title: Thyroid and Islet Autoantibodies Predict Autoimmune Thyroid Disease at Type 1 Diabetes Diagnosis.
abstract: Screening of autoimmune thyroid disease in children with type 1 diabetes is important but varies between clinics.
  
  
  
  To determine the predictive value of thyroid autoantibodies, thyroid function, islet autoantibodies, and HLA-DQ at diagnosis of type 1 diabetes for autoimmune thyroid disease during follow-up.
  
  
  
  Forty-three Swedish pediatric endocrinology units.
  
  
  
  At diagnosis of type 1 diabetes, autoantibodies against thyroid peroxidase (TPOAb), thyroglobulin (TGAb), glutamic acid decarboxylase (GADA), insulin, insulinoma-associated protein-2, and 3 variants of zinc transporter 8 (ZnT8W/R/QA) HLA-DQA1-B1 genotypes and thyroid function were analyzed in 2433 children. After 5.1 to 9.5 years, information on thyroxine treatment was gathered from the Swedish National Board of Health and Welfare's Prescribed Drug Register.
  
  
  
  Thyroxine was prescribed to 6% of patients. In patients <5 years of age, female sex [hazard ratio (HR) = 4.60; P = 0.008] and GADA (HR = 5.80; P = 0.02) were predictors. In patients 5 to 10 years old, TPOAb (HR = 20.56; P < 0.0001), TGAb (HR = 3.40; P = 0.006), and thyroid-stimulating hormone (TSH) (HR = 3.64; P < 0.001) were predictors, whereas in 10 to 15 year olds, TPOAb (HR = 17.00; P < 0.001) and TSH (HR = 4.11; P < 0.001) predicted thyroxine prescription.
  
  
  
  In addition to TPOAb and TSH, GADA at diagnosis of type 1 diabetes is important for the prediction of autoimmune thyroid disease in children <5 years of age.
authors.affiliation: Department of Clinical Sciences, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden.
authors.forename: Berglind
authors.initials: B
authors.lastname: Jonsdottir
authors.affiliation: Department of Laboratory Medicine, Lund University, SE-211 85 Lund, Sweden.
authors.forename: Christer
authors.initials: C
authors.lastname: Larsson
authors.affiliation: Department of Pediatrics, Lund University, Skåne University Hospital, SE-211 85 Lund, Sweden.
authors.forename: Annelie
authors.initials: A
authors.lastname: Carlsson
authors.affiliation: Department of Pediatrics, The Queen Silvia Children's Hospital, SE-416 86 Gothenburg, Sweden.
authors.forename: Gun
authors.initials: G
authors.lastname: Forsander
authors.affiliation: Department of Clinical Sciences, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden.
authors.forename: Sten Anders
authors.initials: SA
authors.lastname: Ivarsson
authors.affiliation: Department of Clinical Sciences, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden.
authors.forename: Åke
authors.initials: Å
authors.lastname: Lernmark
authors.affiliation: Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University Hospital, SE-58183 Linköping, Sweden.
authors.forename: Johnny
authors.initials: J
authors.lastname: Ludvigsson
authors.affiliation: Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institute, SE-171 77 Stockholm, Sweden.
authors.forename: Claude
authors.initials: C
authors.lastname: Marcus
authors.affiliation: Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University Hospital, SE-58183 Linköping, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Samuelsson
authors.affiliation: Pediatric Endocrinology Unit, Department of Women's and Children's Health, Karolinska Institute, SE-171 77 Stockholm, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Örtqvist
authors.affiliation: Department of Clinical Sciences, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden.
authors.forename: Helena Elding
authors.initials: HE
authors.lastname: Larsson
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D005260:Female; D006801:Humans; D007328:Insulin / Q000276:immunology*; D007453:Iodide Peroxidase / Q000276:immunology*; D007515:Islets of Langerhans / Q000276:immunology*; D008297:Male; D013954:Thyroglobulin / Q000276:immunology*; D013959:Thyroid Diseases / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D013974:Thyroxine / Q000627:therapeutic use
chemical_list: D001323:Autoantibodies; D007328:Insulin; D013954:Thyroglobulin; D007453:Iodide Peroxidase; D013974:Thyroxine