三级医疗中心甲状腺功能减退患者中系统性红斑狼疮的患病率

Prevalence of systemic lupus erythematosus among patients of hypothyroidism in a tertiary care center.

作者信息

Paul Rudrajit, Raychaudhuri Pradip, Sinha Pradip Kumar, Mookerjee Sekhar, Pandit Kaushik, Santra Gouranga

机构信息

Department of Medicine, Medical College, Kolkata, India.

出版信息

Indian J Endocrinol Metab. 2012 Jul;16(4):569-74. doi: 10.4103/2230-8210.98013.

DOI:10.4103/2230-8210.98013

PMID:22837918

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3401758/

Abstract

CONTEXT

Hypothyroidism is a common public health problem in India. With iodine sufficiency, autoimmune thyroiditis is becoming the most important etiology of hypothyroidism. Often, thyroiditis is associated with other systemic autoimmune diseases.

AIMS

We undertook thisobservational study to find the prevalence of systemic lupus erythematosus (SLE) amongst the hypothyroid patients at our Institution.

SETTINGS AND DESIGN

This is probably the first study of its kind from India.

MATERIALS AND METHODS

185 patients with diagnosed hypothyroidism were included and screening for SLE was done by standard epidemiological criteria. Majority of the patients (63.8%) were young adults (20-40 years).

STATISTICAL ANALYSIS USED

Two by two contingency tables were analyzed by Chi-square test or Fisher's exact test as needed. Logistic regression model was used considering the presence of SLE as a dependent variable.

RESULTS

Eleven (5.94%) patients were found to have SLE. However, anti nuclear factor was positive in 145 cases (78.4%). Of the patients with SLE, 8 (72.7%) were found to be anti TPO positive, but the titers of ANF and anti TPO did not correlate. Presence of discoid rash, haematological criteria and presence of antibodies like anti-dsDNA were significantly correlated with the presence of SLE in hypothyroid patients. Presence of ANF was also correlated with the grade of goiter (r=0.62; P<0.05). Also four patients with SLE had a positive family history (OR=9.37). Logistic regression model showed anti-TPO has OR=1.54 (P=0.02) for the development of SLE.

CONCLUSIONS

Prevalence of SLE in hypothyroid patients is high compared to the general population, especially, as thyroiditis is very common in SLE.

摘要

背景

甲状腺功能减退症是印度常见的公共卫生问题。在碘充足的情况下，自身免疫性甲状腺炎正成为甲状腺功能减退症最重要的病因。甲状腺炎常与其他系统性自身免疫性疾病相关。

目的

我们开展这项观察性研究，以确定我院甲状腺功能减退症患者中系统性红斑狼疮（SLE）的患病率。

设置与设计

这可能是印度首例此类研究。

材料与方法

纳入185例确诊为甲状腺功能减退症的患者，并根据标准流行病学标准对SLE进行筛查。大多数患者（63.8%）为年轻人（20 - 40岁）。

所用统计分析方法

根据需要，通过卡方检验或Fisher精确检验对二乘二列联表进行分析。以SLE的存在作为因变量，使用逻辑回归模型。

结果

发现11例（5.94%）患者患有SLE。然而，145例（78.4%）患者抗核因子呈阳性。在患有SLE的患者中，8例（72.7%）抗甲状腺过氧化物酶呈阳性，但抗核因子和抗甲状腺过氧化物酶的滴度无相关性。盘状红斑、血液学标准以及抗双链DNA等抗体的存在与甲状腺功能减退症患者中SLE的存在显著相关。抗核因子的存在也与甲状腺肿的程度相关（r = 0.62；P < 0.05）。此外，4例患有SLE的患者有阳性家族史（比值比 = 9.37）。逻辑回归模型显示抗甲状腺过氧化物酶在SLE发生中的比值比为1.54（P = 0.02）。