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GADA positivity at onset of type 1 diabetes is a risk factor for the development of autoimmune thyroiditis.
Pediatr Diabetes. 2011 Feb; 12(1):31-3.PD

Abstract

AIM

To evaluate whether the presence of diabetes-specific autoantibodies may predict the development of autoimmune thyroiditis (AIT) in children with type 1 diabetes (T1D).

METHODS

Glutamic acid decarboxylase antibodies (GADA), tyrosine phosphatase IA2 antibodies (IA2A), and insulin autoantibodies (IAA) were determined at T1D onset in 341 children and adolescents. Thyroid antibodies (anti-TG, anti-TPO), thyroid stimulating hormone (TSH), T(3) and T(4) were measured in 335 patients at T1D onset and thereafter annually with a follow-up time of 1-15 yr. In case of thyroid antibody positivity and/or TSH elevation, thyroid gland sonography was performed. Treatment with l-thyroxine was started if persistent elevation of TSH and/or thyroid volume was present.

RESULTS

The majority of patients (92.1%) had at least one T1D antibody (71.6% GADA, 73.0% IA2A, and 44.9% IAA). GADA positive patients were older than those without GADA (p < 0.001). Thyroid autoimmunity was found in 15 of 335 patients (4.5%) at T1D onset with female preponderance (p = 0.013). At the end of follow-up, 70 patients (20.9%) had developed thyroid autoantibodies [cumulative incidence (CI) 0.36 ± 0.06 at 10 yr of T1D]. In 30 patients (9.0%), AIT was diagnosed up to 9.4 yr after T1D onset (CI 0.24 ± 0.06 at 10 yr). AIT incidence was not influenced by IAA or IA2A positivity. In multivariate analysis, GADA positive patients were estimated to have a 3.5-fold increased risk of AIT (CI 0.31 ± 0.11 at 10 yr) compared to those without GADA (p = 0.024).

CONCLUSION

Based on the present results, a special focus should be given to GADA positive patients concerning screening for AIT as they are at increased risk to develop autoimmune thyroiditis.

Authors+Show Affiliations

Diabetes Centre for Children and Adolescents, Children's Hospital at the Bult, Janusz-Korczak-Allee 12, Hannover, Germany. kordonouri@hka.deNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20723098

Citation

Kordonouri, Olga, et al. "GADA Positivity at Onset of Type 1 Diabetes Is a Risk Factor for the Development of Autoimmune Thyroiditis." Pediatric Diabetes, vol. 12, no. 1, 2011, pp. 31-3.
Kordonouri O, Charpentier N, Hartmann R. GADA positivity at onset of type 1 diabetes is a risk factor for the development of autoimmune thyroiditis. Pediatr Diabetes. 2011;12(1):31-3.
Kordonouri, O., Charpentier, N., & Hartmann, R. (2011). GADA positivity at onset of type 1 diabetes is a risk factor for the development of autoimmune thyroiditis. Pediatric Diabetes, 12(1), 31-3. https://doi.org/10.1111/j.1399-5448.2010.00666.x
Kordonouri O, Charpentier N, Hartmann R. GADA Positivity at Onset of Type 1 Diabetes Is a Risk Factor for the Development of Autoimmune Thyroiditis. Pediatr Diabetes. 2011;12(1):31-3. PubMed PMID: 20723098.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - GADA positivity at onset of type 1 diabetes is a risk factor for the development of autoimmune thyroiditis. AU - Kordonouri,Olga, AU - Charpentier,Nicola, AU - Hartmann,Reinhard, Y1 - 2010/08/15/ PY - 2010/8/21/entrez PY - 2010/8/21/pubmed PY - 2011/4/30/medline SP - 31 EP - 3 JF - Pediatric diabetes JO - Pediatr Diabetes VL - 12 IS - 1 N2 - AIM: To evaluate whether the presence of diabetes-specific autoantibodies may predict the development of autoimmune thyroiditis (AIT) in children with type 1 diabetes (T1D). METHODS: Glutamic acid decarboxylase antibodies (GADA), tyrosine phosphatase IA2 antibodies (IA2A), and insulin autoantibodies (IAA) were determined at T1D onset in 341 children and adolescents. Thyroid antibodies (anti-TG, anti-TPO), thyroid stimulating hormone (TSH), T(3) and T(4) were measured in 335 patients at T1D onset and thereafter annually with a follow-up time of 1-15 yr. In case of thyroid antibody positivity and/or TSH elevation, thyroid gland sonography was performed. Treatment with l-thyroxine was started if persistent elevation of TSH and/or thyroid volume was present. RESULTS: The majority of patients (92.1%) had at least one T1D antibody (71.6% GADA, 73.0% IA2A, and 44.9% IAA). GADA positive patients were older than those without GADA (p < 0.001). Thyroid autoimmunity was found in 15 of 335 patients (4.5%) at T1D onset with female preponderance (p = 0.013). At the end of follow-up, 70 patients (20.9%) had developed thyroid autoantibodies [cumulative incidence (CI) 0.36 ± 0.06 at 10 yr of T1D]. In 30 patients (9.0%), AIT was diagnosed up to 9.4 yr after T1D onset (CI 0.24 ± 0.06 at 10 yr). AIT incidence was not influenced by IAA or IA2A positivity. In multivariate analysis, GADA positive patients were estimated to have a 3.5-fold increased risk of AIT (CI 0.31 ± 0.11 at 10 yr) compared to those without GADA (p = 0.024). CONCLUSION: Based on the present results, a special focus should be given to GADA positive patients concerning screening for AIT as they are at increased risk to develop autoimmune thyroiditis. SN - 1399-5448 UR - https://www.unboundmedicine.com/medline/citation/20723098/GADA_positivity_at_onset_of_type_1_diabetes_is_a_risk_factor_for_the_development_of_autoimmune_thyroiditis_ L2 - https://doi.org/10.1111/j.1399-5448.2010.00666.x DB - PRIME DP - Unbound Medicine ER -