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Early appearance of thyroid autoimmunity in children followed from birth for type 1 diabetes risk

Jonsdottir, Berglind LU ; Clasen, Joanna L ; Vehik, Kendra LU ; Lernmark, Åke LU orcid ; Lundgren, Markus LU ; Bonifacio, Ezio ; Schatz, Desmond ; Ziegler, Anette-Gabriele ; Hagopian, William and Rewers, Marian , et al. (2024) In The Journal of clinical endocrinology and metabolism
Abstract

PURPOSE: Autoantibodies to thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) define pre-clinical autoimmune thyroid disease (AITD) which can progress to either clinical hypo- or hyperthyroidism. We determined the age at seroconversion in children genetically at risk for type 1 diabetes.

METHODS: TPOAb and TgAb seropositivity were determined in 5066 healthy children with HLA DR3 or DR4 containing haplogenotypes from The Environmental Determinants of Diabetes in the Young (TEDDY) Study. Children seropositive on the cross-sectional initial screen at 8-13 years of age had longitudinally collected samples (from 3.5 months of age) screened retrospectively and prospectively for thyroid autoantibodies to identify the age at... (More)

PURPOSE: Autoantibodies to thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) define pre-clinical autoimmune thyroid disease (AITD) which can progress to either clinical hypo- or hyperthyroidism. We determined the age at seroconversion in children genetically at risk for type 1 diabetes.

METHODS: TPOAb and TgAb seropositivity were determined in 5066 healthy children with HLA DR3 or DR4 containing haplogenotypes from The Environmental Determinants of Diabetes in the Young (TEDDY) Study. Children seropositive on the cross-sectional initial screen at 8-13 years of age had longitudinally collected samples (from 3.5 months of age) screened retrospectively and prospectively for thyroid autoantibodies to identify the age at seroconversion. First-appearing autoantibody was related to sex, HLA genotype, family history of AITD, and subsequent thyroid dysfunction and disease.

RESULTS: The youngest appearance of TPOAb and TgAb was 10 and 15 months of age, respectively. Girls had higher incidence rates of both autoantibodies. Family history of AITD was associated with a higher risk of TPOAb hazard ratio [HR] 1.90, 95% confidence interval [CI] 1.17, 3.08; and TgAb HR 2.55, 95% CI 1.91, 3.41. The risk of progressing to hypo- or hyperthyroidism was not different between TgAb and TPOAb, but children with both autoantibodies appearing at the same visit had a higher risk compared to TPOAb appearing first (HR 6.34, 95% CI 2.72, 14.76).

MAIN CONCLUSION: Thyroid autoantibodies may appear during the first years of life, especially in girls, and in children with a family history of AITD. Simultaneous appearance of both autoantibodies increases the risk for hypo- or hyperthyroidism.

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type
Contribution to journal
publication status
epub
subject
in
The Journal of clinical endocrinology and metabolism
article number
dgae478
publisher
Oxford University Press
external identifiers
  • pmid:38996042
ISSN
1945-7197
DOI
10.1210/clinem/dgae478
language
English
LU publication?
yes
additional info
© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.
id
c58cb7ed-9403-46b0-97bd-d673d8a3befa
date added to LUP
2024-07-13 12:14:05
date last changed
2024-07-15 15:04:40
@article{c58cb7ed-9403-46b0-97bd-d673d8a3befa,
  abstract     = {{<p>PURPOSE: Autoantibodies to thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) define pre-clinical autoimmune thyroid disease (AITD) which can progress to either clinical hypo- or hyperthyroidism. We determined the age at seroconversion in children genetically at risk for type 1 diabetes.</p><p>METHODS: TPOAb and TgAb seropositivity were determined in 5066 healthy children with HLA DR3 or DR4 containing haplogenotypes from The Environmental Determinants of Diabetes in the Young (TEDDY) Study. Children seropositive on the cross-sectional initial screen at 8-13 years of age had longitudinally collected samples (from 3.5 months of age) screened retrospectively and prospectively for thyroid autoantibodies to identify the age at seroconversion. First-appearing autoantibody was related to sex, HLA genotype, family history of AITD, and subsequent thyroid dysfunction and disease.</p><p>RESULTS: The youngest appearance of TPOAb and TgAb was 10 and 15 months of age, respectively. Girls had higher incidence rates of both autoantibodies. Family history of AITD was associated with a higher risk of TPOAb hazard ratio [HR] 1.90, 95% confidence interval [CI] 1.17, 3.08; and TgAb HR 2.55, 95% CI 1.91, 3.41. The risk of progressing to hypo- or hyperthyroidism was not different between TgAb and TPOAb, but children with both autoantibodies appearing at the same visit had a higher risk compared to TPOAb appearing first (HR 6.34, 95% CI 2.72, 14.76).</p><p>MAIN CONCLUSION: Thyroid autoantibodies may appear during the first years of life, especially in girls, and in children with a family history of AITD. Simultaneous appearance of both autoantibodies increases the risk for hypo- or hyperthyroidism.</p>}},
  author       = {{Jonsdottir, Berglind and Clasen, Joanna L and Vehik, Kendra and Lernmark, Åke and Lundgren, Markus and Bonifacio, Ezio and Schatz, Desmond and Ziegler, Anette-Gabriele and Hagopian, William and Rewers, Marian and McIndoe, Richard and Toppari, Jorma and Krischer, Jeffrey and Akolkar, Beena and Steck, Andrea and Veijola, Riitta and Haller, Michael J and Elding Larsson, Helena}},
  issn         = {{1945-7197}},
  language     = {{eng}},
  month        = {{07}},
  publisher    = {{Oxford University Press}},
  series       = {{The Journal of clinical endocrinology and metabolism}},
  title        = {{Early appearance of thyroid autoimmunity in children followed from birth for type 1 diabetes risk}},
  url          = {{http://dx.doi.org/10.1210/clinem/dgae478}},
  doi          = {{10.1210/clinem/dgae478}},
  year         = {{2024}},
}