García García Blanca, Gimeno Orna José Antonio, Aguillo Gutiérrez Esperanza, Altemir Trallero Jara, Cabrejas Gómez Carmen, Ilundaín González Ana, Lázaro Puente Francisca, Ocón Bretón Julia, Faure Nogueras Eduardo
Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
Endocrinol Nutr. 2010 Feb;57(2):49-53. doi: 10.1016/j.endonu.2009.11.001. Epub 2010 Feb 10.
Our aim was to evaluate the prevalence of parietal cell antibodies (PCA) in patients with autoimmune thyroid disease (ATD).
We performed a descriptive, cross-sectional study of patients with ATD. The presence of PCA was determined. Elevated antithyroid antibodies (ATAs) were defined as those higher than the 75th percentile of distribution. Multivariate logistic regression models were built to assess the independent contribution of the following variables to PCA positivity: age, sex, hemoglobin, medium corpuscular volume (MCV), dose/Kg of levothyroxine (LT4), disease duration and elevated ATA levels.
A total of 148 patients were included (137 females). The mean age was 45.7 (SD 15) years and disease duration was 4.5 (SD 4) years. Forty-three patients (29%) with Graves' disease and 105 (71%) with primary hypothyroidism were included. The 75th percentile of distribution was 420U/ml for anti-peroxidase antibodies and 200U/ml for anti-thyroglobulin antibodies. PCA positivity was found in 30 patients, with an overall prevalence of 20.3%. PCA positivity with titers higher than 1/640 was found in 19 patients (12.8%). The only independent predictive factor of PCA positivity was the presence of elevated levels of ATAs (odds ratio (OR)=3; 95% confidence interval (CI): 1.1-8.6; p=0.04). The only independent predictive factor of PCA positivity at titers >/=1/640 was also the presence of elevated levels of ATAS (OR=7.3; 95% CI: 1.6-32.7; p=0.009).
The prevalence of PCA positivity in patients with ATD was 20%. Elevated levels of ATAs increase the risk of PCA positivity.
我们的目的是评估自身免疫性甲状腺疾病（ATD）患者中壁细胞抗体（PCA）的患病率。
我们对ATD患者进行了一项描述性横断面研究。确定PCA的存在情况。抗甲状腺抗体（ATA）升高定义为高于分布的第75百分位数。构建多变量逻辑回归模型以评估以下变量对PCA阳性的独立贡献：年龄、性别、血红蛋白、平均红细胞体积（MCV）、左甲状腺素（LT4）的剂量/千克、病程以及ATA水平升高。
共纳入148例患者（137例女性）。平均年龄为45.7（标准差15）岁，病程为4.5（标准差4）年。其中包括43例（29%）格雷夫斯病患者和105例（71%）原发性甲状腺功能减退患者。抗过氧化物酶抗体的第75百分位数为420U/ml，抗甲状腺球蛋白抗体为200U/ml。30例患者PCA呈阳性，总体患病率为20.3%。19例患者（12.8%）PCA阳性且滴度高于1/640。PCA阳性的唯一独立预测因素是ATA水平升高（比值比（OR）=3；95%置信区间（CI）：1.1 - 8.6；p = 0.04）。滴度≥1/640时PCA阳性的唯一独立预测因素也是ATA水平升高（OR = 7.3；95% CI：1.6 - 32.7；p = 0.009）。
ATD患者中PCA阳性的患病率为20%。ATA水平升高会增加PCA阳性的风险。
