Risk factors for and prevalence of thyroid disorders in a cross‐sectional study among healthy female relatives of patients with autoimmune thyroid disease

Strieder, Thea G. A.; Prummel, Mark F.; Tijssen, Jan G.P.; Endert, E.; Wiersinga, Wilmar M.

doi:10.1046/j.1365-2265.2003.01862.x

Cited by 200 publications

(147 citation statements)

References 28 publications

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“…Estrogen has been shown to be lower in smoking women and the use of oral contraceptives or estrogen has been associated with a lower frequency of GD (24)(25)(26)(27).…”

Section: Discussionmentioning

confidence: 99%

Immigration and the incidence of Graves' thyrotoxicosis, thyrotoxic multinodular goiter and solitary toxic adenoma

Lantz¹,

Abraham-Nordling²,

Svensson³

et al. 2009

European Journal of Endocrinology

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“…Estrogen has been shown to be lower in smoking women and the use of oral contraceptives or estrogen has been associated with a lower frequency of GD (24)(25)(26)(27).…”

Section: Discussionmentioning

confidence: 99%

Immigration and the incidence of Graves' thyrotoxicosis, thyrotoxic multinodular goiter and solitary toxic adenoma

Lantz¹,

Abraham-Nordling²,

Svensson³

et al. 2009

European Journal of Endocrinology

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“…Similarly, estrogen usage negatively correlated with the presence of TPO antibodies (83). During the menstrual cycle, lower levels of estrogens during menstruation and luteal phase and higher levels of estrogens during the follicular phase lead to a shift from Th1-to Th2-mediated immunity respectively (84).…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome

Gaberšček

Zaletel

Schwetz

et al. 2015

European Journal of Endocrinology

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Thyroid disorders, especially Hashimoto's thyroiditis (HT), and polycystic ovary syndrome (PCOS) are closely associated, based on a number of studies showing a significantly higher prevalence of HT in women with PCOS than in controls. However, the mechanisms of this association are not as clear. Certainly, genetic susceptibility contributes an important part to the development of HT and PCOS. However, a common genetic background has not yet been established. Polymorphisms of the PCOS-related gene for fibrillin 3 (FBN3) could be involved in the pathogenesis of HT and PCOS. Fibrillins influence the activity of transforming growth factor beta (TGFb). Multifunctional TGFb is also a key regulator of immune tolerance by stimulating regulatory T cells (Tregs), which are known to inhibit excessive immune response. With lower TGFb and Treg levels, the autoimmune processes, well known in HT and assumed in PCOS, might develop. In fact, lower levels of TGFb1 were found in HT as well as in PCOS women carrying allele 8 of D19S884 in the FBN3 gene. Additionally, vitamin D deficiency was shown to decrease Tregs. Finally, high estrogen-to-progesterone ratio owing to anovulatory cycles in PCOS women could enhance the immune response. Harmful metabolic and reproductive effects were shown to be more pronounced in women with HT and PCOS when compared with women with HT alone or with controls. In conclusion, HT and PCOS are associated not only with respect to their prevalence, but also with regard to etiology and clinical consequences. However, a possible crosstalk of this association is yet to be elucidated.

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“…Vestergaard et al (25) found that ever having used OCs was associated with a slightly lower risk of Graves'disease but not of Hashimoto's disease. In a cohort study of 803 subjects at risk of developing AITD, Strieder et al (26) found that the use of oestrogen was negatively correlated with the presence of TPO-Ab. In a follow-up study of healthy middle-aged women, Massoudi et al (27) found no difference in antibody level in postmenopausal women using HRT compared with women who did not (27).…”

Section: Odds Ratiomentioning

confidence: 99%

Lack of association between thyroid autoantibodies and parity in a population study argues against microchimerism as a trigger of thyroid autoimmunity

et al. 2006

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Background: Thyroid autoimmunity is more common in females than in males. One possible explanation for this female preponderance may be the effect of oestrogens on the immune system. It has also been suggested that foetal microchimerism involving transfer of foetal cells into maternal tissue during pregnancy may play an important role. Objective: We investigated the association between the presence of circulating thyroid autoantibodies and previous pregnancy, parity and the use of oral contraceptives (OCs) and hormone replacement therapy (HRT) in a population cohort. Methods: We examined 3712 women randomly selected from the general population. Serum was analysed for thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (Tg-Ab) using assays based on an RIA technique (DYNO test). Data were analysed in logistic regression models to adjust for possible confounders. Women previously treated for thyroid disease or with pregnancy within 1 year prior to the study were excluded from the analyses. Results: In both univariate and multivariate models and whether the presence of TPO-Ab and Tg-Ab was investigated alone or in combination, findings were negative with respect to an association between circulating thyroid antibodies and previous pregnancy, number of pregnancies, parity and previous abortion. There was no association between thyroid autoantibodies and use of OCs. Women aged 60 -65 years receiving HRT now or previously had a lower prevalence of Tg-Ab (univariate, P ¼ 0.01; multivariate, P ¼ 0.02). No such association was observed between HRT and TPO-Ab. Conclusion: In this population study there was no association between previous pregnancy, parity and thyroid antibodies, which argues against the role of microchimerism as a trigger of thyroid autoimmunity. Exogenous oestrogens may reduce aspects of autoimmunity.

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Risk factors for and prevalence of thyroid disorders in a cross‐sectional study among healthy female relatives of patients with autoimmune thyroid disease

Cited by 200 publications

References 28 publications

Immigration and the incidence of Graves' thyrotoxicosis, thyrotoxic multinodular goiter and solitary toxic adenoma

Immigration and the incidence of Graves' thyrotoxicosis, thyrotoxic multinodular goiter and solitary toxic adenoma

MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome

Lack of association between thyroid autoantibodies and parity in a population study argues against microchimerism as a trigger of thyroid autoimmunity

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