Background: Autoimmune thyroid diseases (AITD) are one of the most common organ-specific autoimmune disorders, of which Hashimotos thyroiditis (HT) and Graves disease (GD) are 2 of the most common clinical expressions. HT is characterized by hypothyroidism (hypoT) that results from the destruction of the thyroid by specific T cell-mediated cytotoxicity. In contrast, GD is characterized by hyperthyroidism (hyperT) induced by thyrotropin receptor-specific stimulatory autoantibodies.
Objective and hypotheses: The aim of the study was to determine the relationship between concentration of cytokines IL-1β and sFasL with anthropometric, hormonal and immune thyroid factors in serum of children with autoimmune thyroid disease.
Method: The group comprised 45 newly diagnosed children with Hashimoto thyroiditis, Graves disease vs euthyroid control group: 11 hypoT (10 girls, 1 boy), 19 hyperT (15 girls, four boys) and 15 healthy subjects (seven girls, eight boys). Thyroid function, autoimmune and anthropometric parameters were evaluated.
Results: In our study IL-1β concentration was significantly higher in hypoT children ([median] 2.16 pg/ml) vs control (1.88 pg/ml) (P<0.05) and vs hyperT (1.39 pg/ml)(P<0.01). IL-1β positively correlated with ATPO in hyperT children (r=0.47; P<0.05), as well as sFasL with BMISDS (r=0.48; P<0.5) Significantly higher sFasL level (0.26 ng/ml) was identified in children with hypothyroidism (0.06 ng/ml, P<0.001) and hyperthyroidism (0.14 ng/ml, P<0.05) compared to the controls. ROC analysis indicates that both cytokines IL-1β and sFasL effectively discriminated hypothyroid and healthy children (IL-1β: AUC=0.77; P=0.003 and sFasL AUC=0.897; P<0.001). sFasL with high sensitivity 100% and specificity 73.3% but IL-1β with low sensitivity 59.1% and high specificity 95%. Moreover IL-1β and sFasL effectively discriminated both clinically opposing states, hyperthyroidism and hypothyroidism among themselves: sFasL (AUC=0.833; P=0.003; sensitivity: 94.7%,specificity: 72.7%. and IL-1β (AUC=0.773; P=0.002; sensitivity: 72.7%; specificity: 86.4%).
Conclusions: Both cytokines IL-1β and TNF-a may be useful markers in the assessment of thyroid dysfunction of autoimmune hypothyroid and hyperthyroid children.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology