Suk J H, Lee J H, Kim J M
Department of Internal Medicine, Division of Endocrinology and Metabolism, Maryknoll Medical Center, Busan, Republic of Korea.
Exp Clin Endocrinol Diabetes. 2012 Jul;120(7):401-4. doi: 10.1055/s-0032-1309008. Epub 2012 Apr 27.
Evidence exists that autoimmune thyroiditis is present in a high percentage of fibromyalgia (FM) and associated with the presence of typical symptoms of FM. However, the role of thyroperoxidase antibody (TPO Ab) in the manifestation of FM is still unclear. The goal of this study was to investigate the prevalence of positive TPO Ab in euthyroid FM patients, and whether TPO Ab positivity is associated with the clinical manifestations in euthyroid FM patients.Thyroid assessment was done by free T4, TSH and TPO Ab. The clinical parameters including Fibromyalgia Impact questionnaire (FIQ), pain visual analogical scale (VAS) and tender point counts were evaluated in euthyroid primary FM patients, not associated with autoimmune rheumatic disease. The immunologic tests including rheumatoid factor and antinuclear antibody were measured. We compared the prevalence of positive TPO Ab between FM patients, and healthy control. We also compared clinical and laboratory parameter in FM patients according to the presence of TPO Ab.149 patients of FM, 68 healthy controls were recruited. FM patients showed higher prevalence of positive TPO Ab than healthy controls (28 out of 149 patients, 19%; 5 out of 68 healthy controls, 7%; P=0.04). There was no difference of clinical and laboratory parameters in FM patients between 2 groups subdivided by the presence of TPO Ab.In our study, euthyroid FM patients showed significantly higher prevalence of positive TPO Ab, as compared to age and sex matched healthy control. However, TPO Ab positivity was relatively low and not associated with the clinical manifestations in euthyroid FM patients. This finding support thyroid autoimmunity may influence the development of FM, but the evidence which support that FM is related to autoimmune etiology is not clear, and FM severity may not be affected by the presence of thyroid autoantibody.
有证据表明，自身免疫性甲状腺炎在纤维肌痛（FM）患者中占比很高，且与FM的典型症状相关。然而，甲状腺过氧化物酶抗体（TPO Ab）在FM表现中的作用仍不明确。本研究的目的是调查甲状腺功能正常的FM患者中TPO Ab阳性的患病率，以及TPO Ab阳性是否与甲状腺功能正常的FM患者的临床表现相关。通过游离T4、促甲状腺激素（TSH）和TPO Ab进行甲状腺评估。在与自身免疫性风湿疾病无关的甲状腺功能正常的原发性FM患者中，评估包括纤维肌痛影响问卷（FIQ）、疼痛视觉模拟量表（VAS）和压痛点计数在内的临床参数。检测包括类风湿因子和抗核抗体在内的免疫指标。我们比较了FM患者和健康对照中TPO Ab阳性的患病率。我们还根据TPO Ab的存在情况比较了FM患者的临床和实验室参数。招募了149例FM患者和68例健康对照。FM患者中TPO Ab阳性的患病率高于健康对照（149例患者中有28例，19%；68例健康对照中有5例，7%；P = 0.04）。根据TPO Ab的存在情况将FM患者分为两组，两组之间的临床和实验室参数没有差异。在我们的研究中，与年龄和性别匹配的健康对照相比，甲状腺功能正常的FM患者中TPO Ab阳性患病率显著更高。然而，TPO Ab阳性率相对较低，且与甲状腺功能正常的FM患者的临床表现无关。这一发现支持甲状腺自身免疫可能影响FM的发展，但支持FM与自身免疫病因相关的证据并不明确，且FM的严重程度可能不受甲状腺自身抗体存在的影响。
