title: Thyroid autoimmunity and type 1 diabetes in children and adolescents: screening data from Juvenile Diabetes Tuscany Regional Centre.
abstract: OBJECTIVE
  The incidence of autoimmune thyroiditis in patients with type 1 diabetes mellitus (T1DM) is higher than in healthy population. The aim of this study is to investigate epidemiology and natural history of thyroid autoimmunity (AIT), thyroiditis diagnosis and need for therapy in paediatric patients with T1DM and to find the most suitable timing of AIT screening.
  
  
  METHODS
  T1DM patients (493 pts., 268 males and 225 females) treated in the Juvenile Diabetes Tuscany Regional Centre at Meyer's Children Hospital were enrolled to determine TSH, fT4, thyroid autoantibodies levels and to undergo thyroid ultrasound. Anamnestic data about T1DM onset, AIT onset, time frame between T1DM and AIT onsets and the relationship between AIT and celiac disease (CD) were studied.
  
  
  RESULTS
  In the screened population 11.7% of patients presented with increased thyroid autoantibodies, and 63.6% of them showed positive thyroid ultrasound. AIT was significantly more frequent in females compared to males (p < 0.01). The mean age at AIT onset was 11.17 +/- 3.29 years (range 4.99-20, 30) and AIT onset before 12 yrs. of age was found in 54.5% of cases; 18.4% patients (all females) presented CD. The mean time between T1DM and AIT onset was 2.46 +/- 3.41 years (range 0-13, 41). The subgroup with increased thyroid autoantibodies was not statistically different from the whole population with regard to TDM1 duration and mean age at onset.
  
  
  CONCLUSIONS
  AIT is frequently associated with T1DM (11.7%) regardless of age and duration of diabetes. We suggest a yearly screening for AIT after TDM1 onset, at every age.
authors.affiliation: Juvenile Diabetes Tuscany Regional Centre, Meyer's Children Hospital, Florence Italy. lr.lenzi@meyer.it
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Lenzi
authors.forename: Silvia
authors.initials: S
authors.lastname: Mirri
authors.forename: Marta
authors.initials: M
authors.lastname: Generoso
authors.forename: Monica
authors.initials: M
authors.lastname: Guasti
authors.forename: Federica
authors.initials: F
authors.lastname: Barni
authors.forename: Rossella
authors.initials: R
authors.lastname: Pepe
authors.forename: Laura
authors.initials: L
authors.lastname: Nanni
authors.forename: Sonia
authors.initials: S
authors.lastname: Toni
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001323:Autoantibodies / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000276:immunology; D013967:Thyroiditis, Autoimmune / Q000453:epidemiology*
chemical_list: D001323:Autoantibodies