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

Berglind Jonsdottir; Christer Larsson; Annelie Carlsson; Gun Forsander; Sten Anders Ivarsson; Åke Lernmark; Johnny Ludvigsson; Claude Marcus; Ulf Samuelsson; Eva Örtqvist; Helena Elding Larsson; BDD Study group

doi:10.1210/jc.2016-2335

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

Berglind Jonsdottir, Christer Larsson, Annelie Carlsson, Gun Forsander, Sten Anders Ivarsson, Åke Lernmark, Johnny Ludvigsson, Claude Marcus, Ulf Samuelsson, Eva Örtqvist, Helena Elding Larsson, BDD Study group

Research output: Contribution to journal › Article › peer-review

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 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.

Original language	English
Pages (from-to)	1277-1285
Journal	The Journal of clinical endocrinology and metabolism
Volume	102
Issue number	4
Early online date	2016 Oct 14
DOIs	https://doi.org/10.1210/jc.2016-2335
Publication status	Published - 2017

Subject classification (UKÄ)

Endocrinology and Diabetes

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Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1210/jc.2016-2335

1 Doctoral Thesis (compilation)

Childhood Thyroid and Islet Autoimmunity. Immunogenetics, Risk Factors and Prediction
Jonsdottir, B., 2017, Lund: Lund University: Faculty of Medicine. 109 p.
Research output: Thesis › Doctoral Thesis (compilation)

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BDD: Better Diabetes Diagnosis (BDD)
Carlsson, A. (PI), Lernmark, Å. (CoI), Elding Larsson, H. (CoI), Forsander, G. (Researcher), Ivarsson, S. (Researcher), Marcus, C. (Researcher), Ludvigsson, J. (CoI), Persson, M. (Researcher), Samuelsson, U. (Researcher), Åkesson, K. (Researcher) & Pundziute Lyckå, A. (Researcher)
Barndiabetesfonden, Diabetesfonden - Stiftelsen Svenska Diabetesförbundets Forskningsfond
2005/05/01 → …
Project: Research

Cite this

Jonsdottir, B., Larsson, C., Carlsson, A., Forsander, G., Ivarsson, S. A., Lernmark, Å., Ludvigsson, J., Marcus, C., Samuelsson, U., Örtqvist, E., Elding Larsson, H., & BDD Study group (2017). Thyroid and islet autoantibodies predict autoimmune thyroid disease already at Type 1 diabetes diagnosis. The Journal of clinical endocrinology and metabolism, 102(4), 1277-1285. https://doi.org/10.1210/jc.2016-2335

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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 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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Jonsdottir, B , Larsson, C , Carlsson, A, Forsander, G, Ivarsson, SA , Lernmark, Å, Ludvigsson, J, Marcus, C, Samuelsson, U, Örtqvist, E, Elding Larsson, H & BDD Study group 2017, 'Thyroid and islet autoantibodies predict autoimmune thyroid disease already at Type 1 diabetes diagnosis', The Journal of clinical endocrinology and metabolism, vol. 102, no. 4, pp. 1277-1285. https://doi.org/10.1210/jc.2016-2335

TY - JOUR

T1 - Thyroid and islet autoantibodies predict autoimmune thyroid disease already at Type 1 diabetes diagnosis

AU - Jonsdottir, Berglind

AU - Larsson, Christer

AU - Carlsson, Annelie

AU - Forsander, Gun

AU - Ivarsson, Sten Anders

AU - Lernmark, Åke

AU - Ludvigsson, Johnny

AU - Marcus, Claude

AU - Samuelsson, Ulf

AU - Örtqvist, Eva

AU - Elding Larsson, Helena

AU - BDD Study group

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - Journal Article

U2 - 10.1210/jc.2016-2335

DO - 10.1210/jc.2016-2335

M3 - Article

C2 - 27740884

SN - 1945-7197

VL - 102

SP - 1277

EP - 1285

JO - The Journal of clinical endocrinology and metabolism

JF - The Journal of clinical endocrinology and metabolism

IS - 4

ER -

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

Abstract

Subject classification (UKÄ)

Free keywords

UN SDGs

Access to Document

Fingerprint

Research output

Childhood Thyroid and Islet Autoimmunity. Immunogenetics, Risk Factors and Prediction

Projects

BDD: Better Diabetes Diagnosis (BDD)

Cite this