1 Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .
2 Department of Urology, Huashan Hospital, Fudan University , Shanghai, China .
Thyroid. 2017 Jul;27(7):960-966. doi: 10.1089/thy.2016.0661. Epub 2017 Jun 21.
Autoimmune thyroid disease (AITD) is highly prevalent. Although AITD is less common in males, it is unclear whether estradiol (E) combined with total testosterone (T) contributes to the prevalence of AITD. This study evaluated the association between the E/T ratio and the prevalence of AITD in males.
The data were obtained from a cross-sectional population-based study, the SPECT-China study, 2014-2015. A total of 4109 males ≥18 years of age were enrolled in this study. Participants underwent several checkups, which included assays of serum E, T, thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) levels, as well as thyroid ultrasonography (US). AITD was defined based on the presence of TPOAb and TgAb levels, and the presence of thyroid US findings.
Overall, the prevalence of positivity for TPOAb and/or TgAb (TPO/TgAb[+]) was 11.02%, and the positivity for TPOAb and/or TgAb together with US (TPO/TgAb[+] and US[+]) was 4.58%. The E/T ratio levels were significantly higher in the TPO/TgAb(+) group and the TPO/TgAb(+) and US(+) group (7.91 ± 8.03 vs. 7.19 ± 10.30, p = 0.003; 8.78 ± 11.26 vs. 7.19 ± 10.30, p = 0.001) compared to the TPO and TgAb(-) group. The prevalence of TPO/TgAb(+) and US(+) significantly increased with an increasing E/T ratio (p = 0.013). Binary logistic analysis showed that increased E/T ratio levels were associated with an increased risk of AITD (TPO/TgAb[+]: odds ratio = 1.35, p = 0.002; TPO/TgAb[+] and US[+]: odds ratio = 1.48, p = 0.006).
AITD is highly prevalent in males in China. Higher E/T ratios were significantly associated with AITD among males. Further studies will be needed to assess whether there is a causal relationship between E/T ratios and AITD.
自身免疫性甲状腺疾病（AITD）的患病率很高。尽管男性中 AITD 的发病率较低，但尚不清楚雌二醇（E）与总睾酮（T）的联合是否会导致 AITD 的流行。本研究评估了 E/T 比值与男性 AITD 患病率之间的关系。
本研究的数据来自于 2014-2015 年的一项基于人群的横断面研究，即 SPECT-China 研究。共纳入 4109 名年龄≥18 岁的男性。所有参与者均接受了多项检查，包括血清 E、T、甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TgAb）水平以及甲状腺超声（US）检查。根据 TPOAb 和 TgAb 水平以及甲状腺 US 结果定义 AITD。
总体而言，TPOAb 和/或 TgAb 阳性（TPO/TgAb[+]）的患病率为 11.02%，TPOAb 和/或 TgAb 阳性并伴有 US 异常（TPO/TgAb[+]和 US[+]）的患病率为 4.58%。TPO/TgAb（+）组和 TPO/TgAb（+）和 US（+）组的 E/T 比值水平显著高于 TPO 和 TgAb（-）组（7.91±10.30 比 7.19±10.30，p=0.003；8.78±11.26 比 7.19±10.30，p=0.001）。随着 E/T 比值的增加，TPO/TgAb（+）和 US（+）的患病率显著增加（p=0.013）。二元逻辑分析表明，E/T 比值升高与 AITD 风险增加相关（TPO/TgAb[+]：比值比=1.35，p=0.002；TPO/TgAb[+]和 US[+]：比值比=1.48，p=0.006）。
中国男性 AITD 的患病率很高。较高的 E/T 比值与男性 AITD 显著相关。需要进一步的研究来评估 E/T 比值与 AITD 之间是否存在因果关系。
