Friedrich Nele, Schwarz Sabine, Thonack Jens, John Ulrich, Wallaschofski Henri, Völzke Henry
Institute of Community Medicine-Unit SHIP, Ernst Moritz Arndt University of Greifswald, Greifswald, Germany.
Autoimmunity. 2008 Mar;41(2):174-80. doi: 10.1080/08916930701777629.
Autoimmune thyroid disease (AIT) is more common in females than in males. Furthermore, it is well documented that the risk of thyroid autoimmunity increases during pregnancy and in the postpartum period. The objective of the present study was to analyse the association between parity and AIT by using ultrasound and serological data.
The study population included 2156 women, aged 20-79 years. Serum thyroperoxidase antibodies (anti-TPO) and thyrotropin levels were measured and thyroid ultrasonography was performed. AIT was defined according to the combined presence of a hypoechogenic thyroid pattern and positive anti-TPO levels (>200 IU/ml). Odds ratios (OR) and 95% confidence intervals (CI) were calculated.
The analyses revealed an association between parity and AIT. Women with at least one pregnancy had increased odds for AIT (OR 4.6 [95%-CI 1.4-15.1], p < 0.05) compared to women who have never been pregnant. Similar results were observed using hypoechogenic thyroid pattern (OR 1.7 [95%-CI 1.0-2.9], p < 0.05) and positive anti-TPO levels (OR 1.8 [95%-CI 1.0-3.3], p = 0.05) as separate dependent variables or using number of births as alternate independent variable.
In this female population we found an association between parity and AIT and conclude that parity appears to be a potential risk factor for AIT.
自身免疫性甲状腺疾病（AIT）在女性中比在男性中更为常见。此外，有充分的文献记载，甲状腺自身免疫的风险在孕期和产后会增加。本研究的目的是利用超声和血清学数据分析产次与AIT之间的关联。
研究人群包括2156名年龄在20 - 79岁之间的女性。检测血清甲状腺过氧化物酶抗体（抗-TPO）和促甲状腺激素水平，并进行甲状腺超声检查。AIT根据低回声甲状腺模式和抗-TPO水平阳性（>200 IU/ml）同时存在来定义。计算比值比（OR）和95%置信区间（CI）。
分析揭示了产次与AIT之间的关联。与从未怀孕的女性相比，至少怀孕过一次的女性患AIT的几率增加（OR 4.6 [95%-CI 1.4 - 15.1]，p < 0.05）。使用低回声甲状腺模式（OR 1.7 [95%-CI 1.0 - 2.9]，p < 0.05）和抗-TPO水平阳性（OR 1.8 [95%-CI 1.0 - 3.3]，p = 0.05）作为单独的因变量，或使用生育次数作为替代自变量时，观察到了类似的结果。
在这个女性人群中，我们发现产次与AIT之间存在关联，并得出结论，产次似乎是AIT的一个潜在风险因素。
