title: Thyroid autoimmunity in children and adolescents with type 1 diabetes: a multicenter survey.
abstract: OBJECTIVE
  To investigate thyroid autoimmunity in a very large nationwide cohort of children and adolescents with type 1 diabetes.
  
  
  METHODS
  Data were analyzed from 17,749 patients with type 1 diabetes aged 0.1-20 years who were treated in 118 pediatric diabetes centers in Germany and Austria. Antibodies to thyroglobulin (anti-TG) and thyroperoxidase (anti-TPO) were measured and documented at least once in 7,097 patients. A total of 49.5% of these patients were boys, the mean age was 12.4 years (range 0.3-20.0 years), and the mean duration of diabetes was 4.5 years (range 0.0-19.5 years). A titer exceeding 100 units/ml or 1:100 was considered significantly elevated.
  
  
  RESULTS
  In 1,530 patients, thyroid antibody levels were elevated on at least one occasion, whereas 5,567 were antibody-negative during the observation period. Patients with thyroid antibodies were significantly older (P < 0.001), had a longer duration of diabetes (P < 0.001), and developed diabetes later in life (P < 0.001) than those without antibodies. A total of 63% of patients with positive antibodies were girls, compared with 45% of patients without antibodies (P < 0.001). The prevalence of significant thyroid antibody titers increased with increasing age; the highest prevalence was in the 15- to 20-year age group (anti-TPO: 16.9%, P < 0.001; anti-TG: 12.8%, P < 0.001). Thyroid-stimulating hormone (TSH) levels were higher in patients with thyroid autoimmunity (3.34 microU/ml, range 0.0-615.0 microU/ml) than in control subjects (1.84 microU/ml, range 0.0-149.0 microU/ml) (P < 0.001). Even higher TSH levels were observed in patients with both anti-TPO and anti-TG (4.55 microU/ml, range 0.0-197.0 microU/ml).
  
  
  CONCLUSIONS
  Thyroid autoimmunity seems to be particularly common in girls with diabetes during the second decade of life and may be associated with elevated TSH levels, indicating subclinical hypothyroidism.
authors.affiliation: Clinic for General Pediatrics, Otto-Heubner Centrum, Charité, Campus Virchow-Klinikum, Humboldt University, Berlin, Germany. olga.kordonouri@charite.de
authors.forename: Olga
authors.initials: O
authors.lastname: Kordonouri
authors.forename: Albrecht
authors.initials: A
authors.lastname: Klinghammer
authors.forename: Egbert B
authors.initials: EB
authors.lastname: Lang
authors.forename: Annette
authors.initials: A
authors.lastname: Grüters-Kieslich
authors.forename: Matthias
authors.initials: M
authors.lastname: Grabert
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D000328:Adult; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology*; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000276:immunology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use; D016036:Seroepidemiologic Studies; D013961:Thyroid Gland / Q000502:physiology; D013967:Thyroiditis, Autoimmune / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000627:therapeutic use
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D013972:Thyrotropin; D013974:Thyroxine