Helicobacter pylori Infection Is Associated With Thyroid Dysfunction in Children With Congenital Hypothyroidism
Ivani Novato Silva1, Lara Vieira Marçal1, Dulciene Maria Magalhães Queiroz2
1Pediatrics Department, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Insights
Helicobacter pylori infection was linked to lower T3 levels in children with congenital hypothyroidism, suggesting a potential impact on thyroid hormone balance. Further research is needed to confirm these findings and explore mechanisms.
Area of Science:
- Pediatric Endocrinology
- Infectious Diseases
- Thyroidology
Background:
- Helicobacter pylori infection causes systemic inflammation and is linked to extra-gastric disorders.
- The role of H. pylori in autoimmune thyroid disease (ATD) pathogenesis is understudied in pediatric populations.
- Previous research on H. pylori and ATD in children is limited.
Purpose of the Study:
- To investigate the prevalence of H. pylori infection in children with congenital hypothyroidism (CH) and ATD.
- To assess the association between H. pylori infection and thyroid hormone levels and antibody status in these pediatric groups.
- To explore the potential impact of H. pylori on thyroid hormonal balance in children.
Main Methods:
- A cross-sectional study of 142 children and adolescents (106 with CH, 36 with ATD) was conducted.
- H. pylori infection was detected using the 13C-Urea Breath Test (13C-UBT).
- Thyroid hormones (TSH, free T4, T3) and antithyroid antibodies (ATPO, antiTg, TRAb) were measured. Data were analyzed using logistic models.
Main Results:
- The prevalence of H. pylori infection was 19.44% in children with ATD and 34.90% in children with CH.
- No association was found between H. pylori status and gender, thyroid hormones, or antithyroid antibodies in the ATD group.
- In the CH group, infected children had significantly lower mean T3 serum levels compared to uninfected children (p=0.001).
Conclusions:
- H. pylori infection may impair thyroid hormonal balance, specifically affecting T3 levels, in children with CH.
- The infection did not appear to affect hypothalamic-pituitary-thyroid axis function (TSH, T4) or ATD pathogenesis in this cohort.
- Further studies are warranted to confirm these findings and elucidate the underlying mechanisms of H. pylori's impact on thyroid function in children.
Abstract:
Helicobacter pylori (H. pylori) infection leads to a systemic low-grade inflammatory state and has been associated causally with a diverse spectrum of extra-gastric disorders. Among them, the infection has been involved in the pathogenesis of autoimmune thyroid disease (ATD), but only one study had evaluated children. Therefore, a cross-sectional study was conducted in a cohort of 142 children and adolescents, randomly assessed among those followed up for thyroid diseases in a university pediatric endocrinology service: 106 with congenital hypothyroidism (CH) and 36 with ATD. All children were asymptomatic, under strict control on levothyroxine replacement, and reported no other diseases or use of drugs. Helicobacter pylori status was evaluated by the 13C-Urea Breath Test (13C-UBT). Antithyroid antibodies (ATPO, antiTg, and TRAb) and serum thyroid hormones (TSH, free T4, and T3) were assessed by standard assays. Data were analyzed in logistic models by the SPSS statistical software package, and a p-value ≤ 0.05 was considered statistically significant. The prevalence of H. pylori infection was 19.44% in children with ATD. Neither the gender nor the serum levels of thyroid hormones and antithyroid antibodies were associated with the H. pylori-positive status. Thirty-seven (34.90%) children with CH were infected with H. pylori. The mean T3 serum level (3.59 ± 0.84) was significantly lower (p = 0.001) in the infected children than in those free from the infection (3.95 ± 0.89), association that remained after adjustment for the other variables in the multivariate analysis. Because no difference was observed in the levels of TSH and T4, the results indicate that the infection may lead to impairment in the thyroid hormonal balance, but not in the hypothalamic-pituitary-thyroid axis function. In as much as H. pylori infection is highly widespread and the prevalence of CH is also not negligible, additional studies are required to confirm our results and to identify the involved mechanisms.
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