A team of researchers, led by Berglind Jonsdottir, MD, of Lund University, Skåne University Hospital Malmö, Sweden, has recently identified markers in the children with a diagnosis of type I diabetes which can predict autoimmune thyroid disease.
This team of experts found that in addition to previously known disease predictors, TPOAb and TSH, positive results for GADA was also observed as a strong predictor for type 1 diabetes sufferers below the age of five years.
Blood samples of Swedish children and adolescents who were already suffering from type 1 diabetes were collected between May 2005 and October 2009 during the study named Better Diabetes Diagnosis (BDD).
Out of a total of 2,670 children, 237 children were excluded and 2,433 samples were tested to identify the predictors of autoimmune thyroid disease. The findings of this significant investigation were also recently published in the Journal of Clinical Endocrinology & Metabolism on 14th October.
The researchers had set out to delve into the predictive value of thyroid autoantibodies, thyroid function, islet autoantibodies and HLA-DQ in particular. For accomplishing this endeavor, 43 pediatric endocrinology units were used during the study.
It was found that in children below the age of 5 years, particularly in females, GADA was a significant predictive (HR=5.80, p=0.02).
In children between the age of 5 to 10 years, TPOAb, TGAb and TSH were prominently observed, while in children between 10 to 15 years, TPOAb and TSH were present as predictors of autoimmune thyroid disease. It is worth noting that only 6% of the children were already prescribed thyroxine to counteract the effects of hypothyroidism while the other 94% did not have the prior prescription.
An autoimmune disease, in general, can be any disease in which the immune cells of an individual begin to attack cells of the body, leading to malfunctioning of organs. This can lead to many autoimmune diseases, such as type 1 diabetes and autoimmune thyroiditis.
According to Johns Hopkins Medicine, one out of every 4,000 to 5,000 babies born in the US have congenial hypothyroidism.
Although 10-20% of the cases have inherited conditions, other reasons are not well understood.
In addition to this, American Diabetes Association suggests that on an average 17% to 30% children with type 1 diabetes develop autoimmune thyroid disease.
Autoimmune thyroid diseases include both hypothyroidism and hyperthyroidism; however, the occurrence of hypothyroidism is common as compared to hyperthyroidism.
Hashimoto’s thyroiditis is an autoimmune sub-type of hypothyroidism in which the thyroid gland is inflamed. The condition is more common in females than males and often it co-exists with other autoimmune diseases like celiac disease or type 1 diabetes, as we already have seen in this study.
Feeling fatigued, sleepiness, constipation, feeling cold, depression, weight gain and dry skin are the common symptoms of the disease. This study also observed that dyslipidemia characterized by increased levels of plasma cholesterol, reduced levels of high-density lipoprotein levels or elevated levels of triglycerides and coronary heart disease were salient symptoms of children with hypothyroidism and type 1 diabetes.
It is astonishing to see that the risk of coronary heart diseases multiplies in these children but no standardized screening procedures are currently present to identify the hypothyroidism at an earlier stage to minimize the damage.
Contrary to this finding, the US Preventive Task Force rejects the association of subclinical hypothyroidism with dyslipidemia and atherosclerosis, claiming that the evidence is insufficient for general population.
Which Markers Can Predict Autoimmune Thyroid Disease In Your Child?
TPOAb is an autoantibody which is directed against thyroid peroxidase. Under normal condition, when autoimmune against it is not produced by the body, thyroid peroxide plays an integral catalytic role in thyroid gland function.
Thyroid gland has a vital role in the metabolism regulation, growth and maturation of human body. In addition to this, it also regulates the amount of hormones in the bloodstream to ensure optimal functioning of the body.
Similarly, TGAb are the autoimmune antibodies which target thyroglobulin. Under normal functioning, thyroglobulin has a role in the synthesis of thyroid hormone.
Thyroid-stimulating hormone (TSH) levels in the blood, that have also been found in this case, have previously been identified as prediction of the condition. This hormone is released in the bloodstream when hypothalamus in the brain releases thyrotropin-releasing hormone (TRH) which in turns triggers pituitary gland to release TSH. High levels of TSH inevitably indicate hypothyroidism.
Glutamic acid decarboxylase was identified at a novel marker for early detection of autoimmune thyroid disease in the study participants. Under normal conditions, glutamic acid decarboxylase synthesizes gamma aminobutyric acid which is an inhibitory neurotransmitter in neurons and in beta pancreatic cells.
As the neurotransmitter is targeted in the pancreas, it leads to the risk of type 1 diabetes, but now it’s novel link to increasing the likelihood of autoimmune thyroid disease in children is recorded in the study.
The study has raised a concern about screening type 1 diabetes sufferers for autoimmune thyroid diseases so that preventive measures can be taken to improve the quality of life for these children.