Antonelli Alessandro, Ferri Clodoveo, Pampana Alessandro, Fallahi Poupak, Nesti Claudia, Pasquini Martina, Marchi Santino, Ferrannini Ele
Department of Internal Medicine and CNR Institute of Clinical Physiology, University of Pisa School of Medicine, Pisa, Italy.
Am J Med. 2004 Jul 1;117(1):10-3. doi: 10.1016/j.amjmed.2004.01.023.
To explore the association of hepatitis C virus (HCV) infection with thyroid disorders.
We investigated the prevalence of thyroid disorders in 630 consecutive patients with chronic hepatitis due to HCV infection; all patients were free of cirrhosis and hepatocarcinoma, and were not on interferon treatment. Also included were a control group of 389 subjects from an iodine-deficient area, another control group of 268 persons living in an area of iodine sufficiency, and 86 patients >40 years of age with chronic hepatitis B. Levels of thyroid-stimulating hormone (TSH), free thyroxine (T(4)), and triiodothyronine (T(3)), as well as anti-thyroglobulin and anti-thyroid peroxidase antibodies, were measured.
Mean TSH levels were higher (P = 0.001), and free T(3) and free T(4) levels were lower (P <0.0001), in patients with chronic hepatitis C than in all other groups. Patients with chronic hepatitis C were more likely to have hypothyroidism (13% [n = 82]), anti-thyroglobulin antibodies (17% [n = 108]), and anti-thyroid peroxidase antibodies (21% [n = 132]) than were any of the other groups.
Both hypothyroidism and thyroid autoimmunity are more common in patients with chronic hepatitis C-even in the absence of cirrhosis, hepatocellular carcinoma, or interferon treatment-than in normal controls or those with chronic hepatitis B infection.
探讨丙型肝炎病毒（HCV）感染与甲状腺疾病之间的关联。
我们调查了630例连续的丙型肝炎病毒感染所致慢性肝炎患者的甲状腺疾病患病率；所有患者均无肝硬化和肝癌，且未接受干扰素治疗。还纳入了来自碘缺乏地区的389名受试者作为对照组，另一个对照组为居住在碘充足地区的268人，以及86例年龄>40岁的慢性乙型肝炎患者。检测了促甲状腺激素（TSH）、游离甲状腺素（T4）、三碘甲状腺原氨酸（T3）水平，以及抗甲状腺球蛋白和抗甲状腺过氧化物酶抗体。
慢性丙型肝炎患者的平均TSH水平较高（P = 0.001），游离T3和游离T4水平较低（P <0.0001），高于所有其他组。与其他任何组相比，慢性丙型肝炎患者更易出现甲状腺功能减退（13% [n = 82]）、抗甲状腺球蛋白抗体（17% [n = 108]）和抗甲状腺过氧化物酶抗体（21% [n = 132]）。
与正常对照组或慢性乙型肝炎感染患者相比，慢性丙型肝炎患者即使在没有肝硬化、肝细胞癌或未接受干扰素治疗的情况下，甲状腺功能减退和甲状腺自身免疫也更为常见。
