Abstract
In order to obtain prospective data on occurrence of thyroid autoantibodies [against thyroid peroxidase (antiTPO) and against thyroglobulin (antiTgl)] and their clinical relevance, we followed up on 109 young adults with Type 1 diabetes for 12 yr after diabetes onset. The patients were divided into subgroup I [positivity of both thyroid autoantibodies (T-Ab); 25%, women predominantly], subgroup II (isolated antiTPO positivity only, 26%, men and women equally) and subgroup III (thyroid autoimmunity not present, 49%, men mainly). Cumulative incidence of T-Ab during the 12 yr of follow-up was 51% with predominance of women over men (65% vs 38%, p<0.01). At the time of the first T-Ab detection, an ultrasonography pattern of a hypoechogenic thyroid gland was noted in 59% of subgroup I patients and in 25% of subgroup II patients (p<0.05). At the same time, TSH>4.5 mIU/l was shown in 30 and 7% of patients of subgroups I and II, respectively (p<0.05). In the patients with the repeated positivity of both T-Ab (subgroup I) subclinical hypothyroidism developed in all patients within 4 yr after the first detection of T-Ab. On the contrary, the clinical course in patients with isolated antiTPO positivity (subgroup II) was milder with 11% developing subclinical hypothyroidism within 4 yr after the first antiTPO detection (p<0.001). The data shed new light on the relative diagnostic value of thyroid antibodies, ultrasonography and functional examination for an early detection of thyroid autoimmunity of adult diabetic patients.
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Kordonouri O, Klinghammer A, Lang EB, Gruters-Kieslich AG, Grabert M, Holl RW. Thyroid autoimmunity in children and adolescent with type 1 diabetes: a multicenter survey. Diabetes Care 2002, 25: 1346–50.
Umpierrez GE, Latif KA, Murphy MB, et al. Thyroid dysfunction in patients with Type 1 diabetes: a longitudinal study. Diabetes Care 2003, 26: 1181–5.
Kordonouri O, Deiss D, Danne T, Dorow A, Bassir C, Gruters-Kieslich. A Predictivity of thyroid autoantibodies for the development overt thyroid disorders in children and adolescents with type 1 diabetes. Diabet Med 2002, 19: 518–21.
Hansen D, Bennedbaek FN, Hober-Madsen M, Hegedus L, Jacobsen BB. A prospective study of thyroid function, morphology and autoimmunity in young patients with type 1 diabetes. Eur J Endocrinol 2003, 148: 245–51.
Bednar J. Thyroid gland antibodies. Methods and clinical significance. Vntr Lek 1992, 38: 887–96.
Vrbikova J, Zamrazil V, Tomiško F, Novák Z, Vlcek P. Ultrasonographic examination of thyroid gland in 3 regions of Czech Republic in past with different degree of iodine endemia. Eur J Endocrinol 1994, 130 (Suppl 2): 133.
Zamrazil V, Cerovská J, Šimeiková A, Dvoráková M, Bílek R. Iodine deficiency and iodine supply in Czech Republic. Contemporary situation (German). In: Baesch K eds. Aktuelle Aspekte des Iodmangels und Ioduberschuss. 3. Interdisziplinares Iodsymposium. Berlin, Wien/u.a./: Blackwell-Wiss.-Verl. 2000, 21–33.
Holl RW, Bohm B, Loos U, Grabert M, Heinze E, Homoki J. Thyroid autoimmunity in children and adolescents with type 1 diabetes mellitus. Effect of age, gender, and HLA type. Horm Res 1999, 52: 113–8.
Maugendre D, Sonnet E, Derrien C, et al. Combined analysis of long-term anti-beta-cell humoral reactivity in type 1 diabetes with and without thyroid disease. Diabetes Metab 1999, 25: 28–33.
Raber W, Gessl A, Nowotny P, Vierhapper H. Thyroid ultrasound versus antithyroid peroxidase antibody determination: a cohort study of four hundred fifty-one subjects. Thyroid 2002, 12: 725–31.
Rago T, Chiovato L, Grasso L, Pinchera A, Vitti P. Thyroid ultrasonography as a tool for detecting thyroid autoimmune diseases and predicting thyroid dysfunction in apparently healthy subjects. J Endocrinol Invest 2001, 24: 763–9.
Mohn A, Di Michele S, Di Luzio R, Tumini S, Chiarelli F. The effect of subclinical hypothyroidism on metabolic control in children and adolescents with Type 1 diabetes mellitus. Diabet Med 2002, 19: 70–3.
Vanderpump, MP, Tunbridge WMG. The epidemiology of autoimmune thyroid disease. In: Volpe R ed. Contemporary endocrinology: autoimmune endocrinopathies. Totowa, NJ: Humana Press Inc. 1999, 141–62.
Geul KW, van Sluisveld ILL, Grobbee DE. The importance of thyroid microsomal antibodies in the development of elevated serum TSH in middle-aged women. Clin Endocrinol (oxf) 1993, 39: 275–80.
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Vondra, K., Vrbíková, J., Šterzl, I. et al. Thyroid autoantibodies and their clinical relevance in young adults with Type 1 diabetes during the first 12 yr after diabetes onset. J Endocrinol Invest 27, 728–732 (2004). https://doi.org/10.1007/BF03347513
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DOI: https://doi.org/10.1007/BF03347513