Thyroid peroxidase and thyroglobulin autoantibodies in a large survey of populations with mild and moderate iodine deficiency

BACKGROUND AND AIMS: Autoimmune thyroiditis is one of the most common autoimmune disorders. Autoantibodies against the thyroid gland, with thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (Tg-Ab) as the most common autoantibodies, can often be demonstrated in serum in population surveys. In the present study we evaluated if TPO-Ab and Tg-Ab tend to develop in parallel or whether one or the other may be more prevalent in subsets of the population.

METHODS: In a cross-sectional comparative study, performed in two areas of Denmark with mild and moderate iodine deficiency, 4649 randomly selected subjects in age groups between 18 and 65 years were examined. Blood tests were analysed for TPO-Ab and Tg-Ab using assays based on the radioimmunoassay (RIA) technique. The participants answered questionnaires, were clinically examined and had urine samples collected.

RESULTS: The overall prevalence rate of thyroid autoantibodies (TPO-Ab and/or Tg-Ab) was 18.8%. The prevalence rates of TPO-Ab and Tg-Ab were similar (13.1 vs. 13.0%). Both antibodies were more frequent in females than in males, and in females the prevalence rates increased with age. In the age group 60-65 years thyroid antibodies were more frequently measured in sera from moderate than from mild iodine-deficient area (P = 0.02), whereas no differences were seen in younger subjects. In 38.8% of participants with thyroid autoantibodies in serum, both antibodies were present. In sera with both TPO-Ab and Tg-Ab present the concentrations of the antibodies were generally higher than in sera with only one type of antibody present.

CONCLUSION: The prevalence rates of TPO-Ab and Tg-Ab were similar in this large population survey. The results suggest that TPO-Ab and Tg-Ab predominantly develop due to a general alteration in the immune system, whereas specific antigenic mechanisms are probably of less importance. However, further studies are needed to clarify the mechanisms involved in the development of thyroid autoantibodies.