Atopy as a risk factor for subclinical hypothyroidism development in children
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Marcella Pedullà
, Giuseppina Rosaria Umano , Vincenzo Fierro , Francesco Capuano , Anna Di Sessa , Pierluigi Marzuillo, Laura Perrone
und Emanuele Miraglia del Giudice
Abstract
Background:
Increased thyroid stimulating hormone (TSH) serum concentration can be a marker of subclinical hypothyroidism (SCH) or transient hyperthyrotropinemia. The aim of our study was to evaluate whether high serum TSH concentrations in allergic children could represent true SCH or isolated and transient hyperthyrotropinemia.
Methods:
We enrolled 620 allergic children (1.11–12.8 years) consecutively attending to our department. They were classified as atopics and non-atopics on the basis of the atopy work-up and, at baseline, they were investigated for thyroid function and low-grade inflammation state. Further, TSH was evaluated after 6 (T1) and 12 (T2) months.
Results:
Both atopics and non-atopics showed higher SCH prevalence compared to controls (p=0.0055 and p=0.02, respectively), and a significant association between atopy and SCH (OR 10.11, 95% CI 1.36–75.12) was found. Both at T1 and T2, atopics had a significant risk of developing severe SCH compared to non-atopics (RR 1.8, 95% CI 1.39–2.34 and 1.61, 95% CI 1.21–2.14; respectively).
Conclusions:
Our data may suggest that hyperthyrotropinemia in atopic children could be used as a marker of true SCH.
Author contributions: MP drafted the manuscript. MP, EMDG and LP participated in the conception and the design of the study. MP and LP designed and interpreted the biochemical evaluations. PM, ADS, GRU conducted the statistical analyses. VF and FC examined the patients, collected anthropometric data, and EMDG supervised the design and execution of the study. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Aversa T, Valenzise M, Corrias A, Salerno M, De Luca F, et al. Underlying Hashimoto’s thyroiditis negatively affects the evolution of subclinical hypothyroidism in children irrespective of other concomitant risk factors. Thyroid 2015;25:183–7.10.1089/thy.2014.0235Suche in Google Scholar
2. Catli G, Abaci A, Büyükgebiz A, Bober E. Subclinical hypothyroidism in childhood and adolescence. J Pediatr Endocrinol Metab 2014;27:1049–57.Suche in Google Scholar
3. Aypak C, Türedi O, Yüce A, Görpelioğlu S. Thyroid-stimulating hormone (TSH) level in nutritionally obese children and metabolic co-morbidity. J Pediatr Endocrinol Metab 2013;26:703–8.10.1515/jpem-2012-0384Suche in Google Scholar
4. Brienza C, Grandone A, Di Salvo G, Corona AM, Di Sessa A, et al. Subclinical hypothyroidism and myocardial function in obese children. Nutr Metab Cardiovasc Dis 2013;23:898–902.10.1016/j.numecd.2012.04.006Suche in Google Scholar
5. Grandone A, Santoro N, Coppola F, Calabrò P, Perrone L, et al. Thyroid function derangement and childhood obesity: an Italian experience. BMC Endocr Disord 2010;10:8.10.1186/1472-6823-10-8Suche in Google Scholar
6. Kariyawasam D, Carré A, Luton D, Polak M. Down syndrome and nonautoimmune hypothyroidisms in neonates and infants. Horm Res Paediatr 2015;83:126–31.10.1159/000370004Suche in Google Scholar
7. Aversa T, Messina MF, Mazzanti L, Salerno M, Mussa A, et al. The association with Turner syndrome significantly affects the course of Hashimoto’s thyroiditis in children, irrespective of karyotype. Endocrine 2015;50:777–82.10.1007/s12020-014-0513-6Suche in Google Scholar
8. Pedullà M, Fierro V, Marzuillo P, Del Tufo E, Grandone A, et al. Subclinical hypothyroidism in atopic South Italian children. World J Clin Pediatr 2016;5:306–10.10.5409/wjcp.v5.i3.306Suche in Google Scholar
9. Cooper DS, Biondi B. Subclinical thyroid disease. Lancet 2012;379:1142–54.10.1016/S0140-6736(11)60276-6Suche in Google Scholar
10. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008. Allergy 2008;63:8–160.10.1111/j.1398-9995.2007.01620.xSuche in Google Scholar PubMed
11. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention; 2010. Available from: http://www.ginasthma.com.Suche in Google Scholar
12. Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, et al. EAACI/GA2 LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy 2014;69:868–87.10.1111/all.12313Suche in Google Scholar PubMed
13. Akdis CA, Akdis M, Bieber T, Bindslev-Jensen C, Boguniewicz M, et al. Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report. Allergy 2006;61:969–87.10.1111/j.1398-9995.2006.01153.xSuche in Google Scholar PubMed
14. Cole TJ. The LMS method for constructing normalized growth standards. Eur J Clin Nutr 1990;44:45–60.Suche in Google Scholar
15. Lazarus J, Brown RS, Daumerie C, Hubalewska-Dydejczyk A, Negro R, et al. European thyroid association guidelines for the management of subclinical hypothyroidism in pregnancy and in children. Eur Thyroid J 2014;3:76–94.10.1159/000362597Suche in Google Scholar PubMed PubMed Central
16. Taubner K, Schubert G, Pulzer F, Pfaeffle R, Körner A, et al. Serum concentrations of anti-thyroid peroxidase and anti-thyroglobulin antibodies in children and adolescents without apparent thyroid disorders. Clin Biochem 2014;47:3–7.10.1016/j.clinbiochem.2013.09.017Suche in Google Scholar PubMed
17. Lazar L, Frumkin RB, Battat E, Lebenthal Y, Phillip M, et al. Natural history of thyroid function tests over 5 years in a large pediatric cohort. J Clin Endocrinol Metab 2009;94:1678–82.10.1210/jc.2008-2615Suche in Google Scholar PubMed
18. Parle JV, Franklyn JA, Cross KW, Jones SC, Sheppard MC. Prevalence and follow-up of abnormal thyrotrophin (TSH) concentrations in the elderly in the United Kingdom. Clin Endocrinol (Oxf) 1991;34:77–83.10.1111/j.1365-2265.1991.tb01739.xSuche in Google Scholar PubMed
19. Meyerovitch J, Rotman-Pikielny P, Sherf M, Battat E, Levy Y, et al. Serum thyrotropin measurements in the community: five-year follow-up in a large network of primary care physicians. Arch Intern Med 2007;23;167:1533–8.10.1001/archinte.167.14.1533Suche in Google Scholar PubMed
20. Li Y, Teng D, Shan Z, Teng X, Guan H, et al. Antithyroperoxidase and antithyroglobulin antibodies in a five-year follow-up survey of populations with different iodine intakes. J Clin Endocrinol Metab 2008;93:1751–7.10.1210/jc.2007-2368Suche in Google Scholar PubMed
21. Díez JJ, Iglesias P, Burman KD. Spontaneous normalization of thyrotropin concentrations in patients with subclinical hypothyroidism. J Clin Endocrinol Metab 2005;90:4124–7.10.1210/jc.2005-0375Suche in Google Scholar PubMed
22. Wasniewska M, Salerno M, Cassio A, Corrias A, Aversa T, et al. Prospective evaluation of the natural course of idiopathic subclinical hypothyroidism in childhood and adolescence. Eur J Endocrinol 2009;160:417–21.10.1530/EJE-08-0625Suche in Google Scholar PubMed
23. De Luca F, Wasniewska M, Zirilli G, Aversa T, Arrigo T. At the end of a two-year follow-up elevated TSH levels normalize or remain unchanged in most the children with subclinical hypothyroidism. Ital J Pediatr 2010;36:11.10.1186/1824-7288-36-11Suche in Google Scholar PubMed PubMed Central
24. Rueter K, Haynes A, Prescott SL. Developing primary intervention strategies to prevent allergic disease. Curr Allergy Asthma Rep 2015;15:40.10.1007/s11882-015-0537-xSuche in Google Scholar PubMed
25. Prescott SL. Early-life environmental determinants of allergic diseases and the wider pandemic of inflammatory noncommunicable diseases. J Allergy Clin Immunol 2013;131:23–30.10.1016/j.jaci.2012.11.019Suche in Google Scholar PubMed
26. Navratil M, Plavec D, Dodig S, Jelcic Z, Nogalo B, et al. Markers of systemic and lung inflammation in childhood asthma. J Asthma 2009;46:822–8.10.1080/02770900903159718Suche in Google Scholar
27. Lee HM, Kim JJ, Kim HJ, Shong M, Ku BJ, et al. Upregulated NLRP3 inflammasome activation in patients with type 2 diabetes. Diabetes 2013;62:194–204.10.2337/db12-0420Suche in Google Scholar PubMed PubMed Central
28. Barbu A, Hamad OA, Lind L, Ekdahl KN, Nilsson B. The role of complement factor C3 in lipid metabolism. Mol Immunol 2015;67:101–7.10.1016/j.molimm.2015.02.027Suche in Google Scholar PubMed
29. Walters DM, Breysse PN, Schofield B, Wills-Karp M. Complement factor 3 mediates particulate matter-induced airway hyperresponsiveness. Am J Respir Cell Mol Biol 2002;27:413–8.10.1165/rcmb.4844Suche in Google Scholar PubMed
30. Humbles AA, Lu B, Nilsson CA, Lilly C, Israel E, et al. A role for the C3a anaphylatoxin receptor in the effector phase of asthma. Nature 2000;406:998–1001.10.1038/35023175Suche in Google Scholar PubMed
31. Chen M, Daha MR, Kallenberg CG. The complement system in systemic autoimmune disease. J Autoimmun 2010;34:J276–86.10.1016/j.jaut.2009.11.014Suche in Google Scholar PubMed
32. Blanchin S, Estienne V, Durand-Gorde JM, Carayon P, Ruf J. Complement activation by direct C4 binding to thyroperoxidase in Hashimoto’s thyroiditis. Endocrinology 2003;144:5422–9.10.1210/en.2003-0918Suche in Google Scholar PubMed
©2017 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- Endocrine aspects in cystic fibrosis
- Original Articles
- A retrospective analysis of longitudinal changes in bone mineral content in cystic fibrosis
- Cystic-fibrosis related-diabetes (CFRD) is preceded by and associated with growth failure and deteriorating lung function
- Partial clinical remission in type 1 diabetes: a comparison of the accuracy of total daily dose of insulin of <0.3 units/kg/day to the gold standard insulin-dose adjusted hemoglobin A1c of ≤9 for the detection of partial clinical remission
- Concentrations of leptin, adiponectin and other metabolic parameters in non-obese children with Down syndrome
- Parent reported nutritional risk and laboratory indices of cardiometabolic risk and in preschool-aged children
- Multinodular goiter in children: treatment controversies
- Atopy as a risk factor for subclinical hypothyroidism development in children
- Mutation analysis of the NKX2.5 gene in Iranian pediatric patients with congenital hypothyroidism
- Health-related quality of life among children with Turner syndrome: controlled cross-sectional study
- Growth and pubertal patterns in young survivors of childhood acute lymphoblastic leukemia
- Clinical features and genotyping of patients with primary carnitine deficiency identified by newborn screening
- Letter to the Editor
- Sensitivity and specificity of cystic fibrosis-related diabetes screening methods: which test should be the reference method?
- Case Reports
- Type 1 rhizomelic chondrodysplasia punctata with a homozygous PEX7 mutation
- Severe hypertriglyceridemia at new onset type 1 diabetes mellitus
- 45,X/46,XY ovotesticular disorder of sex development revisited: undifferentiated gonadal tissue may be mistaken as ovarian tissue
- MRI in medium-chain acyl-coenzyme a dehydrogenase deficiency: neuroimaging during the first month
Artikel in diesem Heft
- Frontmatter
- Editorial
- Endocrine aspects in cystic fibrosis
- Original Articles
- A retrospective analysis of longitudinal changes in bone mineral content in cystic fibrosis
- Cystic-fibrosis related-diabetes (CFRD) is preceded by and associated with growth failure and deteriorating lung function
- Partial clinical remission in type 1 diabetes: a comparison of the accuracy of total daily dose of insulin of <0.3 units/kg/day to the gold standard insulin-dose adjusted hemoglobin A1c of ≤9 for the detection of partial clinical remission
- Concentrations of leptin, adiponectin and other metabolic parameters in non-obese children with Down syndrome
- Parent reported nutritional risk and laboratory indices of cardiometabolic risk and in preschool-aged children
- Multinodular goiter in children: treatment controversies
- Atopy as a risk factor for subclinical hypothyroidism development in children
- Mutation analysis of the NKX2.5 gene in Iranian pediatric patients with congenital hypothyroidism
- Health-related quality of life among children with Turner syndrome: controlled cross-sectional study
- Growth and pubertal patterns in young survivors of childhood acute lymphoblastic leukemia
- Clinical features and genotyping of patients with primary carnitine deficiency identified by newborn screening
- Letter to the Editor
- Sensitivity and specificity of cystic fibrosis-related diabetes screening methods: which test should be the reference method?
- Case Reports
- Type 1 rhizomelic chondrodysplasia punctata with a homozygous PEX7 mutation
- Severe hypertriglyceridemia at new onset type 1 diabetes mellitus
- 45,X/46,XY ovotesticular disorder of sex development revisited: undifferentiated gonadal tissue may be mistaken as ovarian tissue
- MRI in medium-chain acyl-coenzyme a dehydrogenase deficiency: neuroimaging during the first month