Thyroid and Islet Autoantibodies Predict Autoimmune Thyroid Disease at Type 1 Diabetes Diagnosis

Context:Screening of autoimmune thyroid disease in children with type 1 diabetes is important but varies between clinics.Objective:To determine the predictive value of thyroid autoantibodies, thyroid function, islet autoantibodies, and HLA-DQ at diagnosis of type 1 diabetes for autoimmune thyroid di...

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Vydáno v:	The journal of clinical endocrinology and metabolism Ročník 102; číslo 4; s. 1277 - 1285
Hlavní autoři:	Jonsdottir, Berglind, Larsson, Christer, Carlsson, Annelie, Forsander, Gun, Ivarsson, Sten Anders, Lernmark, Åke, Ludvigsson, Johnny, Marcus, Claude, Samuelsson, Ulf, Örtqvist, Eva, Larsson, Helena Elding
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Washington, DC Endocrine Society 01.04.2017 Copyright Oxford University Press Oxford University Press
Témata:	Adolescent Autoantibodies Autoantibodies - blood Autoimmune Diseases - blood Autoimmune Diseases - diagnosis Autoimmune Diseases - immunology Child Child, Preschool Children Clinical s Diabetes Diabetes mellitus Diabetes mellitus (insulin dependent) Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - diagnosis Diabetes Mellitus, Type 1 - immunology Diagnosis DQA1 protein Endocrinology Female Genotypes Glutamate decarboxylase Glutamic acid Health risk assessment Histocompatibility antigen HLA Humans Insulin Insulin - immunology Insulinoma Iodide peroxidase Iodide Peroxidase - immunology Islets of Langerhans - immunology Male Neuroendocrine tumors Patients Pediatrics Peroxidase Protein transport Sex ratio Thyroglobulin Thyroglobulin - immunology Thyroid Thyroid diseases Thyroid Diseases - blood Thyroid Diseases - diagnosis Thyroid Diseases - immunology Thyroid-stimulating hormone Thyroxine Thyroxine - therapeutic use Zinc transporter
ISSN:	0021-972X, 1945-7197, 1945-7197
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Shrnutí:	Context:Screening of autoimmune thyroid disease in children with type 1 diabetes is important but varies between clinics.Objective: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 follow-up.Setting:Forty-three Swedish pediatric endocrinology units.Design, Patients, and Main Outcome Measures:At diagnosis of type 1 diabetes, autoantibodies against thyroid peroxidase (TPOAb), thyroglobulin (TGAb), glutamic acid decarboxylase (GADA), insulin, insulinoma-associated protein-2, and 3 variants of zinc transporter 8 (ZnT8W/R/QA) HLA-DQA1-B1 genotypes and thyroid function were analyzed in 2433 children. After 5.1 to 9.5 years, information on thyroxine treatment was gathered from the Swedish National Board of Health and Welfare’s Prescribed Drug Register.Results:Thyroxine was prescribed to 6% of patients. In patients <5 years of age, female sex [hazard ratio (HR) = 4.60; P = 0.008] and GADA (HR = 5.80; P = 0.02) were predictors. In patients 5 to 10 years old, TPOAb (HR = 20.56; P < 0.0001), TGAb (HR = 3.40; P = 0.006), and thyroid-stimulating hormone (TSH) (HR = 3.64; P < 0.001) were predictors, whereas in 10 to 15 year olds, TPOAb (HR = 17.00; P < 0.001) and TSH (HR = 4.11; P < 0.001) predicted thyroxine prescription.Conclusion:In addition to TPOAb and TSH, GADA at diagnosis of type 1 diabetes is important for the prediction of autoimmune thyroid disease in children <5 years of age.We studied whether markers at type 1 diabetes diagnosis were predictive of later autoimmune thyroid disease. We found that TPOAb and TSH as well as GADA were predictive in girls ˂5 years old at diagnosis.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Members of the Better Diabetes Diagnosis study group are listed in the Appendix.
ISSN:	0021-972X 1945-7197 1945-7197
DOI:	10.1210/jc.2016-2335