Thyroid Autoimmunity in an Iodine-Replete Population: A Research Article (original) (raw)
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Clinical Chemistry, 2006
We present a large European population-based study of thyroid function, performed in a population with longstanding borderline sufficient iodine intake. The Nijmegen Biomedical Study is a population-based survey conducted in the eastern part of The Netherlands. Randomly selected inhabitants received a postal questionnaire on lifestyle and medical history, which was filled out by 9371 individuals (41.7%). We measured serum thyroid-stimulating hormone (TSH), free thyroxine (FT4), and anti-thyroperoxidase antibodies (TPOAbs) in 6434 responders. A reference population of 5167 individuals was selected by excluding those at risk for thyroid disease. Overt thyrotoxicosis was found in 0.4% of the total population and subclinical thyrotoxicosis in 0.8%. Overt hypothyroidism was found in 0.4% and subclinical hypothyroidism in 4.0%. In individuals older than 60 years, mean FT4 concentrations increased with age. Mean TSH decreased with age, from 1.46 mIU/L at 18-24 years to 1.07 mIU/L after 85 years. The mean TSH in the total population did not differ from the mean TSH in the reference population; the exclusion of those at risk for thyroid disease, however, lowered the upper limit of the TSH reference interval considerably. In the total population, 8.6% of males and 18.5% of females had positive TPOAbs. The presence of TPOAbs was associated with abnormally high and low TSH concentrations. In inhabitants of the eastern part of The Netherlands, serum TSH gradually decreases with age, whereas after age 60, serum FT4 increases, possibly because of the development of thyroid autonomy after longstanding borderline sufficient iodine intake.
Evolution of thyroid autoimmunity during iodine prophylaxis--the Sri Lankan experience
European Journal of Endocrinology, 2003
Objective: To study the evolution of thyroid autoimmunity, in relation to the change in goitre prevalence, during 3 years of iodine prophylaxis in Sri Lanka. Methods: Two groups of Sri Lankan schoolgirls between the ages of 10.8 and 17.5 years were studied in 1998 (401 girls) and 2001 (282 girls). A prospective study was performed in 42 schoolgirls who were thyroid autoantibody (Ab)-positive (þ ve) in 1998. Anthropometric measures, urinary iodine excretion (UIE), thyroid volume, free thyroxine, free tri-iodothyronine, TSH, and thyroglobulin (Tg) and thyroid peroxidase (TPO) Ab were evaluated in all 683 girls. Results: Goitre prevalence was significantly lower in 2001 compared with 1998 related to age (2.9% compared with 20.2%) and body surface area (11.6% compared with 40.8%), although UIE was unchanged. Prevalence of thyroid Ab in 2001 was also lower (23.4% compared with 49.9%); among those with the Ab, 34.8% had TgAb alone and 46.9% had a combination of TgAbþ TPOAb, compared with 82.0% TgAb alone in 1998. In 2001, subclinical hypothyroidism was more frequent in Abþve (6.3%) than Ab-negative girls (1.0%). A cohort of 42 Abþve schoolgirls in 1998 (34 with TgAb alone, eight with TgAb þ TPOAb) were evaluated again in 2001. Only 10 of them (23.8%) remained Abþve (mostly TPOAb^TgAb) in 2001.
Thyroid autoantibodies in women with and without thyroid disorders in an iodine-replete area
Thyroid, 2008
To compare the prevalence of positive autoantibodies in patients with thyroid disorders and healthy subjects in an iodine-replete area of the Islamic Republic of Iran, we studied 930 women in a clinic-based study: 698 patients (286 hypothyroid, 140 hyperthyroid, 272 with simple goitre) and 232 healthy women. Serum thyroxine (T4), triiodothyronine (T3), thyroid stimulating hormone, and antithyroid antibodies were measured. Positive autoantibodies were detected in 75.5% of patients with hypothyroidism, 73.6% of those with hyperthyroidism, 48.9% of those with simple goitre and 35.8% of the control group (P < 0.001). Autoimmunity may have a role in the genesis of common thyroid disorders. Autoanticorps thyroïdiens chez les femmes avec et sans troubles thyroïdiens dans une région riche en iode RÉSUMÉ Afin de comparer la prévalence des autoanticorps positifs chez les patients atteints de troubles thyroïdiens et chez des sujets en bonne santé dans une région riche en iode de la République islamique d'Iran, nous avons effectué une étude clinique sur 930 femmes : 698 patientes (286 hypothyroïdiennes, 140 hyperthyroïdiennes et 272 présentant un goitre simple) et 232 femmes en bonne santé. La thyroxine (T 4), la triiodothyronine (T 3), la thyréostimuline, ou TSH (pour thyroid stimulating hormone) sériques et les anticorps antithyroïdiens ont été mesurés. Des autoanticorps positifs ont été détectés chez 75,5 % des patientes atteintes d'hypothyroïdie, 73,6 % de celles atteintes d'hyperthyroïdie, 48,9 % de celles présentant un goitre simple et 35,8 % dans le groupe témoin (p < 0,001). L'auto-immunité peut avoir un rôle dans l'apparition des troubles thyroïdiens courants.
Bangladesh journal of nuclear medicine, 2024
Background: Graves' disease (GD) is an autoantibody-mediated autoimmune disease caused by direct stimulation of the thyroid epithelial cells. Thyrotropin Receptor Antibody and Thyroid Peroxidase Antibody are among the best-characterized autoantibodies for this pathology. Among different treatment modalities, radioiodine therapy (RAIT) is a proven safe and highly cost-effective therapeutic option, with the frequent side effect of developing hypothyroidism. Serum concentrations of various autoantibodies before and after RAIT may be used to predict the early or late onset of hypothyroidism. Objective: To measure and statistically analyze the thyrotropin receptor antibody (TRAb) and thyroid peroxidase antibodies (TPOAb) in a group of hyperthyroid patients who did or did not develop early hypothyroidism after RAIT.
Clinical-Laboratory Evaluation of a Group of Patients with Hashimoto Thyroiditis
Japan Journal of Research, 2020
Chronic lymphocytic thyroiditis (or chronic thyroiditis, or Hashimoto thyroiditis-HT) was first described in 1992 in Germany by the Japanese pathologist Hakuru Hashimoto as a new disease called lymphomatous struma. Today it represents the most frequent cause of hypothyroidism and goiter in the US and in areas of iodine sufficiency. It is the main cause of goiter in children and young adults and of idiopathic mixedema. The most important auto antibodies are antithyroglobulin (Anti-TG), antithyroperoxidase (Anti-TPO) and TSH receptor antibody blocker (TRAB). In the initial phase Anti-TG is markedly elevated while Anti-TPO is only mildly elevated. Anti-TG may disappear, but Anti-TPO continues to be positive for many years. Its pathogenesis has not been fully clarified. The estimate is that the pathogenesis of this immune disease is due genetic factors in 70 to 80% of cases and to environmental factors in 20 to 30% of cases. The study was conducted on 399 patients, 336 women (87.2%) and 63 men (12.8 %), ranging in age from 11 to 95 years. The predominant age ranges were 20 to 70 years for women and 30 to 60 years for men. Blood samples were obtained for the determination of TSH, T4L, T3L, thyroglobulin, and anti-TPO, anti-thyroglobulin and TSH receptor (TRAB) antibodies by chemiluminescence. Anti-TPO and anti-TG autoantibody values were higher in Anti-TPO-positive and AntiTG-negative: Type 1 thyroiditis; and in Anti-TPO-negative and AntiTG-positive: Type 2 thyroiditis; and in Anti-TPO-positive and antiTG-positive: Type 3 thyroiditis; and in Anti-TPO-negative and AntiTG-negative: Type 4 thyroiditis. Autoantibody expression was similar in men and women, with predominance of type 4 > type 3 > type 2> type 1 when considering the oldest age of each sex (95 years for women and 85 years for men). When considering the youngest age studied, the following results were obtained: type 2 > type 4 > type 1> type 3 for women and type 3 > type 1 > type 4 > type 2 for men.
2016
Background: Autoantibodies to thyroid antigens in general, and thyroid peroxidase in particular, are considered as the hallmark of autoimmune thyroid dysfunctions. While a pro-inflammatory response is considered as predominant in hypothyroidism, in Grave's disease it is a predominant antibody response. Objectives: The objective of the present study was to evaluate seropositivity to TPO and TG antigens in these two conditions with apparently diversified patterns of immune responses. Methods: An Enzyme linked immunosorbent assay was employed for detection of Anti-Thyroid Peroxidase (TPO) and Anti-Thyrooglobulin (TG) auto-antibodies in sera of patients with Hypo and Hyperthyroidism. Results: Total seropositivity to both TPO Ab/ TG Ab was found to be 69.09% in hypo and 66.66% in hyperthyroidism; it was 54.54% and 53.33% for hypo and hyperthyroidism respectively for TPO Ab alone. A substantially less seropositivity of 41.81% and 40% was observed for Hypo and Hyperthyroid respectively for TG Ab. Analysis of seropositivity in relation to age at onset revealed higher sero-posiivity (53.33%) in early onset (≤35 years) group in hypo for TPO Ab. Functional significance of TPO Ab in the two thyroid conditions has been discussed particularly in the light of their diagnostic utility and epidemiological significance. Conclusion: It is concluded that higher sera positivity was observed for TPO compare to TG. These variations may be due to differences in antigenic characteristics of these two thyroid antigens.
Journal of Clinical Research in Pediatric Endocrinology, 2011
Objective: Chronic autoimmune thyroiditis (CAT) is the most common form of thyroiditis in childhood and a frequent cause of acquired hypothyroidism. The objective of this study was to evaluate the thyroid status of children and adolescents with CAT with respect to iodine status and diagnostic values of thyrotropin-releasing hormone (TRH) test. Methods: Seventy-one children (mean age: 11.6 years) were studied in a retrospective analysis. Free thyroxine (T4), thyrotropin (TSH), TSH response to TRH test, thyroid autoantibodies, thyroid sonography, and urinary iodine excretion (UIE) were evaluated. Results: At diagnosis, 8.5% of patients had overt hypothyroidisim and 36.6% subclinical hypothyroidism; 5.6% had overt hyperthyroidisim and 8.5% had subclinical hyperthyroidism. Of them, 40.8% were euthyroid. Median UIE was 51 μg/L in overt hypothyroidism and 84 μg/L in subclinical hypothyroidism. The values were 316 μg/L and 221 μg/L in overt and subclinical hyperthyroidism, respectively. Basal TSH showed a strong correlation with peak TSH level on TRH test. Thirtyfour percent of patients with normal basal TSH level showed an exaggerated TSH response. Conclusion: Iodine deficiency was seen more in cases with hypothyroidism, while excess of iodine was observed to be more frequent in hyperthyroid patients. Iodine status was a strong predictor of the thyroid status in CAT. TRH test may be helpful in further delineating patients with subclinical hypothyroidism. K Ke ey y w wo or rd ds s: : Chronic autoimmune thyroiditis, childhood, adolescent, C Co on nf fl li ic ct t o of f i in nt te er re es st t: : None declared R Re ec ce ei iv ve ed d: : 31.10.2010
International Journal of Research -GRANTHAALAYAH, 2022
Background: Thyroid disorders are the most second endocrine problem after diabetes mellitus in society. Environmental, immunological, and genetic factors lead to the development of thyroid disorders. Objectives: The study intended to evaluate the role of thyroid antibodies and hormones in the diagnosis of thyroid diseases, as well as the prevalence of thyroid antibodies in patients having thyroid disorders living in Shendi locality. Study design: The current research was prospective, case-control, hospital-based study carried out from 2013-2017, in El-Mek Nimir Uiversity Hospital in Shendi town-Northern Sudan.-. River Nile State. Two hundred and eighty-three (283) participants selected randomly as study population, of whom Hundred and eleven (111) patients with hypothyroidism; Seventy-two (72) patients with hyperthyroidism; Hundred (100) healthy normal subjects as control group. Participants were recruited from outpatient clinics in El-Mek Nimir Uiversity Hospital in Shendi Thyroid hormones profile (TSH, T4, T3, fT3, and fT4) and Thyroid antibodies (Anti-thyroid peroxidase and antithyroglobulin) were measured. Results: The study revealed that (60.7%) had hypothyroidism, (39.3%) had hyperthyroidism, (91.9%) of hypothyroidism were female, and only (8.1%) were male, while (84.7%) of hyperthyroidism were female while male represented only (15.3%) of them. The current study revealed that 107 of the case group (58.5%) were positive when evaluated for thyroid peroxidase antibodies (TPO Ab), with level more than (40.0 IU/ml). 72 (64.9%) of them were hypothyroidism, whereas a 35 (48.6%) of them were hyperthyroidism. As regard Thyroglobulin antibodies (Tg Ab), 73 (39.9%) of the case studied were positive, 51 (69.9%) of them were hypothyroidism, and 22 (30.1%) of them were hyperthyroidism. The study also revealed statistically significant positive correlation between the presence of TPO Ab and the values of fT3.
Thyroid Hormones and Autoantibodies in Iraqi Hyperthyroid Patients
Al-Nahrain journal of science, 2023
Hyperthyroidism can be defined as the status of over production of thyroid hormones: tri-iodothyronine (T3) and thyroxine (T4) as a results of thyroid gland dysfunction. The aim of the current study was to investigate the association between the abnormalities of thyroid hormones (T3 and T4) and serum levels of thyroid auto-antibodies: anti-thyroid peroxidase (TPO-Ab) and anti-thyroid stimulating hormone receptor (TR-Ab) and the state of hyperthyroidism. Blood samples were collected from 75 Iraqi individuals were early diagnosed as hyperthyroidism patients in addition to 25 Iraqi individuals as a healthy control group. Enzyme Linked Fluorescent Assay (ELFA) used to determine the levels of thyroid hormones (T3 and T4) and the level of thyroid stimulating hormone (TSH), Enzyme Linked Immuno-Sorbent Assay (ELISA) was used to determine the levels of auto-antibodies (TPO-Ab and TR-Ab). The results show that T3 levels and T4 levels in hyperthyroidism patients (2.07 nmol/L and 14.02 µg/dl respectively) increased significantly (< 0.01) compared to healthy control levels (1.33 nmol/L and 6.4 µg/dl respectively). While the levels of thyroid stimulating hormone (TSH) in hyperthyroidism patient (0.17 µIU/Ml) decreased significantly (< 0.01) when compared with healthy control group (1.84 µIU/Ml). The results also showed that levels of TPO-Ab and TR-Ab in hyperthyroidism patients (235.29 IU/mL and 32.05 IU/mL respectively) increased significantly (< 0.01) when compared to healthy control group (20.76 IU/mL and 0.3 IU/mL respectively). This study revealed that there is an association between thyroid hormones disorders and the positivity of thyroid auto-antibodies in hyperthyroidism patients.