Acay Akif, Ulu Memnune Sena, Ahsen Ahmet, Eroglu Selma, Ozuguz Ufuk, Yuksel Seref, Acarturk Gursel
Department of Internal Medicine, Afyon Kocatepe University Faculty of Medicine, Address: Afyon Kocatepe Universitesi, Tip Fakultesi, Ic Hastaliklari AD, 03200, Afyonkarahisar, Turkey.
Endocr Metab Immune Disord Drug Targets. 2014;14(3):182-6. doi: 10.2174/1871530314666140626113111.
We investigated whether there was a significant increase in thyroid autoimmunity, and disorders in patients with rheumatic diseases (RDs). We enrolled 201 patients with RDs (41 with ankylosing spondylitis, 15 with systemic lupus erythematosus, 80 with rheumatoid arthritis [RA], 65 with familial Mediterranean fever), and 122 healthy controls. Serum levels of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), C-reactive protein, and thyroid autoantibodies (anti-thyroglobulin and anti-thyroid peroxidase) were measured in all participants. There were no significant differences between the ages of the patients and controls. The mean TSH values of the patients with RDs and the controls were 3.1 ± 2.68 mIU/L and 1.9 ± 0.83 mIU/L, respectively (P = 0.004). The mean fT4 value of the patients with RDs was 1.43 ± 0.67 ng/dL whereas that of the controls was 1.58 ± 0.68 ng/dL (P <0.001). Subclinical hypothyroidism was detected in 24 patients with RDs. Thyroid antibodies were detected in 16 of 201 (8%) patients with RDs. Three of these patients had subclinical hypothyroidism, while the others were euthyroid. Thyroid autoantibodies were significantly higher in patients with RDs (P <0.001). Additionally, thyroid disorders were observed more frequently in patients with RDs than in the healthy controls. Based on our findings, we recommend that thyroid function tests should better be included in the clinical evaluation of patients with RDs.
我们调查了风湿性疾病（RDs）患者的甲状腺自身免疫及疾病是否有显著增加。我们纳入了201例RDs患者（41例强直性脊柱炎、15例系统性红斑狼疮、80例类风湿关节炎[RA]、65例家族性地中海热）以及122例健康对照者。检测了所有参与者的血清促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（fT3）、游离甲状腺素（fT4）、C反应蛋白和甲状腺自身抗体（抗甲状腺球蛋白和抗甲状腺过氧化物酶）。患者和对照者的年龄无显著差异。RDs患者和对照者的平均TSH值分别为3.1±2.68 mIU/L和1.9±0.83 mIU/L（P = 0.004）。RDs患者的平均fT4值为1.43±0.67 ng/dL，而对照者为1.58±0.68 ng/dL（P<0.001）。24例RDs患者检测出亚临床甲状腺功能减退。201例（8%）RDs患者中有16例检测出甲状腺抗体。其中3例患者有亚临床甲状腺功能减退，其他患者甲状腺功能正常。RDs患者的甲状腺自身抗体显著更高（P<0.001）。此外，RDs患者中甲状腺疾病的观察频率高于健康对照者。基于我们的研究结果，我们建议在RDs患者的临床评估中最好纳入甲状腺功能检查。
