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Serological Evidence of Thyroid Autoimmunity among Schoolchildren in Two Different Socioeconomic Environments

Department of Virology (A.K., H.V., T.S., H.H.), University of Tampere, Medical School, 33014 Tampere, Finland; Department of Pediatrics (A.K.), University of Petrozavodsk, 185910 Petrozavodsk, Russia; Department of Clinical Microbiology (A.-M.H., H.H.), Center for Laboratory Medicine, Tampere Pirkanmaa Hospital District, 33521 Tampere, Finland; Department of Pediatrics (P.K.), University of Oulu, 90014 Oulu, Finland; Department of Clinical Microbiology (J.I.), University of Kuopio, 70211 Kuopio, Finland; and Immunogenetics Laboratory (J.I.), University of Turku, 20014 Turku, Finland; Department of Pediatrics (M.K.), Tampere University Hospital, 33521 Tampere, Finland; and Hospital for Children and Adolescents (M.K.), University of Helsinki, 00014 Helsinki, Finland

Address all correspondence and requests for reprints to: Professor Heikki Hyöty, Department of Virology, University of Tampere, Medical School, Biokatu 10, FI-33520 Tampere, Finland. E-mail: Heikki.Hyoty{at}uta.fi.

Context: The mechanisms leading to thyroid autoimmunity are largely unknown.

Objective: Our objective was to assess the role of environment in the development of thyroid autoimmunity.

Design: Prevalence of thyroid autoantibodies in two neighboring populations living in completely different socioeconomic circumstances (Russian Karelia and Finland) was studied.

Setting: We studied two population-based cohorts partly sharing the same ancestry.

Patients or Other Participants: A total of 532 schoolchildren from Russian Karelia and 532 schoolchildren in Finland matched for age, gender, and season of the blood sampling were included.

Interventions: There were no interventions.

Main Outcome Measures: The prevalence of thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TGAb) and HLA-DQ alleles was measured.

Results: The prevalence of TPOAb was significantly lower in Russian Karelian than in Finnish children (0.4 vs. 2.6%, P = 0.006). A similar difference was observed for TGAb (0.6 vs. 3.4%, P = 0.002). Finnish girls tested positive for both TPOAb (4.3 vs. 0.4%, P = 0.01) and TGAb (5.3 vs. 0.9%, P = 0.01) more frequently than Finnish boys. Seven of the 23 tested subjects with signs of thyroid autoimmunity (30%) had increased serum TSH concentrations as a sign of subclinical hypothyroidism. The frequency of HLA genotypes did not differ between the two countries or between autoantibody-positive and -negative subjects.

Conclusions: The prevalence of thyroid autoimmunity is lower in Russian Karelia than in Finland. This difference was not related to ethnic background or HLA-DQ alleles. The results support the idea that the Russian Karelian environment, which is characterized by inferior prosperity and standard of hygiene, may provide protection against thyroid autoimmunity.

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