Thyroid autoantibodies and their clinical relevance in young adults with type 1 diabetes during the first 12 yr after diabetes onset.
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 mlU/I 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.
Vondra
K
K
Institute of Endocrinology, Prague, Czech Republic. kvondra@endo.cz
Vrbíková
J
J
Sterzl
I
I
Bílek
R
R
Vondrova
M
M
Zamrazil
V
V
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000032:analysis / Q000276:immunology*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000276:immunology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007037:Hypothyroidism / Q000276:immunology; D007453:Iodide Peroxidase / Q000276:immunology; D008297:Male; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000276:immunology*; D013967:Thyroiditis, Autoimmune / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000276:immunology*; D014463:Ultrasonography
D001323:Autoantibodies; D007453:Iodide Peroxidase