Background: Chronic autoimmune thyroiditis (CAT) displays a strong female predominance with female-to-male (F:M) ratios of 4-20:1 in adults and 2-9:1 in children and adolescents. Both genetic and hormonal factors are involved in this phenomenon. The relation between puberty and F:M ratio in CAT has never been evaluated.
Methods: The F:M ratio of 133 children with CAT (group A, age at diagnosis 2.4-17.7 years) was compared with that of 113 adult CAT patients (group B, age at diagnosis 21-79 years). Group A included 64 prepubertal (aged 2.4-13.2 years, group A1) and 69 pubertal (aged 9.2-17.4, group A2) children.
Results: The F:M ratio in group A was 3.0, which is significantly (p < 0.001) lower than that (10.3) found in group B patients. The F:M ratio of group A1 prepubertal children was lower (1.6) and significantly different from that of pubertal (6.7, p < 0.01) and adult patients (10.3, p < 0.0001). This phenomenon was more evident in hypothyroid as compared to euthyroid CAT.
Conclusions: This study provides the first evidence that female predominance of CAT strongly increases during puberty, suggesting a major role for sex hormones in this phenomenon. Further studies are needed to clarify this point.
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