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    Home > Active Ingredient News > Endocrine System > Eur J Endocrinol: Common causes of type 1 diabetes and Hashimoto's thyroiditis - a population-based twin study

    Eur J Endocrinol: Common causes of type 1 diabetes and Hashimoto's thyroiditis - a population-based twin study

    • Last Update: 2022-11-14
    • Source: Internet
    • Author: User
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    Background: Type 1 diabetes and hypothyroidism due to Hashimoto's thyroiditis are the two most common autoimmune diseases
    .
    It is common for both diseases to occur co-existing in the same person, with up to a quarter of people with type 1 diabetes carrying autoantibodies predisposing to thyroid disease, and more than one in ten patients eventually developing significant Hashimoto's thyroiditis
    .
    Vice versa, people with Hashimoto's thyroiditis also have an increased risk of developing type 1 diabetes, especially in
    early-onset disease.
    In fact, the same patient with type 1 diabetes and Hashimoto's thyroiditis are the most common autoimmune polyendocrine diseases, sometimes referred to as variants
    of autoimmune polyglandular syndrome type 3 (APS3).
    In addition, familial studies have repeatedly shown that relatives of people with one disease are at higher risk of another, further supporting a common origin
    .

    Type 1 diabetes and Hashimoto's thyroiditis are complex autoimmune diseases that contribute to a variety of genetic and non-genetic factors
    .
    Twin studies confirm that a genetic component (i.
    e.
    , heritability) explains most of the observed differences between the two diseases, and molecular genetic studies have identified genetic polymorphisms
    associated with both diseases.
    Still, identical twins affected by both diseases are often uncoordinated, with only one pair of twins affected by the disease, highlighting the importance
    of environmental factors in triggering autoimmunity.
    As a result, the scale and composition of the common origins of these diseases remain largely unclear
    .

    Objective: The purpose of this study was to assess the common familial risk of type 1 diabetes and Hashimoto's thyroiditis and to quantify the common genetic and environmental sources
    of the disease using a large population-based cohort of twins.

    Methods: The National Health Register was used to identify
    cases of Swedish twins 110814.
    Co-aggregation calculated the risk ratio of identical twins of patients with Hashimoto's thyroiditis for type 1 diabetes and vice versa
    .
    By comparing the association between identical and fraternal twins using a structural equation model, the variance (i.
    e.
    , heritability) explained by genetics and its proportion
    between diseases are estimated.

    Results: Individuals with one disease had a higher risk of developing another (adjusted hazard ratio: 11.
    4 (95% CI: 8.
    5-15.
    3)).

    Co-aggregation was more common in monozygotes than in bizygotes, with adjusted hazard ratios of 7.
    0 (95% confidence interval, CI: 3.
    2 to 15.
    1) and 1.
    7 (95% CI: 0.
    7 to 4.
    1),
    respectively.
    Among the variants of type 1 diabetes and Hashimoto's thyroiditis, the shared genetic effect accounts for 11% and in the variation of Hashimoto's thyroiditis 9%, while environmental factors specific to the twins individually, but shared between different diseases, account for 10% and 18%
    of the variants of type 1 diabetes and Hashimoto's thyroiditis.

    Table 1 Number of individuals and column percentages
    .
    Data is expressed
    in n (%).

    Table 2 Association of type 1 diabetes mellitus and Hashimoto's thyroiditis in twins, family clustering, and family co-aggregation
    .

    Table 3 Consistency, inconsistency and thyroid correlation
    between type 1 diabetes and Hashimoto's thyroiditis.

    Table 4 Adjustment results for best-fitting acoustic emission models

    Figure 1A, additive genetic effects
    .
    Environmental influences are not shared by twins
    .
    A is equivalent to heritability
    .
    Estimates are adjusted
    for sex and birth cohort.

    Conclusion: Both the genes and environment specific to the twins contributed to the discovery of the cause
    between type 1 diabetes and Hashimoto's thyroiditis.
    These findings add to current knowledge about the mechanisms behind the clustering of autoimmune diseases and may guide future research
    aimed at identifying pathophysiological mechanisms and intervention targets.

    Original source:

    Skov J, Kuja-Halkola R, Magnusson PKE, et al.
    Shared etiology of type 1 diabetes and Hashimoto's thyroiditis: a population-based twin study.
    Eur J Endocrinol.
    2022 May 9; 186(6):677-685.

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