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Thyroid and islet autoantibodies predict autoimmune thyroid disease already at Type 1 diabetes diagnosis

Jonsdottir, Berglind LU ; Larsson, Christer LU ; Carlsson, Annelie LU ; Forsander, Gun; Ivarsson, Sten Anders LU ; Lernmark, Åke LU ; Ludvigsson, Johnny; Marcus, Claude; Samuelsson, Ulf and Örtqvist, Eva, et al. (2017) In The Journal of clinical endocrinology and metabolism 102(4). p.1277-1285
Abstract

CONTEXT: Screening of autoimmune thyroid disease in children and young adults with Type 1 diabetes is important but vary greatly between clinics.

OBJECTIVE: The aim was to determine the predictive value of thyroid autoantibodies, thyroid function, islet autoantibodies, and HLA- DQ at diagnosis of Type 1 diabetes for autoimmune thyroid disease during subsequent follow-up.

SETTING: 43 Paediatric Endocrinology units Sweden. Design, patients and main outcome measures: At diagnosis of Type 1 diabetes, samples from 2433 children were analysed for autoantibodies against thyroid peroxidase (TPOAb), thyroglobulin (TGAb), glutamic acid decarboxylase (GADA), insulin (IAA), insulinoma-associated protein-2 (IA-2A), and the three variants... (More)

CONTEXT: Screening of autoimmune thyroid disease in children and young adults with Type 1 diabetes is important but vary greatly between clinics.

OBJECTIVE: The aim was to determine the predictive value of thyroid autoantibodies, thyroid function, islet autoantibodies, and HLA- DQ at diagnosis of Type 1 diabetes for autoimmune thyroid disease during subsequent follow-up.

SETTING: 43 Paediatric Endocrinology units Sweden. Design, patients and main outcome measures: At diagnosis of Type 1 diabetes, samples from 2433 children were analysed for autoantibodies against thyroid peroxidase (TPOAb), thyroglobulin (TGAb), glutamic acid decarboxylase (GADA), insulin (IAA), insulinoma-associated protein-2 (IA-2A), and the three variants of the zinc transporter 8 (ZnT8W/R/QA) as well as HLA-DQA1-B1 genotypes and thyroid function. After 5.1-9.5 years disease duration, children treated with thyroxine were identified in the Swedish National Board of Health and Welfare Prescribed Drug Register.

RESULTS: Thyroxine had been prescribed to 6% (147/2433; 66% girls). In patients below 5 years, female gender (HR=4.60, p=0.008) and GADA (HR=5.80, p=0.02) were significant predictors. In patients 5-10 years, TPOAb (HR=20.56, p<0.0001), TGAb (HR=3.40, p=0.006) and TSH outside the reference limit (HR=3.64, p<0.001) were predictors while in the 10-15 year olds, TPOAb (HR=17.00, p<0.001) and TSH outside the reference limit (HR=4.11, p<0.001) predicted future thyroxine prescription.

CONCLUSION: In addition to TPOAb and TSH, positive GADA tested at the diagnosis of type 1 diabetes is important for the prediction of autoimmune thyroid disease in children below 5 years of age.

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Journal Article
in
The Journal of clinical endocrinology and metabolism
volume
102
issue
4
pages
1277 - 1285
publisher
The Endocrine Society
external identifiers
  • scopus:85017306337
  • wos:000402195300021
ISSN
1945-7197
DOI
10.1210/jc.2016-2335
language
English
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yes
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29d2e78d-1fc0-4062-aded-345fea476174
date added to LUP
2017-03-21 16:16:18
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2018-04-01 04:30:49
@article{29d2e78d-1fc0-4062-aded-345fea476174,
  abstract     = {<p>CONTEXT: Screening of autoimmune thyroid disease in children and young adults with Type 1 diabetes is important but vary greatly between clinics.</p><p>OBJECTIVE: The aim was to determine the predictive value of thyroid autoantibodies, thyroid function, islet autoantibodies, and HLA- DQ at diagnosis of Type 1 diabetes for autoimmune thyroid disease during subsequent follow-up.</p><p>SETTING: 43 Paediatric Endocrinology units Sweden. Design, patients and main outcome measures: At diagnosis of Type 1 diabetes, samples from 2433 children were analysed for autoantibodies against thyroid peroxidase (TPOAb), thyroglobulin (TGAb), glutamic acid decarboxylase (GADA), insulin (IAA), insulinoma-associated protein-2 (IA-2A), and the three variants of the zinc transporter 8 (ZnT8W/R/QA) as well as HLA-DQA1-B1 genotypes and thyroid function. After 5.1-9.5 years disease duration, children treated with thyroxine were identified in the Swedish National Board of Health and Welfare Prescribed Drug Register.</p><p>RESULTS: Thyroxine had been prescribed to 6% (147/2433; 66% girls). In patients below 5 years, female gender (HR=4.60, p=0.008) and GADA (HR=5.80, p=0.02) were significant predictors. In patients 5-10 years, TPOAb (HR=20.56, p&lt;0.0001), TGAb (HR=3.40, p=0.006) and TSH outside the reference limit (HR=3.64, p&lt;0.001) were predictors while in the 10-15 year olds, TPOAb (HR=17.00, p&lt;0.001) and TSH outside the reference limit (HR=4.11, p&lt;0.001) predicted future thyroxine prescription.</p><p>CONCLUSION: In addition to TPOAb and TSH, positive GADA tested at the diagnosis of type 1 diabetes is important for the prediction of autoimmune thyroid disease in children below 5 years of age.</p>},
  author       = {Jonsdottir, Berglind and Larsson, Christer and Carlsson, Annelie and Forsander, Gun and Ivarsson, Sten Anders and Lernmark, Åke and Ludvigsson, Johnny and Marcus, Claude and Samuelsson, Ulf and Örtqvist, Eva and Elding Larsson, Helena and , },
  issn         = {1945-7197},
  keyword      = {Journal Article},
  language     = {eng},
  number       = {4},
  pages        = {1277--1285},
  publisher    = {The Endocrine Society},
  series       = {The Journal of clinical endocrinology and metabolism},
  title        = {Thyroid and islet autoantibodies predict autoimmune thyroid disease already at Type 1 diabetes diagnosis},
  url          = {http://dx.doi.org/10.1210/jc.2016-2335},
  volume       = {102},
  year         = {2017},
}