Autoimmune Thyroid Disease in a Cohort of Children With Increased Genetic Susceptibility to Type 1 Diabetes: The Environmental Determinants of Diabetes in the Young Study - UTU Research Portal

A1 Refereed original research article in a scientific journal

Autoimmune Thyroid Disease in a Cohort of Children With Increased Genetic Susceptibility to Type 1 Diabetes: The Environmental Determinants of Diabetes in the Young Study

Authors: Clasen, Joanna L.; Jonsdottir, Berglind; Toppari, Jorma; Johnson, Suzanne; Andren Aronsson, Carin; Lundgren, Markus; Vehik, Kendra; Haller, Michael J.; Elding Larsson, Helena; TEDDY Study Group

Publisher: Wiley

Publication year: 2025

Journal: Clinical Endocrinology

Article number: cen.70070

ISSN: 0300-0664

eISSN: 1365-2265

DOI: https://doi.org/10.1111/cen.70070

Publication's open availability at the time of reporting: No Open Access

Publication channel's open availability : Partially Open Access publication channel

Web address : https://doi.org/10.1111/cen.70070

Abstract

Objective

Clinical autoimmune thyroid disease (AITD), presenting as either hypo- or hyperthyroidism, can occur at any age. Autoantibodies against thyroid peroxidase or thyroglobulin precede the onset of clinical AITD. We aimed to assess factors associated with AITD in children and determine if risk factors for AITD differ among the subset who have developed thyroid autoantibodies.

Design

Prospective cohort study.

Patients

The TEDDY Study is a cohort of 8676 children with increased genetic susceptibility for type 1 diabetes, followed to age 15 years.

Measurements

Hypothyroidism and hyperthyroidism clinical diagnoses as well as medications used for treating AITD were reported to study staff at every visit, 2 to 4 times per year. Children were screened for thyroid autoantibodies at ages 9 and 14, and if positive, previously collected samples were retrospectively analyzed to determine the age when autoantibodies first appeared.

Results

Of 5203 children screened for thyroid autoantibodies, 99 were diagnosed with AITD. Female sex, human leukocyte antigen (HLA) haplogenotype, and family history of hypothyroidism, hyperthyroidism, type 1 diabetes, and celiac disease were associated with risk of AITD. Among the 575 children positive for thyroid autoantibodies, HLA remained associated with AITD, while the estimates for family history were attenuated, and no association was present for sex.

Conclusions

Female sex, family history of autoimmune disease, and HLA haplogenotype are risk factors for AITD in genetically high-risk children, but these trends differ for progression from thyroid autoimmunity to AITD.

Funding information in the publication:
The TEDDY Study is funded 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 Breakthrough T1D (formerly 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.