Are Perinatal Events Risk Factors for Childhood Thyroid Autoimmunity?

Berglind Jonsdottir; Markus Lundgren; Sara Wallengren; Åke Lernmark; Ida Jönsson; Helena Elding Larsson; DiPiS Study Group

doi:10.1159/000479964

Are Perinatal Events Risk Factors for Childhood Thyroid Autoimmunity?

Eur Thyroid J. 2017 Nov;6(6):298-306. doi: 10.1159/000479964. Epub 2017 Sep 19.

Authors

Berglind Jonsdottir¹, Markus Lundgren¹, Sara Wallengren¹, Åke Lernmark¹, Ida Jönsson¹, Helena Elding Larsson¹; DiPiS Study Group

Affiliation

¹ Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden.

Abstract

Background: Environmental and genetic factors possibly trigger thyroid autoimmunity. Studies on perinatal risk factors for childhood thyroid autoimmunity are sparse.

Objectives: The aim was to investigate if perinatal factors, family history of autoimmune diseases, and HLA-DQ genotypes contribute to thyroid autoimmunity in the Diabetes Prediction in Skåne (DiPiS) study.

Methods: Samples from 1,874 ten-year-old children were analyzed for autoantibodies to thyroid peroxidase (TPOAb), thyroglobulin (TGAb), and HLA-DQ genotypes. Information on perinatal events and family history of autoimmunity was gathered prospectively in questionnaires.

Results: Thyroid autoimmunity was found in 6.9% of the children (TPOAb 4.4%, TGAb 5.8%, both autoantibodies 3.3%) and was overrepresented in girls. Prematurity was positively related to TGAb (OR: 2.4, p = 0.003, p_c = 0.021). Autoimmune diseases in the family increased the risk of thyroid autoimmunity: TPOAb (OR: 2.2, p = 0.012), any autoantibody (OR: 1.7, p = 0.04), and both autoantibodies (OR: 2.2, p = 0.024). A first-degree relative (FDR) with thyroid disease increased the risk for TPOAb (OR: 2.4, p = 0.03) and both autoantibodies (OR: 2.6, p = 0.03), a FDR or sibling with celiac disease increased the risk for both autoantibodies (OR: 3.7, p = 0.03, and OR: 4.8, p = 0.003), a FDR or sibling with diabetes increased the risk for thyroid autoantibody (OR: 3.0, p = 0.01, and OR: 5.4, p = 0.032), and a father with rheumatic disease increased the risk for TPOAb (OR: 15.2, p = 0.017), TGAb (OR: 11.3, p = 0.029), any autoantibody (OR: 9.6, p = 0.038), and both autoantibodies (OR: 20, p = 0.01).

Conclusions: Thyroid autoimmunity was found in 6.9% of the 10-year-old children who were being followed for their risk of type 1 diabetes. No relation to perinatal factors was found, with the exception of a possible association between prematurity and TGAb. Family history of autoimmune diseases increased the risk of thyroid autoimmunity.

Keywords: Childhood thyroid autoimmunity; HLA-DQ genotypes; Perinatal and hereditary risk factors; Thyroglobulin autoantibodies; Thyroid peroxidase autoantibodies.