Editing Hashimoto's thyroiditis (section)

==== Sex ====
Study of healthy Danish twins divided to three groups (monozygotic and dizygotic same sex, and opposite sex twin pairs) estimated that genetic contribution to thyroid peroxidase antibodies susceptibility was 61% in males and 72% in females, and contribution to thyroglobulin antibodies susceptibility was 39% in males and 75% in females.<ref>{{cite journal | vauthors = Hansen PS, Brix TH, Iachine I, Kyvik KO, Hegedüs L | title = The relative importance of genetic and environmental effects for the early stages of thyroid autoimmunity: a study of healthy Danish twins | journal = European Journal of Endocrinology | volume = 154 | issue = 1 | pages = 29–38 | date = January 2006 | pmid = 16381988 | doi = 10.1530/eje.1.02060 | s2cid = 25372591 | doi-access =  }}</ref>

The high female predominance in thyroid autoimmunity may be associated with the X chromosome. It contains sex and immune-related genes responsible for [[immune tolerance]].<ref>{{cite journal | vauthors = McCombe PA, Greer JM, Mackay IR | title = Sexual dimorphism in autoimmune disease | journal = Current Molecular Medicine | volume = 9 | issue = 9 | pages = 1058–1079 | date = December 2009 | pmid = 19747114 | doi = 10.2174/156652409789839116 }}</ref>
A higher incidence of thyroid autoimmunity was reported in patients with a higher rate of X-chromosome [[monosomy]] in peripheral white blood cells.<ref>{{cite journal | vauthors = Invernizzi P, Miozzo M, Selmi C, Persani L, Battezzati PM, Zuin M, Lucchi S, Meroni PL, Marasini B, Zeni S, Watnik M, Grati FR, Simoni G, Gershwin ME, Podda M | title = X chromosome monosomy: a common mechanism for autoimmune diseases | journal = Journal of Immunology | volume = 175 | issue = 1 | pages = 575–578 | date = July 2005 | pmid = 15972694 | doi = 10.4049/jimmunol.175.1.575 | s2cid = 40557667 | doi-access = free }}</ref> Another potential mechanism might be skewed [[X-chromosome inactivation]].<ref name="Ramos-Levi2023" />