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Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease

Genetic factors contribute for about 70% to 80% and environmental factors for about 20% to 30% to the pathogenesis of autoimmune thyroid disease (AITD). Relatives of AITD patients carry a risk to contract AITD themselves. The 5-year risk can be quantified by the so-called Thyroid Events Amsterdam-sc...

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Autor principal: Wiersinga, Wilmar M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Endocrine Society 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923404/
https://www.ncbi.nlm.nih.gov/pubmed/27184015
http://dx.doi.org/10.3803/EnM.2016.31.2.213
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author Wiersinga, Wilmar M.
author_facet Wiersinga, Wilmar M.
author_sort Wiersinga, Wilmar M.
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description Genetic factors contribute for about 70% to 80% and environmental factors for about 20% to 30% to the pathogenesis of autoimmune thyroid disease (AITD). Relatives of AITD patients carry a risk to contract AITD themselves. The 5-year risk can be quantified by the so-called Thyroid Events Amsterdam-score, based on serum thyroid-stimulating hormone, thyroid peroxidase (TPO)-antibodies and family history. Subjects at risk may ask what they can do to prevent development of AITD. This review summarizes what is known about modulation of exposure to environmental factors in terms of AITD prevention. To stop smoking decreases the risk on Graves disease but increases the risk on Hashimoto disease. Moderate alcohol intake provides some protection against both Graves and Hashimoto disease. Low selenium intake is associated with a higher prevalence of thyroid autoimmunity, but evidence that selenium supplementation may lower TPO antibodies and prevent subclinical hypothyroidism remains inconclusive. Low serum vitamin D levels are associated with a higher prevalence of TPO antibodies, but intervention studies with extra vitamin D have not been done yet. Stress may provoke Graves hyperthyroidism but not Hashimoto thyroiditis. Estrogen use have been linked to a lower prevalence of Graves disease. The postpartum period is associated with an increased risk of AITD. Taking together, preventive interventions to diminish the risk of AITD are few, not always feasible, and probably of limited efficacy.
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spelling pubmed-49234042016-07-07 Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease Wiersinga, Wilmar M. Endocrinol Metab (Seoul) Review Article Genetic factors contribute for about 70% to 80% and environmental factors for about 20% to 30% to the pathogenesis of autoimmune thyroid disease (AITD). Relatives of AITD patients carry a risk to contract AITD themselves. The 5-year risk can be quantified by the so-called Thyroid Events Amsterdam-score, based on serum thyroid-stimulating hormone, thyroid peroxidase (TPO)-antibodies and family history. Subjects at risk may ask what they can do to prevent development of AITD. This review summarizes what is known about modulation of exposure to environmental factors in terms of AITD prevention. To stop smoking decreases the risk on Graves disease but increases the risk on Hashimoto disease. Moderate alcohol intake provides some protection against both Graves and Hashimoto disease. Low selenium intake is associated with a higher prevalence of thyroid autoimmunity, but evidence that selenium supplementation may lower TPO antibodies and prevent subclinical hypothyroidism remains inconclusive. Low serum vitamin D levels are associated with a higher prevalence of TPO antibodies, but intervention studies with extra vitamin D have not been done yet. Stress may provoke Graves hyperthyroidism but not Hashimoto thyroiditis. Estrogen use have been linked to a lower prevalence of Graves disease. The postpartum period is associated with an increased risk of AITD. Taking together, preventive interventions to diminish the risk of AITD are few, not always feasible, and probably of limited efficacy. Korean Endocrine Society 2016-06 2016-05-13 /pmc/articles/PMC4923404/ /pubmed/27184015 http://dx.doi.org/10.3803/EnM.2016.31.2.213 Text en Copyright © 2016 Korean Endocrine Society http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Wiersinga, Wilmar M.
Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease
title Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease
title_full Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease
title_fullStr Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease
title_full_unstemmed Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease
title_short Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease
title_sort clinical relevance of environmental factors in the pathogenesis of autoimmune thyroid disease
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923404/
https://www.ncbi.nlm.nih.gov/pubmed/27184015
http://dx.doi.org/10.3803/EnM.2016.31.2.213
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