Original Articles

Association between Thyroid Function indices and Thyroid Autoantibodies with Thyroid Ultrasonography Outcomes in Children and Adolescents

Abstract

Objectives: Thyroid Ultrasonography (US) is recommended as a valuable tool for evaluating the status and function of the thyroid gland. The objective of this study was to compare and analyze the thyroid ultrasonography outcomes in children and adolescents who have normal thyroid function and thyroid antibodies.
Methods: A cross-sectional study was conducted on a group of 233 selected females aged 9 to 14 years old. Blood samples were obtained from the subjects and analyzed for thyroid hormones and thyroid autoantibodies. Additionally, a thyroid ultrasound was performed to provide an in-depth evaluation.
Results: Of all the participants, 25% displayed hypoechogenicity. Individuals with reduced echogenicity had higher median levels of thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPO-Ab), and thyroglobulin antibody (Tg-Ab) compared to those with normal echogenicity. Moreover, those with hypoechogenicity had significantly higher thyroid volume (TVol), iodine status, and thyroglobulin levels than their counterparts with normal echogenicity. Hypoechogenicity was also significantly associated with higher levels of TPO-Ab, Tg-Ab, and TSH. Logistic regression analysis revealed that high TSH and TPO-Ab levels were associated with a higher risk of irregular echo patterns and thyroid autoantibodies.
Conclusion: The results revealed that irregular thyroid patterns in the ultrasonography were useful for assessing thyroid structure and dysfunction. Moreover, elevated TPOAb, Tg-Ab, and TSH concentrations in the serum may indicate thyroid malfunction. Ultrasound can help to identify early thyroid dysfunction along with the standard thyroid assessment biomarkers.

1. Khan, L., Thyroid Disease in Children and Adolescents. Pediatr Ann, 2021. 50(4): p. e143-e147.
2. Organization, W.H., A Guide for Programme Managers. Assessment of Iodine Deficiency Disorders and Monitoring their Elimination. Geneva, Switzerland, 2007. 3rd ed: p. 24–46.
3. Sheikhi Narani M, V.A., Kheirollahi A, Teimouri M , Bayat S, Jadidzadeh F., Changes of biochemical parameters in normal weight and overweight/obese women with polycystic ovary Syndrome. Acta Biochimica Iranica, 2023. 1(3): p. 119-125.
4. Pedersen, O.M., N.P. Aardal, T.B. Larssen, J.E. Varhaug, O. Myking, and H. Vik-Mo, The value of ultrasonography in predicting autoimmune thyroid disease. Thyroid, 2000. 10(3): p. 251-9.
5. Rago, T., L. Chiovato, L. Grasso, A. Pinchera, and P. Vitti, Thyroid ultrasonography as a tool for detecting thyroid autoimmune diseases and predicting thyroid dsfunction in apparently healthy subjects. J Endocrinol Invest, 2001. 24(10): p. 763-9.
6. Jeong, S.H., H.S. Hong, and J.Y. Lee, The association between thyroid echogenicity and thyroid function in pediatric and adolescent Hashimoto's thyroiditis. Medicine (Baltimore), 2019. 98(14): p. e15055.
7. Hwang, S.M., J.Y. Hwang, J.H. Moon, I. Yang, J.Y. Woo, and H.J. Lee, Children and adolescent patients with goiter and normal thyroid function: US findings related to underlying autoimmune thyroid diseases. Medicine (Baltimore), 2022. 101(35): p. e30095.
8. Rago, T., L. Chiovato, L. Grasso, A. Pinchera, and P. Vitti, Thyroid ultrasonography as a tool for detecting thyroid autoimmune diseases and predicting thyroid dysfunction in apparently healthy subjects. Journal of Endocrinological Investigation, 2001. 24(10): p. 763-769.
9. Park, J.E., S.M. Hwang, J.Y. Hwang, J.H. Moon, I. Yang, J.Y. Woo, et al., The relationship between ultrasound findings and thyroid function in children and adolescent autoimmune diffuse thyroid diseases. Sci Rep, 2021. 11(1): p. 19709.
10. Vejbjerg, P., N. Knudsen, H. Perrild, P. Laurberg, I.B. Pedersen, L.B. Rasmussen, et al., The association between hypoechogenicity or irregular echo pattern at thyroid ultrasonography and thyroid function in the general population. Eur J Endocrinol, 2006. 155(4): p. 547-52.
11. Rostami, R., M.R. Aghasi, A. Mohammadi, and J. Nourooz-Zadeh, Enhanced oxidative stress in Hashimoto's thyroiditis: inter-relationships to biomarkers of thyroid function. Clin Biochem, 2013. 46(4-5): p. 308-12.
12. Willms, A., D. Bieler, H. Wieler, D. Willms, K.P. Kaiser, and R.J.J.o.U.i.M. Schwab, Correlation between sonography and antibody activity in patients with Hashimoto thyroiditis. 2013. 32(11): p. 1979-1986.
13. Brunn, J., U. Block, G. Ruf, W. Kunze, and P.C.J.D.M.W. Scriba, Volumetrie der Schilddrüsenlappen mittels real-time-Sonographie. 1981(41): p. 1338-1340.
14. Höfling, D.B.C., G.G.; Juliano, A.G.; Marui, S.; Chammas, M.C. , Value of thyroid echogenicity in the diagnosis of chronic autoimmune thyroiditis. Radiol. Bras, 2008. 41: p. 409–417.
15. Dunn, J.T., H.E. Crutchfield, R. Gutekunst, and A.D. Dunn, Two simple methods for measuring iodine in urine. Thyroid, 1993. 3(2): p. 119-23.
16. Rostami, R., S. Nourooz-Zadeh, A. Mohammadi, H.R. Khalkhali, G. Ferns, and J. Nourooz-Zadeh, Serum Selenium Status and Its Interrelationship with Serum Biomarkers of Thyroid Function and Antioxidant Defense in Hashimoto's Thyroiditis. Antioxidants (Basel), 2020. 9(11).
17. Mazloom, H., S. Alizadeh, E.N. Esfahani, F. Razi, and R. Meshkani, Decreased expression of microRNA-21 is associated with increased cytokine production in peripheral blood mononuclear cells (PBMCs) of obese type 2 diabetic and non-diabetic subjects. Molecular and cellular biochemistry, 2016. 419: p. 11-17.
18. Yan, Y.-R., X.-L. Gao, J. Zeng, Y. Liu, Q.-G. Lv, J. Jiang, et al., The association between thyroid autoantibodies in serum and abnormal function and structure of the thyroid. Journal of International Medical Research, 2015. 43(3): p. 412-423.
19. Kocełak, P., A.J. Owczarek, A. Wikarek, N. Ogarek, P. Oboza, M. Sieja, et al., Anti-thyroid antibodies in the relation to TSH levels and family history of thyroid diseases in young Caucasian women. Front Endocrinol (Lausanne), 2022. 13: p. 1081157.
20. Marwaha, R.K., N. Tandon, A.K. Karak, N. Gupta, K. Verma, and N. Kochupillai, Hashimoto's thyroiditis: countrywide screening of goitrous healthy young girls in postiodization phase in India. J Clin Endocrinol Metab, 2000. 85(10): p. 3798-802.
21. Doufas, A.G., G. Mastorakos, S. Chatziioannou, S. Tseleni-Balafouta, G. Piperingos, M.A. Boukis, et al., The predominant form of non-toxic goiter in Greece is now autoimmune thyroiditis. Eur J Endocrinol, 1999. 140(6): p. 505-11.
22. Palaniappan, S., L. Shanmughavelu, H.K. Prasad, S. Subramaniam, N. Krishnamoorthy, and L. Lakkappa, Improving iodine nutritional status and increasing prevalence of autoimmune thyroiditis in children. Indian J Endocrinol Metab, 2017. 21(1): p. 85-89.
23. Zois, C., I. Stavrou, E. Svarna, K. Seferiadis, and A. Tsatsoulis, Natural course of autoimmune thyroiditis after elimination of iodine deficiency in northwestern Greece. Thyroid, 2006. 16(3): p. 289-93.
24. Saberi, H., G. Taheripak, and R. Meshkani, The ENPP1 K121Q polymorphism is associated with obesity-related parameters in Iranian normoglycemic male subjects. Acta Biochimica Iranica, 2023. 1(1): p. 20-25.
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SectionOriginal Articles
DOI https://doi.org/10.18502/abi.v1i4.14721
Keywords
Thyroid Ultrasonography Urmia TSH Adolescents

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1.
Rostami R, Beiranvand A, Nourooz-Zadeh S, Rostami M, Mohammadi A, Nourooz-Zadeh J. Association between Thyroid Function indices and Thyroid Autoantibodies with Thyroid Ultrasonography Outcomes in Children and Adolescents. ABI. 2023;1(4):189-195.