碘充足地区儿童和青少年中抗甲状腺过氧化物酶抗体及自身免疫性甲状腺炎的患病率

The prevalence of anti-thyroid peroxidase antibodies and autoimmune thyroiditis in children and adolescents in an iodine replete area.

作者信息

Kabelitz M, Liesenkötter K P, Stach B, Willgerodt H, Stäblein W, Singendonk W, Jäger-Roman E, Litzenbörger H, Ehnert B, Grüters A

机构信息

University Children's Hospital Charite, Humboldt University Berlin, Augustenburger Platz 1, Germany.

出版信息

Eur J Endocrinol. 2003 Mar;148(3):301-7. doi: 10.1530/eje.0.1480301.

DOI:10.1530/eje.0.1480301

PMID:12611610

Abstract

BACKGROUND

The iodine supply of the population in Berlin has normalized during the last 5 Years. Therefore autoimmune thyroiditis has become the most important differential diagnosis in children and adolescents with goiter.

OBJECTIVE

The aim of the present study was to define the prevalence of anti-thyroid peroxidase (TPO) antibodies and autoimmune thyroiditis in children and adolescents with a normalized iodine intake.

DESIGN

To enable the measurement of antibodies to thyroid peroxidase (anti-TPO-Ab) in a large cohort, a method to determine anti-TPO-Ab in dried filter paper blood spots was established. In co-operation with pediatricians the antibody prevalence was assessed and data regarding thyroid size, echostructure and the medical history concerning iodine intake and familial thyroid diseases were collected.

METHODS

660 children and adolescents participated in the study; urinary iodine, TSH and TPO-Ab were measured and an ultrasound of the thyroid gland was performed.

RESULTS

The sensitivity of the newly established filter paper assay was 91.8% and specificity was 100%. The results confirmed the improved iodine supply, with a median urinary iodine concentration of 139 microg iodine/g creatinine. The prevalence of anti-TPO-Ab was 3.4% with a female to male ratio of 2.7:1.

CONCLUSION

The prevalence of anti-TPO-Ab is lower or equal to data reported from other iodine sufficient areas. Data from a moderate iodine deficiency in schoolchildren range from 0.0 to 7.3%. Using the new filter paper method field studies can be implemented to monitor the effect of changes in iodine nutrition on thyroid autoimmunity. Furthermore, this study on the prevalence of anti-TPO-Ab in a cohort of healthy children and adolescents in an iodine replete area can serve as reference data for future investigations and for the comparison with other groups of patients with increased risks for thyroid autoimmunity.

摘要

背景

在过去5年中，柏林人群的碘供应已恢复正常。因此，自身免疫性甲状腺炎已成为儿童和青少年甲状腺肿最重要的鉴别诊断。

目的

本研究的目的是确定碘摄入量正常的儿童和青少年中抗甲状腺过氧化物酶（TPO）抗体和自身免疫性甲状腺炎的患病率。

设计

为了能够在大量队列中测量甲状腺过氧化物酶抗体（抗-TPO-Ab），建立了一种在干滤纸血斑中测定抗-TPO-Ab的方法。与儿科医生合作，评估抗体患病率，并收集有关甲状腺大小、回声结构以及碘摄入和家族性甲状腺疾病病史的数据。

方法

660名儿童和青少年参与了该研究；测量尿碘、促甲状腺激素（TSH）和TPO-Ab，并对甲状腺进行超声检查。

结果

新建立的滤纸检测方法的灵敏度为91.8%，特异性为100%。结果证实碘供应有所改善，尿碘浓度中位数为139微克碘/克肌酐。抗-TPO-Ab的患病率为3.4%，女性与男性之比为2.7:1。

结论

抗-TPO-Ab的患病率低于或等于其他碘充足地区报告的数据。学龄儿童中度碘缺乏的数据范围为0.0%至7.3%。使用新的滤纸方法可以开展现场研究，以监测碘营养变化对甲状腺自身免疫的影响。此外，这项关于碘充足地区健康儿童和青少年队列中抗-TPO-Ab患病率的研究可为未来的调查以及与其他甲状腺自身免疫风险增加的患者群体进行比较提供参考数据。