A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Early appearance of thyroid autoimmunity in children followed from birth for type 1 diabetes risk
Tekijät: Jonsdottir, Berglind; Clasen, Joanna L; Vehik, Kendra; Lernmark, Åke; Lundgren, Markus; Bonifacio, Ezio; Schatz, Desmond; Ziegler, Anette-Gabriele; Hagopian, William; Rewers, Marian; McIndoe, Richard; Toppari, Jorma; Krischer, Jeffrey; Akolkar, Beena; Steck, Andrea; Veijola, Riitta; Haller, Michael J; Elding Larsson, Helena; the TEDDY Study Group
Kustantaja: Oxford University Press
Julkaisuvuosi: 2025
Journal: Journal of Clinical Endocrinology and Metabolism
Tietokannassa oleva lehden nimi: The Journal of clinical endocrinology and metabolism
Lehden akronyymi: J Clin Endocrinol Metab
Vuosikerta: 110
Numero: 2
Aloitussivu: 498
Lopetussivu: 510
ISSN: 0021-972X
eISSN: 1945-7197
DOI: https://doi.org/10.1210/clinem/dgae478
Verkko-osoite: https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgae478/7712979?login=true
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/457221724
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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Julkaisussa olevat rahoitustiedot:
The TEDDY Study was supported by U01 DK63829, U01 DK63861, U01 DK63821, U01 DK63865, U01 DK63863, U01 DK63836, U01 DK63790, UC4 DK63829, UC4 DK63861, UC4 DK63821, UC4 DK63865, UC4 DK63863, UC4 DK63836, UC4 DK95300, UC4 DK100238, UC4 DK106955, UC4 DK112243, UC4 DK117483, U01 DK124166, U01 DK128847, and contract No. HHSN267200700014C from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute of Allergy and Infectious Diseases (NIAID), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute of Environmental Health Sciences (NIEHS), Centers for Disease Control and Prevention (CDC), and JDRF. This work is supported in part by the NIH/NCATS Clinical and Translational Science Awards to the University of Florida (UL1 TR000064) and the University of Colorado (UL1 TR002535). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
