ESPE Yearbook of Paediatric Endocrinology

To read the full abstract: J Clin Endocrinol Metab 2017;102:4184-4190

The Northern Finland Birth Cohort 1986 has yielded remarkable data over the last decade. Firstly, they reported that first-trimester antibody positivity is a risk factor for perinatal death, which was not affected by thyroid hormone status. They reported that maternal thyroid dysfunction and TPO-Ab positivity during pregnancy modified thyroid function parameters of offspring in adolescence. In the current paper, they report that adolescent offspring of mothers who were TPO-Ab-positive during pregnancy had a two-fold higher odds to develop MetS at age 16 years. Children of mothers with hyperthyroidism had better insulin sensitivity than children of euthyroid mothers. Maternal thyroid antibodies were associated more strongly than maternal thyroid hormones with cardio-metabolic risk factors in the children. More than half (55%) of the mothers with TPO-Ab positivity during pregnancy were euthyroid, suggesting that the effect was not driven by maternal TSH or thyroid hormone concentrations.

Developmental plasticity is defined as the ability of an organism to develop in various ways, depending on the particular environment.⁷ This concept explains the ability of the fetus to adapt to the intrauterine environment at the cost of modifying long-term health prospects. In an unfavorable environment, characterized by fetal hormonal or chemical imbalance or by maternal stress or disease, adaptation is possible but may come at the price of compromised health potentials decades later. The authors suggest two possible mechanisms. One is that TPO-Ab could be linked to the MetS via inflammation, as thyroid antibodies are related to higher levels of interleukins, which are markers of systemic inflammation that are detected in conjunction with the MetS. A second possibility is a common genetic predisposition both to autoimmune and cardio-metabolic risk factors. Long-term follow-up will show whether children of mothers with thyroid peroxidase antibody positivity are more prone to cardiovascular disease and diabetes later in life.

7. Michels KB. Developmental plasticity: Friend or foe? Evolution, Medicine, and Public Health 2017; 2017(1): 183-184.