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Gender Differences at the Onset of Autoimmune Thyroid Diseases in Children and Adolescents

Background: The incidence of autoimmune thyroid diseases (ATD) may vary with the beginning of reproductive function, although few reports differentiate the incidence before and during the onset of puberty, examining gender bias. We analyzed onset of ATD in a pediatric population to assess gender dif...

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Autores principales: Calcaterra, Valeria, Nappi, Rossella E., Regalbuto, Corrado, De Silvestri, Annalisa, Incardona, Antonino, Amariti, Rossella, Bassanese, Francesco, Clemente, Andrea Martina, Vinci, Federica, Albertini, Riccardo, Larizza, Daniela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7181383/
https://www.ncbi.nlm.nih.gov/pubmed/32362875
http://dx.doi.org/10.3389/fendo.2020.00229
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author Calcaterra, Valeria
Nappi, Rossella E.
Regalbuto, Corrado
De Silvestri, Annalisa
Incardona, Antonino
Amariti, Rossella
Bassanese, Francesco
Clemente, Andrea Martina
Vinci, Federica
Albertini, Riccardo
Larizza, Daniela
author_facet Calcaterra, Valeria
Nappi, Rossella E.
Regalbuto, Corrado
De Silvestri, Annalisa
Incardona, Antonino
Amariti, Rossella
Bassanese, Francesco
Clemente, Andrea Martina
Vinci, Federica
Albertini, Riccardo
Larizza, Daniela
author_sort Calcaterra, Valeria
collection PubMed
description Background: The incidence of autoimmune thyroid diseases (ATD) may vary with the beginning of reproductive function, although few reports differentiate the incidence before and during the onset of puberty, examining gender bias. We analyzed onset of ATD in a pediatric population to assess gender differences in onset age, disease subtype, pubertal status, autoimmune co-morbidity, family history and treatment, focusing on the interaction between gender and pubertal stage. Patients and methods: We retrospectively recorded 382 children and adolescents with ATD. In each patient physical examination was considered. The presence of other associated autoimmune diseases (AAD) and familial predisposition was also recorded. Results: Predominant prevalence was noted in females compared to males (p < 0.001), both in Hashimoto's diseases (HD or HT) and Graves' disease (GD) (p < 0.001). Mean age at diagnosis showed no significant difference between sexes (p > 0.05). A higher prevalence in pubertal subjects was noted compared to prepubertal (p < 0.001, particularly HT in early and GD in late pubertal stage), without sexes difference intra-(prepubertal vs. pubertal) and inter-puberty groups (prepubertal vs. early pubertal vs. late pubertal). Both in HT and in GD, the prevalence of autoimmune associated diseases (AAD) was higher in males compared to females (p = 0.04), with similar distribution according to the pubertal maturation. The familial predisposition was similarly distributed in both genders (p > 0.05) and into pubertal stages (p > 0.05). Conclusions: Females are more prone to develop ATD during puberty, earlier in HT than in GD. The effect of puberty is not different between genders, suggesting the role of additional factors other than hormones. The screening for detection of ATD is recommended in all patients with positive family history and other autoimmune diseases, mostly in males. Considerations of gender in pediatrics could be important to define pathogenic mechanisms of ATD and to help in early diagnosis and clinical management.
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spelling pubmed-71813832020-05-01 Gender Differences at the Onset of Autoimmune Thyroid Diseases in Children and Adolescents Calcaterra, Valeria Nappi, Rossella E. Regalbuto, Corrado De Silvestri, Annalisa Incardona, Antonino Amariti, Rossella Bassanese, Francesco Clemente, Andrea Martina Vinci, Federica Albertini, Riccardo Larizza, Daniela Front Endocrinol (Lausanne) Endocrinology Background: The incidence of autoimmune thyroid diseases (ATD) may vary with the beginning of reproductive function, although few reports differentiate the incidence before and during the onset of puberty, examining gender bias. We analyzed onset of ATD in a pediatric population to assess gender differences in onset age, disease subtype, pubertal status, autoimmune co-morbidity, family history and treatment, focusing on the interaction between gender and pubertal stage. Patients and methods: We retrospectively recorded 382 children and adolescents with ATD. In each patient physical examination was considered. The presence of other associated autoimmune diseases (AAD) and familial predisposition was also recorded. Results: Predominant prevalence was noted in females compared to males (p < 0.001), both in Hashimoto's diseases (HD or HT) and Graves' disease (GD) (p < 0.001). Mean age at diagnosis showed no significant difference between sexes (p > 0.05). A higher prevalence in pubertal subjects was noted compared to prepubertal (p < 0.001, particularly HT in early and GD in late pubertal stage), without sexes difference intra-(prepubertal vs. pubertal) and inter-puberty groups (prepubertal vs. early pubertal vs. late pubertal). Both in HT and in GD, the prevalence of autoimmune associated diseases (AAD) was higher in males compared to females (p = 0.04), with similar distribution according to the pubertal maturation. The familial predisposition was similarly distributed in both genders (p > 0.05) and into pubertal stages (p > 0.05). Conclusions: Females are more prone to develop ATD during puberty, earlier in HT than in GD. The effect of puberty is not different between genders, suggesting the role of additional factors other than hormones. The screening for detection of ATD is recommended in all patients with positive family history and other autoimmune diseases, mostly in males. Considerations of gender in pediatrics could be important to define pathogenic mechanisms of ATD and to help in early diagnosis and clinical management. Frontiers Media S.A. 2020-04-17 /pmc/articles/PMC7181383/ /pubmed/32362875 http://dx.doi.org/10.3389/fendo.2020.00229 Text en Copyright © 2020 Calcaterra, Nappi, Regalbuto, De Silvestri, Incardona, Amariti, Bassanese, Clemente, Vinci, Albertini and Larizza. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Calcaterra, Valeria
Nappi, Rossella E.
Regalbuto, Corrado
De Silvestri, Annalisa
Incardona, Antonino
Amariti, Rossella
Bassanese, Francesco
Clemente, Andrea Martina
Vinci, Federica
Albertini, Riccardo
Larizza, Daniela
Gender Differences at the Onset of Autoimmune Thyroid Diseases in Children and Adolescents
title Gender Differences at the Onset of Autoimmune Thyroid Diseases in Children and Adolescents
title_full Gender Differences at the Onset of Autoimmune Thyroid Diseases in Children and Adolescents
title_fullStr Gender Differences at the Onset of Autoimmune Thyroid Diseases in Children and Adolescents
title_full_unstemmed Gender Differences at the Onset of Autoimmune Thyroid Diseases in Children and Adolescents
title_short Gender Differences at the Onset of Autoimmune Thyroid Diseases in Children and Adolescents
title_sort gender differences at the onset of autoimmune thyroid diseases in children and adolescents
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7181383/
https://www.ncbi.nlm.nih.gov/pubmed/32362875
http://dx.doi.org/10.3389/fendo.2020.00229
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