Increasing Prevalence of Thyroid Autoimmunity in Childhood Type 1 Diabetes in the Pre-COVID but Not During the COVID Era

Overview

Journal Front Endocrinol (Lausanne)

Date 2025 Feb 10

PMID 39926395

Authors

Vivien Herczeg

Eszter Muzslay

Diana Czipo

Lili Terkovics

Johanna Takacs

Reka Garai

Fanni Kovacs

Andrea Luczay

Anna Korner

Peter Toth-Heyn

Affiliations

Soon will be listed here.

Abstract

Introduction: Studies assessing longitudinal changes in the prevalence of autoimmune thyroiditis (AIT) among the pediatric population are limited. During the COVID-19 era, several papers proposed a rise in AIT cases. Our study aimed to analyze the prevalence of thyroid autoimmunity (TA) over a 10-year period spanning pre-pandemic and pandemic years in a population who are regularly screened for thyroid disturbances.

Materials And Methods: This single-center retrospective cohort study analyzed data from 1,361 children and young adults with type 1 diabetes (T1D) treated between 2013 and 2022 in Hungary's largest pediatric endocrinology center. Results of anti-thyroid autoantibodies (anti-thyroid peroxidase/ATPO/and antithyroglobulin/ATG/), thyroid function tests (TFTs) and thyroid ultrasound examinations were obtained. Annual prevalence rates of TA and ultrasound-proven thyroiditis were calculated. Mean (± SD) follow-up period was 4.7 (± 2.8) years.

Results: The overall prevalence of TA among our T1D children was 22.8% ([20.3;25.5], 310 cases) with significantly more girls affected (p<0.001). From 2013 to 2022, TA prevalence rose from 15.9% to 20.6% (p=0.041). The increase was detected during the pre-pandemic years but not in the COVID-19 era. Ultrasound-confirmed thyroiditis was present in 80.0% of examined TA cases. Ultrasound positivity rate was stable during the study period. Among our children with TA, 28.5% exhibited clinically relevant thyroid-stimulating hormone (TSH) abnormalities (most commonly subclinical hypothyroidism) and/or were prescribed thyroid medication. Children with AIT had a significantly elevated risk of thyroid dysfunction compared to those with only thyroid autoantibody positivity (p<0.001).

Conclusion: Our results show a rise in the prevalence of thyroid autoimmunity among T1D children over the past decade, but our data do not support the assumed role of SARS-CoV-2 in the development of the disease.

Citing Articles

Occult Thyroid Cancer in Autoimmune Thyroiditis: Lymph Node Ultrasound as the Sole Diagnostic Indicator of Malignancy in a Pediatric Case of Papillary Thyroid Carcinoma.

Szwarkowska M, Kaleta K, Jurek A, Kujdowicz M, Taczanowska-Niemczuk A, Kiszka-Wilkojc A Children (Basel). 2025; 12(2).

PMID: 40003296 PMC: 11854475. DOI: 10.3390/children12020194.

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