Published online Aug 8, 2016. doi: 10.5409/wjcp.v5.i3.306
Peer-review started: March 1, 2016
First decision: March 22, 2016
Revised: March 29, 2016
Accepted: April 14, 2016
Article in press: April 18, 2016
Published online: August 8, 2016
AIM: To verify if subclinical hypothyroidism (SCH) could be associated to atopy in children.
METHODS: Seven hundred and thirty-two Caucasian children from South Italy presenting symptoms of allergic disease were enrolled and submitted to atopy, obesity, chronic low grade inflammation, and SCH work up.
RESULTS: Four hundred and forty-five out of 705 (63.12%) children affected by allergic disease were diagnosed as atopic and 260 (36.88%) as not atopic. The SCH prevalence was 6.3%. Significant higher prevalence of SCH among atopic children with average (group 2) and high (group 3) low grade chronic inflammation compared to atopic children with mild (group 1) low grade chronic inflammation was present. Moreover, group 1 and group 2 presented an OR to show SCH of 2.57 (95%CI: 1.55-6.26) and 2.96 (95%CI: 1.01-8.65), respectively. Both in atopic and not atopic children we found C3 serum levels significantly higher in group 3 respect to group 2 and group 1. Noteworthy, among atopic patients, also total immunoglobulin E (IgE) serum levels, were significantly higher in group 3 compared to group 2 and group 1 children. In atopic children, C3 and total IgE serum values increased in parallel with the increase of C-reactive protein values, while in not atopic children this phenomenon was not evident.
CONCLUSION: The possibility exists that an increasing atopic inflammation contributes to SCH occurrence. So far this is the first report in literature showing an association between SCH and atopy but further studies are needed to confirm our data.
Core tip: A high subclinical hypothyroidism (SCH) prevalence has been associated in childhood to obesity and the chronic low grade inflammation found obese children has been involved in this relationship. In our population, obesity does not influence SCH prevalence. Interestingly, we found a SCH prevalence twice higher compared to all other patients and a significant higher risk to show SCH in atopic children affected by the highest C-reactive protein values characterizing low-grade inflammation.