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在碘摄入量轻度不足的人群中,吸烟与抗甲状腺过氧化物酶抗体和抗甲状腺球蛋白抗体呈正相关。

Smoking Is Positively Associated with Antithyroperoxidase Antibodies and Antithyroglobulin Antibodies in Populations with Mildly Deficient Iodine Intake.

机构信息

Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China.

出版信息

Biol Trace Elem Res. 2019 Feb;187(2):383-391. doi: 10.1007/s12011-018-1410-2. Epub 2018 Jun 25.

Abstract

To evaluate the relationship between smoking and both antithyroperoxidase antibody (TPOAb) and antithyroglobulin antibody (TgAb) positivity in subjects from Panshan, Zhangwu, and Huanghua with mildly deficient, more than adequate, and excessive iodine intake, respectively. Smoking-related data were collected by questionnaire, and laboratory measurements of TPOAb, TgAb, and thyrotropin (TSH) were determined at baseline and follow-up. (1) A 1.48-fold increased risk of TPOAb positivity was found in smokers than in non-smokers after adjusting for confounders (age, sex, and areas) (OR[95% CI] = 1.48[1.12-1.95], p = 0.01). (2) Among female subjects, the prevalence of thyroid autoantibodies in smokers was increased than that in non-smokers in Panshan, Zhangwu, and Huanghua (TPOAb): 16.79 vs. 8.89%, 14.14 vs. 11.09%, 19.53 vs. 9.57%; TgAb 15.32 vs. 9.29%, 12.79 vs. 11.94%, 17.19 vs. 10.55%, respectively). The difference was significant in Panshan after adjusting for age. (3) Female long-term smokers (> 20 years) had an increased frequency of thyroid autoantibody positivity than non-smokers after adjusting for confounders (TPOAb OR[95% CI] = 1.60[1.10-2.34]; TgAb OR[95% CI] = 1.31[0.88-1.94]). (4) There was no difference in the incidence of thyroid autoantibodies among non-smokers, new smokers, and long-term smokers at follow-up. (5) TSH was greater in TPOAb-positive subjects than in seronegative smokers (1.56 vs. 1.20 mU/L, p < 0.001) and non-smokers (1.97 vs. 1.58 mU/L, p < 0.001). However, TSH was also greater in non-smokers than in smokers, regardless of whether subjects were positive (1.97 vs. 1.56 mU/L, p = 0.04) or negative (1.58 vs. 1.20 mU/L, p < 0.001) for TPOAb. Long-term smoking could increase the prevalence of thyroid autoantibodies in a population with mildly deficient iodine intake. TSH levels were lesser in smokers than in non-smokers and greater in subjects with thyroid autoantibody positivity than in seronegative subjects. The influence of smoking on TSH levels was independent of thyroid autoantibody levels.

摘要

为了评估在碘摄入轻度不足、充足和过量的盘山、彰武和黄华人群中,吸烟与抗甲状腺过氧化物酶抗体(TPOAb)和抗甲状腺球蛋白抗体(TgAb)阳性之间的关系。通过问卷收集吸烟相关数据,并在基线和随访时测定 TPOAb、TgAb 和促甲状腺激素(TSH)的实验室测量值。(1)调整混杂因素(年龄、性别和地区)后,发现吸烟者 TPOAb 阳性的风险是不吸烟者的 1.48 倍(OR[95%CI] = 1.48[1.12-1.95],p = 0.01)。(2)在女性中,与不吸烟者相比,吸烟者在盘山、彰武和黄华的甲状腺自身抗体患病率更高(TPOAb:16.79%比 8.89%、14.14%比 11.09%、19.53%比 9.57%;TgAb:15.32%比 9.29%、12.79%比 11.94%、17.19%比 10.55%)。在盘山,调整年龄后差异具有统计学意义。(3)调整混杂因素后,女性长期吸烟者(>20 年)甲状腺自身抗体阳性的频率高于不吸烟者(TPOAb OR[95%CI] = 1.60[1.10-2.34];TgAb OR[95%CI] = 1.31[0.88-1.94])。(4)在随访时,不吸烟者、新吸烟者和长期吸烟者之间甲状腺自身抗体的发生率没有差异。(5)与 TPOAb 阳性的吸烟者相比(1.56 vs. 1.20 mU/L,p < 0.001)和不吸烟者(1.97 vs. 1.58 mU/L,p < 0.001),TSH 在 TPOAb 阳性的吸烟者中更高。然而,与吸烟者相比,不吸烟者的 TSH 也更高,无论受试者 TPOAb 是阳性(1.97 vs. 1.56 mU/L,p = 0.04)还是阴性(1.58 vs. 1.20 mU/L,p < 0.001)。长期吸烟可能会增加轻度碘摄入人群甲状腺自身抗体的患病率。与不吸烟者相比,吸烟者的 TSH 水平较低,与 TPOAb 阴性的受试者相比,甲状腺自身抗体阳性的受试者 TSH 水平较高。吸烟对 TSH 水平的影响独立于甲状腺自身抗体水平。

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