Frontiers in endocrinology · 2026
Thyroid autoimmunity in relation to islet autoantibodies in newly diagnosed type 1 diabetes mellitus in children and adolescents.
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Zhu Yingli, Yang Hongxiu, Hu Conghui, Qiao Lingyan, Li Cheng, Hu Sicui
Аннотация
PURPOSE: This study aimed to investigate the occurrence of thyroid autoantibodies at the onset of type 1 diabetes mellitus (T1DM) in children and adolescents, and to assess whether the presence of islet autoantibodies is associated with thyroid autoantibody presence.
METHODS: This retrospective cross-sectional study included 122 children and adolescents newly diagnosed with T1DM who visited Qingdao University Affiliated Women's and Children's Hospital between January 2022 and December 2024. We collected their blood glucose, glycated hemoglobin (HbA1c), C-peptide levels, and autoantibodies to islet cell antigen (ICA), glutamate decarboxylase (GADA), islet antigen-2 (IA-2A), insulin (IAA) and zinc transporter 8 (ZnT8A), thyroid peroxidase antibodies (TPOAb), and antithyroglobulin antibodies (TGAb).
RESULTS: 84.4% of patients had at least one islet autoantibody, with IA-2A showing the highest positivity rate (64.8%) and ZnT8A the lowest (3.3%). No patient tested positive for all five antibodies. In comparison of 42 thyroid autoantibody (TA)-positive patients (34.4%) with 80 TA-negative patients, the TA-positive group was older (7.8 ± 3.0 years vs. 6.6 ± 3.1 years, P = 0.045). The GADA positivity rate (60.9% vs. 41.4%, P = 0.004) and IAA positivity rate (33.3% vs. 11.3%, P = 0.003) were significantly higher in the TA-positive group than in the TA-negative group, with a higher median GADA titer (29.3 U/ml vs. 5.2 U/ml, P = 0.029). Logistic regression analysis revealed that GADA positivity (OR = 3.18, 95% CI: 1.44-7.01, P = 0.004) and IAA positivity (OR = 3.94, 95% CI: 1.53-10.15, P = 0.004) were significantly associated with TA positivity. After adjusting for age, sex, BMI, and family history of diabetes, both remained independently associated with TA (aOR=2.68 and 4.06, respectively). Additionally, GADA titer showed a weak positive correlation with TPOAb titer (r = 0.204, P = 0.024).
CONCLUSIONS: Positive GADA and IAA antibodies were independently associated with thyroid autoimmunity in children with newly diagnosed type 1 diabetes, and GADA titer correlated with TPOAb titer. These findings support the consideration of early screening and long-term monitoring of thyroid function in children with newly diagnosed type 1 diabetes, particularly those positive for GADA and/or IAA antibodies.
METHODS: This retrospective cross-sectional study included 122 children and adolescents newly diagnosed with T1DM who visited Qingdao University Affiliated Women's and Children's Hospital between January 2022 and December 2024. We collected their blood glucose, glycated hemoglobin (HbA1c), C-peptide levels, and autoantibodies to islet cell antigen (ICA), glutamate decarboxylase (GADA), islet antigen-2 (IA-2A), insulin (IAA) and zinc transporter 8 (ZnT8A), thyroid peroxidase antibodies (TPOAb), and antithyroglobulin antibodies (TGAb).
RESULTS: 84.4% of patients had at least one islet autoantibody, with IA-2A showing the highest positivity rate (64.8%) and ZnT8A the lowest (3.3%). No patient tested positive for all five antibodies. In comparison of 42 thyroid autoantibody (TA)-positive patients (34.4%) with 80 TA-negative patients, the TA-positive group was older (7.8 ± 3.0 years vs. 6.6 ± 3.1 years, P = 0.045). The GADA positivity rate (60.9% vs. 41.4%, P = 0.004) and IAA positivity rate (33.3% vs. 11.3%, P = 0.003) were significantly higher in the TA-positive group than in the TA-negative group, with a higher median GADA titer (29.3 U/ml vs. 5.2 U/ml, P = 0.029). Logistic regression analysis revealed that GADA positivity (OR = 3.18, 95% CI: 1.44-7.01, P = 0.004) and IAA positivity (OR = 3.94, 95% CI: 1.53-10.15, P = 0.004) were significantly associated with TA positivity. After adjusting for age, sex, BMI, and family history of diabetes, both remained independently associated with TA (aOR=2.68 and 4.06, respectively). Additionally, GADA titer showed a weak positive correlation with TPOAb titer (r = 0.204, P = 0.024).
CONCLUSIONS: Positive GADA and IAA antibodies were independently associated with thyroid autoimmunity in children with newly diagnosed type 1 diabetes, and GADA titer correlated with TPOAb titer. These findings support the consideration of early screening and long-term monitoring of thyroid function in children with newly diagnosed type 1 diabetes, particularly those positive for GADA and/or IAA antibodies.