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桥本甲状腺炎患者正常外观脑内的代谢改变与激素变化相关。

The metabolic alterations within the normal appearing brain in patients with Hashimoto's thyroiditis are correlated with hormonal changes.

机构信息

Department of General Radiology, Interventional Radiology and Neuroradiology, Wrocław Medical University, Wrocław, Poland.

Department of Neurology, Wrocław Medical University, ul. Borowska 213, 50-556, Wrocław, Poland.

出版信息

Metab Brain Dis. 2019 Feb;34(1):53-60. doi: 10.1007/s11011-018-0318-z. Epub 2018 Sep 21.

Abstract

Hashimoto's thyroiditis (HT) is the most common autoimmune disease in humans usually associated with subsequent hypothyroidism. The purpose of the study was to assess metabolic alterations within the normal appearing brain in subjects with HT using MR spectroscopy (MRS) and to correlate MRS measurements with hormonal concentrations. Fifty-five HT patients (mean age 43.5 yrs) and 30 healthy controls (mean age 42.5 yrs) were examined with the use of a 1.5 T MR scanner. There were no signs of central nervous system involvement in the studied group. The MRS examinations were performed using the single voxel method. The voxels were placed in the left parietal white matter (PWM) and the posterior cingulate gyrus (PCG). The NAA/Cr, Cho/Cr, and mI/Cr ratios were calculated. The correlations between metabolite ratios and hormonal concentrations (TSH, fT3, fT4) as well as anti-TG and anti-TPO levels were also assessed. We found significantly (p < 0.05) decreased NAA/Cr ratios in PCG and PWM in HT subjects compared to the control group. There were no other significant differences in metabolite ratios. We observed significant positive correlations between the NAA/Cr ratio in PCG as well as the PWM and fT3 level. There was also a significant negative correlation between the Cho/Cr ratio in the PCG and fT4 level. MRS could be a sensitive biomarker capable of depicting early cerebral metabolic disturbances associated with HT. Our findings may indicate the reduction of neuronal activity within the normal appearing brain in patients with HT as well as suggesting that there is a possible biological association between thyroid dysfunction and cerebral metabolic changes.

摘要

桥本甲状腺炎(HT)是人类最常见的自身免疫性疾病,通常与随后的甲状腺功能减退症有关。本研究的目的是使用磁共振波谱(MRS)评估 HT 患者正常表现大脑内的代谢变化,并将 MRS 测量结果与激素浓度相关联。研究共纳入 55 例 HT 患者(平均年龄 43.5 岁)和 30 例健康对照者(平均年龄 42.5 岁),使用 1.5T 磁共振扫描仪进行检查。研究组无中枢神经系统受累迹象。MRS 检查采用单体素法进行。体素放置在左侧顶叶白质(PWM)和后扣带回。计算 NAA/Cr、Cho/Cr 和 mI/Cr 比值。还评估了代谢物比值与激素浓度(TSH、fT3、fT4)以及抗 TG 和抗 TPO 水平之间的相关性。与对照组相比,HT 患者的 PCG 和 PWM 中的 NAA/Cr 比值明显降低(p<0.05)。代谢物比值没有其他显著差异。我们观察到 PCG 和 PWM 中 NAA/Cr 比值与 fT3 水平之间存在显著正相关,而 PCG 中 Cho/Cr 比值与 fT4 水平之间存在显著负相关。MRS 可能是一种敏感的生物标志物,能够描绘与 HT 相关的早期大脑代谢紊乱。我们的发现可能表明 HT 患者正常表现大脑内的神经元活动减少,并表明甲状腺功能障碍与大脑代谢变化之间存在可能的生物学关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb15/6351519/9879786f4ee7/11011_2018_318_Fig1_HTML.jpg

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