In New-onset Insulin-dependent Diabetic Patients the Presence of Anti-thyroid Peroxidase Antibodies is Associated with Islet Cell Autoimmunity and the High Risk Haplotype HLA DQA1*0301-DQB1*0302

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Abstract
In 157 new onset IDDM (104 men, 53 women, ages 10–39 yr) anti‐thyroid peroxidase anti‐bodies (anti‐TPO) were assayed with a specific immunological test. Values greater than 100 U ml−1 were considered positive. Seventeen per cent of the patients were positive (32% of the women versus 10% of the men, p < 0.001). Eighty‐five per cent of the anti‐TPO + patients have a positive titre of islet‐cell antibodies (ICA ⩾ 12 JDFU) versus 64% of the anti‐TPO−patients (p < 0.05). When patients were subdivided in a young (10–25 yr) and an older age group (26–39 yr) this association was also true for ICA ⩾ 50 JDFU and valid for insulin autoantibodies (IAA) at low (⩾0.7%) and high risk (⩾1.5%) (p < 0.005) in the second group. The median of the TSH concentration was not different between anti‐TPO+ and anti‐TPO− when the group is considered as a whole. In the anti‐TPO+ men (26–39 yr) TSH was however significantly greater (1.55 μU ml−1, range 0.74–8.5 versus 1.4 μU ml−1, range 0.21–3.5, p < 0.0001) when compared to the anti‐TPO‐men of the same age group. The haplotype HLA DQA1*0301‐DQB1*0302 was more frequent in the anti‐TPO+ (39%) than in the anti‐TPO− (23%) patients (p < 0.02) for the age group 26–39 yr but not for the age group 10–25 yr. The other diabetes susceptibility haplotype DQA1*0501‐DQB1*0201 was less frequent in anti‐TPO+ patients. In conclusion we suggest that thyroid auto‐immunity must be part of the initial screening of IDDM especially when patients are older at clinical onset of the disease.

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