Saare Liisa, Peet Aleksandr, Tillmann Vallo
Department of Paediatrics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
Children's Clinic, Tartu University Hospital, Tartu, Estonia.
J Pediatr Endocrinol Metab. 2020 Jul 7. doi: 10.1515/jpem-2019-0512.
Background The need for screening for autoimmune thyroid disease in children who have HLA-conferred susceptibility to type 1 diabetes (T1D), but have not yet been diagnosed with T1D, has not been thoroughly studied. The aim of this study was to describe the prevalence of positive thyroid peroxidase antibodies and its effect on thyroid function in children with genetic susceptibility to T1D as well as to describe the association between thyroid autoimmunity and HLA-DQ genotypes. Methods Cross-sectional study in 223 children (112 boys) aged 7.4-10.5 years with HLA-conferred susceptibility to T1D. TPOAb were measured in all children; thyroglobulin antibodies (TGAb) and thyroid function in TPOAb positive subjects. Results Girls had a significantly higher median TPOAb concentration than boys (12 vs 11 kU/L; p=0.001). Positive TPOAb occurred in 13.9% and positive TGAb in 4% of subjects. Only two children had mild changes in thyroid function. There was no association between HLA risk groups and the prevalence of TPOAb. Conclusions TPOAb are common in children with HLA-conferred susceptibility to T1D, yet are weakly associated with thyroid function, suggesting limited value of thyroid screening in this cohort.
对于具有1型糖尿病（T1D）HLA相关易感性但尚未被诊断为T1D的儿童，筛查自身免疫性甲状腺疾病的必要性尚未得到充分研究。本研究的目的是描述T1D遗传易感性儿童中甲状腺过氧化物酶抗体阳性的患病率及其对甲状腺功能的影响，并描述甲状腺自身免疫与HLA-DQ基因型之间的关联。方法：对223名年龄在7.4至10.5岁之间、具有T1D HLA相关易感性的儿童（112名男孩）进行横断面研究。对所有儿童检测甲状腺过氧化物酶抗体（TPOAb）；对TPOAb阳性受试者检测甲状腺球蛋白抗体（TGAb）和甲状腺功能。结果：女孩的TPOAb中位数浓度显著高于男孩（12 vs 11 kU/L；p=0.001）。13.9%的受试者TPOAb阳性，4%的受试者甲状腺球蛋白抗体（TGAb）阳性。只有两名儿童甲状腺功能有轻微变化。HLA风险组与TPOAb患病率之间无关联。结论：TPOAb在具有T1D HLA相关易感性的儿童中很常见，但与甲状腺功能的相关性较弱，提示在该队列中甲状腺筛查价值有限。
