Gluten intake and risk of thyroid peroxidase autoantibodies in the Diabetes Autoimmunity Study In the Young (DAISY)
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ORIGINAL ARTICLE
Gluten intake and risk of thyroid peroxidase autoantibodies in the Diabetes Autoimmunity Study In the Young (DAISY) Jacqueline A. Gardner1 Randi K. Johnson2 Fran Dong3 Michelle Hoffman3 Andrea K. Steck3 Brigitte I. Frohnert3 Marian Rewers3 Jill M. Norris 1 ●
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Received: 7 May 2020 / Accepted: 27 June 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Autoimmune diseases co-occur, perhaps due to common risk factors. The age at gluten introduction and gluten intake in early childhood has been associated with the autoimmunity preceding celiac disease (CD) and type-1 diabetes (T1D). We explored their associations with the development of thyroid autoimmunity. Methods DAISY has prospectively followed children at increased risk for T1D and CD since 1993. During follow-up, 107 children developed thyroid autoimmunity, defined as positivity for autoantibodies against thyroid peroxidase on at least two study visits. Age at gluten introduction was ascertained from food history interviews every 3 months until 15 months of age. Gluten intake (g/day) at age 1–2 years was estimated using a food frequency questionnaire. Results From multivariable Cox regression, there was no association between the age of gluten introduction nor the amount of gluten intake and development of thyroid autoimmunity. However, females (hazard ratio = 2.19, 95% CI: 1.46, 3.27) and cases of islet autoimmunity (HR = 2.20, 95% CI: 1.39, 3.50) were significantly more likely to develop thyroid autoimmunity, while exposure to environmental tobacco smoke decreased the risk (HR = 0.46, 95% CI: 0.30, 0.71). Conclusions Neither the age of gluten introduction nor the amount of gluten consumed in early childhood is associated with risk of thyroid autoimmunity. Keywords Thyroid autoimmunity Gluten Thyroid peroxidase Infant diet Environmental tobacco smoke ●
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Introduction Autoimmune thyroid disease (AITD) affects about 5% of the US population [1], making it one of the most common autoimmune disorders in adults and children. Common forms include Hashimoto’s thyroiditis (autoimmune hypothyroidism) and Graves’ disease (autoimmune hyperthyroidism). Detection
These authors contributed equally: Jacqueline A. Gardner, Randi K. Johnson * Jill M. Norris [email protected] 1
Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
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Division of Bioinformatics and Personalized Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
3
Barbara Davis Center for Diabetes, Aurora, CO, USA
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of antibodies against thyroid peroxidase (TPO), an enzyme critical for hormone production in the thyroid, is a reliable marker of autoimmune destruction of thyroid tissue [2]. TPO antibodies are predictive of AITD in both the general population [3–5] and among those with other autoimmune diseases [6, 7]. Clustering of AITD with celiac disease (CD) and type-1 diabetes (T1D) is well-documented [8–13], and suggesti
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