicates: (1) ATA display geographical heterogeneity, which seems to be unrelated to goiter prevalence and/or to iodine supply; (2) ATA are more frequently detected in females older than 11 years of age, suggesting that puberty has a role in determining the predominance in females of thyroid autoimmunity; (3) although most goitrous children are ATA-negative, the prevalence of ATA is increased in children with enlarged glands; (4) ATA is associated with an increased prevalence of subclinical hypothyroidism.

The usefulness of 99mTc-sestaMIBI thyroid scan in the differential diagnosis and management of amiodarone-induced thyrotoxicosis

“…Normal-3 and 24-h RAIU values in our area, which is borderline iodine deficient (31), ranged between 5-20 and 14-40% respectively.…”

Age-related islet autoantibody incidence in offspring of patients with type 1 diabetes

“…It is, however, interesting to note that another type of autoimmunity has high incidence periods at a later age; seroconversion to TPO autoantibodies was frequent in this cohort, but did not reach high levels until puberty and appeared to peak in adolescence. The thyroid organ undergoes remodelling around this age as a result of increased activity [22][23][24], potentially explaining the increased rate of TPO autoimmunity. Interestingly, neonatal remodelling of the pancreas has been suggested to be involved in the pathogenesis of diabetes in the NOD mouse [25].…”

Prevalence of hypothyroidism among children and adolescents with diabetes mellitus by results of selective screening

“…По литературным данным, распространенность АИТ в детской популяции находится в пределах от 2,1 до 3,4% [6][7][8][9]. У детей младше 9 лет АИТ встреча ется редко, с последующим увеличением его доли в период полового созревания, причем преимущест венно за счет лиц женского пола [6][7][8].…”

“…У детей младше 9 лет АИТ встреча ется редко, с последующим увеличением его доли в период полового созревания, причем преимущест венно за счет лиц женского пола [6][7][8]. Сведения о нарушении функции щитовидной железы (ЩЖ) в исходе АИТ у детей достаточно противоречивы.…”