{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T03:01:39Z","timestamp":1790823699466,"version":"4.1.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Autoimmune thyroid disease (AITD) is the most common associated autoimmune disorder in type 1 diabetes (T1D). Early detection of AITD is crucial to optimize glycemic control, growth, and intellectual development. In this prospective cohort study, we sought to characterize the prevalence, incident ages and risk factors of AITD in children and adolescents with T1D.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      Patients with T1D diagnosed at \u2264 18 years at MacKay Children\u2019s Hospital, Taipei, from 1990 to 2019 underwent annual screening for AITD. Institutional Review Board-approved data on age, sex, and disease profile are collected. Statistical analysis was performed by using independent sample t test for continuous variables, chi-squared test for categorical variables, and Kaplan-Meier estimates of cumulative incidence of AITD were calculated. A\n                      <jats:italic>p<\/jats:italic>\n                      value of &amp;lt;0.05 was considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We prospectively followed up 808 patients with T1D, 761 patients were included in the study. Of these patients, 197 (25.9%) of them had thyroid autoimmunity, meaning positivity of thyroid autoantibodies. Females had a higher prevalence of thyroid autoimmunity than males (59.9%, p = 0.012). Altogether, 5.5% patients developed AITD (4.1% had Graves disease; 1.4% had Hashimoto disease), at a mean age of 17.8 \u00b1 8.5 years. The cumulative incidence of AITD at 30 years of disease duration was 0.29 in the total group and was significantly higher in females (0.39, n = 397) than in males (0.15, n = 364,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In Taiwan, the prevalence of AITD in pediatric population with T1D increases with age, a longer disease duration and female sex. For early detection of autoimmune thyroid disease in Taiwanese children and adolescents with T1D, an annual AITD screening program should be implemented.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2022.1083690","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T15:31:01Z","timestamp":1673364661000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Graves disease is more prevalent than Hashimoto disease in children and adolescents with type 1 diabetes"],"prefix":"10.3389","volume":"13","author":[{"given":"Lu-Ting","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Yu","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Hsu","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bi-Wen","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu-Sung","family":"Lo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Hsin","family":"Ting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann-Jinn","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S180","DOI":"10.2337\/dc21-S013","article-title":"Children and adolescents: Standards of medical care in diabetes\u20132021","volume":"44","year":"2021","journal-title":"Diabetes Care"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.12943","article-title":"Geographical variation in the incidence of type 1 diabetes in the Nordic countries: A study within NordicDiabKids","volume":"21","author":"Samuelsson","year":"2020","journal-title":"Pediatr Diab"},{"key":"B3","doi-asserted-by":"publisher","first-page":"j5295","DOI":"10.1136\/bmj.j5295","article-title":"Incidence of type 1 diabetes in China, 2010-13: population based study","volume":"360","author":"Weng","year":"2018","journal-title":"BMJ"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2006.01925.x","article-title":"Incidence and trends of childhood type 1 diabetes worldwide 1990\u20131999","volume":"23","year":"2006","journal-title":"Diabetic Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"107842","DOI":"10.1016\/j.diabres.2019.107842","article-title":"Worldwide estimates of incidence, prevalence and mortality of type 1 diabetes in children and adolescents: Results from the international diabetes federation diabetes atlas, 9th edition","volume":"157","author":"Patterson","year":"2019","journal-title":"Diabetes Res Clin Pract"},{"key":"B6","doi-asserted-by":"publisher","first-page":"S66","DOI":"10.1016\/j.jfma.2019.06.016","article-title":"Trends in prevalence and incidence of diabetes mellitus from 2005 to 2014 in Taiwan","volume":"118","author":"Sheen","year":"2019","journal-title":"J Formos Med Assoc"},{"key":"B7","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1016\/j.jfma.2012.09.014","article-title":"Incidence and prevalence rates of diabetes mellitus in Taiwan: Analysis of the 2000-2009 nationwide health insurance database","volume":"111","author":"Jiang","year":"2012","journal-title":"J Formos Med Assoc"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-1679","article-title":"Type 1 diabetes-associated autoimmunity: Natural history, genetic associations, and screening","volume":"91","author":"Barker","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-2429","article-title":"Every fifth individual with type 1 diabetes suffers from an additional autoimmune disease: A Finnish nationwide study","volume":"43","author":"M\u00e4kimattila","year":"2020","journal-title":"Diabetes Care"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-1157","article-title":"Late-onset T1DM and older age predict risk of additional autoimmune disease","volume":"42","author":"Hughes","year":"2019","journal-title":"Diabetes Care"},{"key":"B11","doi-asserted-by":"publisher","first-page":"S15","DOI":"10.2337\/dc21-S002","article-title":"Classification and diagnosis of diabetes: &lt;em<Standards of medical care in diabetes\u20132021","volume":"44","year":"2021","journal-title":"Diabetes Care"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-1756","article-title":"Additional autoimmune disease found in 33% of patients at type 1 diabetes onset","volume":"34","author":"Triolo","year":"2011","journal-title":"Diabetes Care"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-0404","article-title":"Polyendocrinopathy in children, adolescents, and young adults with type 1 diabetes: A multicenter analysis of 28,671 patients from the German\/Austrian DPV-wiss database","volume":"33","author":"Warncke","year":"2010","journal-title":"Diabetes Care"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-012-9703-2","article-title":"The incidence and prevalence of thyroid autoimmunity","volume":"42","author":"McLeod","year":"2012","journal-title":"Endocrine."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1111\/cei.13115","article-title":"A quarter of patients with type 1 diabetes have co-existing non-islet autoimmunity: The findings of a UK population-based family study","volume":"192","author":"Kozhakhmetova","year":"2018","journal-title":"Clin Exp Immunol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-9033","article-title":"International expert committee report on the role of the A1C assay in the diagnosis of diabetes","volume":"32","year":"2009","journal-title":"Diabetes Care"},{"key":"B17","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1210\/er.2018-00163","article-title":"Thyroid dysfunction and diabetes mellitus: Two closely associated disorders","volume":"40","author":"Biondi","year":"2019","journal-title":"Endocr Rev"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0152168","article-title":"Higher risk of thyroid disorders in young patients with type 1 diabetes: A 12-year nationwide, population-based, retrospective cohort study","volume":"11","author":"Lu","year":"2016","journal-title":"PloS One"},{"key":"B19","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s001250051105","article-title":"Autoantigens IA-2 and GAD in Type I (insulin-dependent) diabetes","volume":"42","author":"Leslie","year":"1999","journal-title":"Diabetologia"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-003-1197-2","article-title":"The prevalence of insulin autoantibodies at the onset of type 1 diabetes is higher in males than females during adolescence","volume":"46","author":"Williams","year":"2003","journal-title":"Diabetologia"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-007-0594-9","article-title":"Evaluation of beta-cell function in diabetic Taiwanese children using a 6-min glucagon test","volume":"167","author":"Tung","year":"2008","journal-title":"Eur J Pediatr"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.4183\/aeb.2019.416","article-title":"Williams textbook of endocrinology","volume":"15","author":"Badiu","year":"2019","journal-title":"Acta Endocrinol (Buchar)"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.10.070","article-title":"Hashitoxicosis in children: Clinical features and natural history","volume":"146","author":"Nabhan","year":"2005","journal-title":"J Pediatr"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.24527","article-title":"Autoantibodies against islet cell antigens in children with type 1 diabetes mellitus","volume":"9","author":"Cheng","year":"2018","journal-title":"Oncotarget."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.4.850","article-title":"Autoantibody \"subspecificity\" in type 1 diabetes: Risk for organ-specific autoimmunity clusters in distinct groups","volume":"28","author":"Barker","year":"2005","journal-title":"Diabetes Care"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-18-0515","article-title":"Associated auto-immune disease in type 1 diabetes patients: A systematic review and meta-analysis","volume":"180","author":"Nederstigt","year":"2019","journal-title":"Eur J Endocrinol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2249.2001.01668.x","article-title":"Beta-cell, thyroid, gastric, adrenal and coeliac autoimmunity and HLA-DQ types in type 1 diabetes","volume":"126","author":"De Block","year":"2001","journal-title":"Clin Exp Immunol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12318","article-title":"Thyroid autoimmunity in type 1 diabetes: Systematic review and meta-analysis","volume":"31","author":"Shun","year":"2014","journal-title":"Diabetes Med"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2018.11.048","article-title":"Autoimmune thyroiditis in patients with type 1 diabetes mellitus: A long-term follow-up study","volume":"13","author":"Vallianou","year":"2019","journal-title":"Diabetes Metab Syndr"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.00229","article-title":"Gender differences at the onset of autoimmune thyroid diseases in children and adolescents","volume":"11","author":"Calcaterra","year":"2020","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab376","article-title":"Characteristics of patients with type 1 diabetes and additional autoimmune disease in the DPV registry","volume":"106","author":"Prinz","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.6065\/apem.2018.23.1.33","article-title":"Prevalence of autoimmune thyroiditis in patients with type 1 diabetes: A long-term follow-up study","volume":"23","author":"Hwang","year":"2018","journal-title":"Ann Pediatr Endocrinol Metab"},{"key":"B33","doi-asserted-by":"publisher","first-page":"S21","DOI":"10.2337\/dcs15-2005","article-title":"Genetics of autoimmune thyroiditis in type 1 diabetes reveals a novel association with DPB1*0201: Data from the type 1 diabetes genetics consortium","volume":"38","author":"Kahles","year":"2015","journal-title":"Diabetes Care"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.31.1076","article-title":"Type 1 (insulin-dependent) diabetes mellitus with coexisting autoimmune thyroid disease in Japan","volume":"31","author":"Chikuba","year":"1992","journal-title":"Intern Med"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1159\/000327587","article-title":"Prevalence, presentation and clinical evolution of graves' disease in children and adolescents with type 1 diabetes mellitus","volume":"76","author":"Lombardo","year":"2011","journal-title":"Horm Res Paediatr"},{"key":"B36","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1297\/cpe.23.99","article-title":"Type 1 diabetes and autoimmunity","volume":"23","author":"Kawasaki","year":"2014","journal-title":"Clin Pediatr Endocrinol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.9.2170","article-title":"The role of autoimmunity at diagnosis of type 1 diabetes in the development of thyroid and celiac disease and microvascular complications","volume":"28","author":"Glastras","year":"2005","journal-title":"Diabetes Care"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(81)80316-2","article-title":"Thyroid autoimmunity in insulin-dependent diabetes mellitus: The case for routine screening","volume":"99","author":"Riley","year":"1981","journal-title":"J Pediatr"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-2478","article-title":"Autoimmune diseases in children and adults with type 1 diabetes from the T1D exchange clinic registry","volume":"101","author":"Hughes","year":"2016","journal-title":"J Clin Endocrinol Metab"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.1083690\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T15:31:03Z","timestamp":1673364663000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.1083690\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,10]]},"references-count":39,"alternative-id":["10.3389\/fendo.2022.1083690"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2022.1083690","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,10]]},"article-number":"1083690"}}