Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan; School of Dentistry, National Taiwan University, Taipei, Taiwan.
School of Dentistry, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2014 Mar;113(3):155-60. doi: 10.1016/j.jfma.2012.04.003. Epub 2012 Jun 29.
BACKGROUND/PURPOSE: Autoimmune thyroiditis can be diagnosed by measuring patients' serum levels of thyroid stimulating hormone (TSH), anti-thyroglobulin antibody (TGA), and anti-thyroid microsomal antibody (TMA). This study evaluated whether there were hematinic deficiencies, high blood homocysteine levels, and serum gastric parietal cell antibody (GPCA) positivity in patients with TGA or TMA.
The blood hemoglobin (Hb), iron, vitamin B12, folic acid, homocysteine and TSH concentrations and the serum GPCA level in 190 TGA- or TMA-positive patients were measured and compared with the corresponding levels in 190 age- and sex-matched healthy control subjects.
We found that 31 (16.3%), 27 (14.2%), 12 (6.3%), and 2 (1.1%) TGA- or TMA-positive patients had deficiencies of Hb (Men<13g/dL, Women<12g/dL), iron (< 60μg/dL), vitamin B12 (< 200pg/mL), and folic acid (< 4ng/mL), respectively. Moreover, 25 (13.2%) and 48 (25.3%) TGA- or TMA-positive patients had abnormally high blood homocysteine level and serum GPCA positivity, respectively. TGA- or TMA-positive patients had a significantly higher frequency of Hb (p<0.001), iron (p<0.001), or vitamin B12 deficiency (p=0.001), of abnormally elevated blood homocysteine level (p=0.001), or of serum GPCA positivity (p<0.001) than healthy control subjects. Of 190 TGA- or TMA-positive patients, 8 (4.2%) had lower serum TSH level (< 0.1μIU/mL, suggestive of hyperthyroidism), 163 (85.8%) had serum TSH level within normal range (0.1-4.5μIU/mL), and 19 (10%) had higher serum TSH level (>4.5μIU/mL, suggestive of hypothyroidis).
There are significant deficiencies of hemoglobin, iron, and vitamin B12, abnormally high blood homocysteine levels, and serum GPCA positivity in TGA- or TMA-positive patients. In addition, the majority (85.8%) of TGA- or TMA-positive patients had euthyroid and only a small portion (14.2%) of TGA- or TMA-positive patients had either hypothyroidism or hyperthyroidism.
背景/目的：甲状腺刺激激素（TSH）、抗甲状腺球蛋白抗体（TGA）和抗甲状腺微粒体抗体（TMA）的血清水平可用于诊断自身免疫性甲状腺炎。本研究旨在评估 TGA 或 TMA 阳性患者是否存在血液学不足、高血液同型半胱氨酸水平和胃壁细胞抗体（GPCA）阳性。
测量 190 例 TGA 或 TMA 阳性患者的血红蛋白（Hb）、铁、维生素 B12、叶酸、同型半胱氨酸和 TSH 浓度以及血清 GPCA 水平，并与 190 例年龄和性别匹配的健康对照者的相应水平进行比较。
我们发现，31 例（16.3%）、27 例（14.2%）、12 例（6.3%）和 2 例（1.1%）TGA 或 TMA 阳性患者存在 Hb 不足（男性<13g/dL，女性<12g/dL）、铁不足（<60μg/dL）、维生素 B12 不足（<200pg/mL）和叶酸不足（<4ng/mL）。此外，25 例（13.2%）和 48 例（25.3%）TGA 或 TMA 阳性患者存在血液同型半胱氨酸水平升高和血清 GPCA 阳性，分别。TGA 或 TMA 阳性患者的 Hb（p<0.001）、铁（p<0.001）或维生素 B12 不足（p=0.001）、血液同型半胱氨酸水平升高（p=0.001）或血清 GPCA 阳性（p<0.001）的频率显著高于健康对照组。在 190 例 TGA 或 TMA 阳性患者中，8 例（4.2%）血清 TSH 水平较低（<0.1μIU/mL，提示甲状腺功能亢进），163 例（85.8%）血清 TSH 水平在正常范围内（0.1-4.5μIU/mL），19 例（10%）血清 TSH 水平较高（>4.5μIU/mL，提示甲状腺功能减退）。
TGA 或 TMA 阳性患者存在明显的血红蛋白、铁和维生素 B12 不足、血液同型半胱氨酸水平升高和血清 GPCA 阳性。此外，大多数（85.8%）TGA 或 TMA 阳性患者甲状腺功能正常，只有一小部分（14.2%）TGA 或 TMA 阳性患者存在甲状腺功能减退或甲状腺功能亢进。
