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A review of the literature on the epidemiology of autoimmune thyroiditis (AT) is presented. This review examines the etiological factors of autoimmune thyroid damage. In case of damage to thyroid cells, the formation of antibodies and lymphoid infiltration of the gland is of great importance. It is noted that genetic factors precede the occurrence of pathological changes. Loss of immune tolerance to thyroid autoantigens such as thyroid peroxidase (TPO), thyroglobulin underlies the development of AT. The role of oxidative stress and reactive oxygen species is important in the pathogenesis of the disease. It is shown that at the beginning, AT is asymptomatic and the formation of TPO and thyroglobulin antibodies precedes the onset of the disease and may indicate latent AT. The prevalence of latent AT varies from country to country and ranges from 2 to 20 %, and among women it was 4–6 times higher than among men. Subsequently, latent AT progresses to subclinical and overt thyroiditis with hypothyroidism. The incidence of manifest AT in various countries is from 27 to 273 per 100,000 population. Often, the disease began in childhood and adolescence. The frequency of pathology, including latent subclinical and manifest AT, in this cohort of the population according to different authors is from 0.3 to 9.6 %. Pregnancy was also accompanied by the presence of TPO antibodies but with reduced aggression of cellular elements and antibodies to the thyroid gland. The postpartum period was characterized by exacerbation of the disease. In Ukraine, the incidence of AT is 43.1 per 100,000, the prevalence is almost 10 times higher — 421.2 per 100,000. It is concluded that AT is the most common organ-specific autoimmune disease.
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Unal E, Akın A, Yıldırım R, Demir V, Yildiz İ, Haspolat YK. Association of Subclinical Hypothyroidism with Dyslipidemia and Increased Carotid Intima-Media Thickness in Children. J Clin Res Pediatr Endocrinol. 2017 Jun 1;9(2):144-149. doi:10.4274/jcrpe.3719.
Vukovic R, Zeljkovic A, Bufan B, Spasojevic-Kalimanovska V, Milenkovic T, Vekic J. Hashimoto Thyroiditis and Dyslipidemia in Childhood: A Review. Front Endocrinol (Lausanne). 2019 Dec 10;10:868. doi:10.3389/fendo.2019.00868.
Głowinska-Olszewska B, Borysewicz-Sańczyk H, Sawicka B, et al. Does Hashimoto's Thyroiditis Increase the Risk of Cardiovascular Disease in Young Type 1 Diabetic Patients? Front Endocrinol (Lausanne). 2020 Jul 24;11:431. doi:10.3389/fendo.2020.00431.
Hashimoto H. Zur kenntniss der lymphomatosen veranderung der Schilddruse (Struma lymphomatosa) [To know about lymphomatous changes in the thyroid gland (goiter lymphomatosa)]. Arch Klin Chir. 1912;97:219-248.
Zakharchenko TF, Kravchenko VI. Peculiarities of innate and adaptive immunity in the pathogenesis of thyroid autoimmune diseases. Immunocorrection (part 1). Mìžnarodnij endokrinologìčnij žurnal. 2020;16(7):564-576. doi:10.22141/2224-07220.127.116.110.219011. (in Ukrainian).
Hwangbo Y, Park YJ. Genome-Wide Association Studies of Autoimmune Thyroid Diseases, Thyroid Function, and Thyroid Cancer. Endocrinol Metab (Seoul). 2018 Jun;33(2):175-184. doi:10.3803/EnM.2018.33.2.175.
Ajjan RA, Kemp EH, Waterman EA, et al. Detection of binding and blocking autoantibodies to the human sodium-iodide symporter in patients with autoimmune thyroid disease. J Clin Endocrinol Metab. 2000 May;85(5):2020-7. doi:10.1210/jcem.85.5.6526.
Yoshida A, Hisatome I, Taniguchi S, et al. Pendrin is a novel autoantigen recognized by patients with autoimmune thyroid diseases. J Clin Endocrinol Metab. 2009 Feb;94(2):442-8. doi:10.1210/jc.2008-1732.
Belin RM, Astor BC, Powe NR, Ladenson PW. Smoke exposure is associated with a lower prevalence of serum thyroid autoantibodies and thyrotropin concentration elevation and a higher prevalence of mild thyrotropin concentration suppression in the third National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2004 Dec;89(12):6077-86. doi:10.1210/jc.2004-0431.
Carlé A, Bülow Pedersen I, Knudsen N, et al. Smoking cessation is followed by a sharp but transient rise in the incidence of overt autoimmune hypothyroidism - a population-based, case-control study. Clin Endocrinol (Oxf). 2012 Nov;77(5):764-72. doi:10.1111/j.1365-2265.2012.04455.x.
Effraimidis G, Strieder TG, Tijssen JG, Wiersinga WM. Natural history of the transition from euthyroidism to overt autoimmune hypo- or hyperthyroidism: a prospective study. Eur J Endocrinol. 2011 Jan;164(1):107-13. doi:10.1530/EJE-10-0785.
Effraimidis G, Tijssen JG, Wiersinga WM. Discontinuation of smoking increases the risk for developing thyroid peroxidase antibodies and/or thyroglobulin antibodies: a prospective study. J Clin Endocrinol Metab. 2009 Apr;94(4):1324-8. doi:10.1210/jc.2008-1548.
Pankiv VI, Yuzvenko TYu, Pankiv IV. Type 2 diabetes mellitus and subclinical hypothyroidism: focusing on the role of cholecalciferol. Problems of Endocrine Pathology. 2019;2:46-51. doi:10.21856/j-PEP.2019.2.07.
Hwang GB, Yoon JS, Park KJ, Lee HS, Hwang JS. Prevalence of autoimmune thyroiditis in patients with type 1 diabetes: a long-term follow-up study. Ann Pediatr Endocrinol Metab. 2018 Mar;23(1):33-37. doi:10.6065/apem.2018.23.1.33.
Staii A, Mirocha S, Todorova-Koteva K, Glinberg S, Jaume JC. Hashimoto thyroiditis is more frequent than expected when diagnosed by cytology which uncovers a pre-clinical state. Thyroid Res. 2010 Dec 20;3(1):11. doi:10.1186/1756-6614-3-11.
Thomsen H, Li X, Sundquist K, Sundquist J, Försti A, Hemminki K. Familial risks between Graves disease and Hashimoto thyroiditis and other autoimmune diseases in the population of Sweden. J Transl Autoimmun. 2020 Jun 1;3:100058. doi:10.1016/j.jtauto.2020.100058.
Ragusa F, Fallahi P, Elia G, et al. Hashimotos' thyroiditis: Epidemiology, pathogenesis, clinic and therapy. Best Pract Res Clin Endocrinol Metab. 2019 Dec;33(6):101367. doi:10.1016/j.beem.2019.101367.
Dragin N, Bismuth J, Cizeron-Clairac G, et al. Estrogen-mediated downregulation of AIRE influences sexual dimorphism in autoimmune diseases. J Clin Invest. 2016 Apr 1;126(4):1525-37. doi:10.1172/JCI81894.
Thompson EE, Nicodemus-Johnson J, Kim KW, et al. Global DNA methylation changes spanning puberty are near predicted estrogen-responsive genes and enriched for genes involved in endocrine and immune processes. Clin Epigenetics. 2018 May 9;10:62. doi:10.1186/s13148-018-0491-2.
Bliddal S, Nielsen CH, Feldt-Rasmussen U. Recent advances in understanding autoimmune thyroid disease: the tallest tree in the forest of polyautoimmunity. F1000Res. 2017 Sep 28;6:1776. doi:10.12688/f1000research.11535.1.
Eaton WW, Pedersen MG, Atladóttir HO, Gregory PE, Rose NR, Mortensen PB. The prevalence of 30 ICD-10 autoimmune diseases in Denmark. Immunol Res. 2010 Jul;47(1-3):228-31. doi:10.1007/s12026-009-8153-2.
Kaloumenou I, Mastorakos G, Alevizaki M, et al. Thyroid autoimmunity in schoolchildren in an area with long-standing iodine sufficiency: correlation with gender, pubertal stage, and maternal thyroid autoimmunity. Thyroid. 2008 Jul;18(7):747-54. doi:10.1089/thy.2007.0370.
Mariotti S, Prinzis A, Ghiani M, et al. Puberty is associated with a marked increase of the female sex predominance in chronic autoimmune thyroiditis. Horm Res. 2009;72(1):52-6. doi:10.1159/000224341.
Kiyaev AV, Savelyev LI, Gerasimova LYu, Koroleva NP, Boyarsky SN, Tsvirenko SV. The Prevalence of Thyroid Disease in the Children and Teenagers in Iodine-Deficient Region. Clinical and experimental thyroidology. 2007;3(2):33-38. doi:10.14341/ket20073233-38. (in Russian).
Wasniewska M, Corrias A, Salerno M, et al. Thyroid function patterns at Hashimoto's thyroiditis presentation in childhood and adolescence are mainly conditioned by patients' age. Horm Res Paediatr. 2012;78(4):232-6. doi:10.1159/000343815.
Aversa T, Corrias A, Salerno M, et al. Five-Year Prospective Evaluation of Thyroid Function Test Evolution in Children with Hashimoto's Thyroiditis Presenting with Either Euthyroidism or Subclinical Hypothyroidism. Thyroid. 2016 Oct;26(10):1450-1456. doi:10.1089/thy.2016.0080.
Negro R, Formoso G, Mangieri T, Pezzarossa A, Dazzi D, Hassan H. Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications. J Clin Endocrinol Metab. 2006 Jul;91(7):2587-91. doi:10.1210/jc.2005-1603.
Andersen SL, Olsen J. Early Pregnancy Thyroid Function Test Abnormalities in Biobank Sera from Women Clinically Diagnosed with Thyroid Dysfunction Before or After Pregnancy. Thyroid. 2017 Mar;27(3):451-459. doi:10.1089/thy.2016.0542.
Stagnaro-Green A, Roman SH, Cobin RH, el-Harazy E, Alvarez-Marfany M, Davies TF. Detection of at-risk pregnancy by means of highly sensitive assays for thyroid autoantibodies. JAMA. 1990 Sep 19;264(11):1422-5.
Feldt-Rasmussen U, Høier-Madsen M, Rasmussen NG, Hegedüs L, Hornnes P. Anti-thyroid peroxidase antibodies during pregnancy and postpartum. Relation to postpartum thyroiditis. Autoimmunity. 1990;6(3):211-4. doi:10.3109/08916939009041041.
Walfish PG, Meyerson J, Provias JP, Vargas MT, Papsin FR. Prevalence and characteristics of post-partum thyroid dysfunction: results of a survey from Toronto, Canada. J Endocrinol Invest. 1992 Apr;15(4):265-72. doi:10.1007/BF03348726.
Kaminskyi OV, Pankiv VI, Pankiv IV, Afanasyev DE. Vitamin D Content In Population Of Radiologically Contaminated Areas In Chernivtsi Oblast (pilot project). Probl Radiac Med Radiobiol. 2018 Dec;23:442-451. doi:10.33145/2304-8336-2018-23-442-451. (in Ukrainian).
Kravchenko VI, Andrusyshyna IM, Luzanchuk IA, Polumbryk MO, Tarashchenko YM. Association Between Thyroid Hormone Status and Trace Elements in Serum of Patients with Nodular Goiter. Biol Trace Elem Res. 2020 Aug;196(2):393-399. doi:10.1007/s12011-019-01943-9.
Rostami R, Nourooz-Zadeh S, Mohammadi A, Khalkhali HR, Ferns G, Nourooz-Zadeh J. Serum Selenium Status and Its Interrelationship with Serum Biomarkers of Thyroid Function and Antioxidant Defense in Hashimoto's Thyroiditis. Antioxidants (Basel). 2020 Oct 31;9(11):1070. doi:10.3390/antiox9111070.
Luzanchuk A, Kravchenko VI, Polumbryk MO, Tarachenko YM. Thyroid status, major and trace elements content in patients with autoimmune thyroiditis living in Chernobyl-affected areas of Zhytomyr region. Problems of Endocrine Pathology. 2020;3:54-62. doi:10.21856/j-PEP.2020.3.07.
Erdal M, Sahin M, Hasimi A, Uckaya G, Kutlu M, Saglam K. Trace element levels in hashimoto thyroiditis patients with subclinical hypothyroidism. Biol Trace Elem Res. 2008 Summer;123(1-3):1-7. doi:10.1007/s12011-008-8117-8.
Rasic-Milutinovic Z, Jovanovic D, Bogdanovic G, Trifunovic J, Mutic J. Potential Influence of Selenium, Copper, Zinc and Cadmium on L-Thyroxine Substitution in Patients with Hashimoto Thyroiditis and Hypothyroidism. Exp Clin Endocrinol Diabetes. 2017 Feb;125(2):79-85. doi:10.1055/s-0042-116070.
Wang K, Wei H, Zhang W, et al. Severely low serum magnesium is associated with increased risks of positive anti-thyroglobulin antibody and hypothyroidism: A cross-sectional study. Sci Rep. 2018 Jul 2;8(1):9904. doi:10.1038/s41598-018-28362-5.