Department of Endocrinology and Metabolism, Institute of Endocrinology, The First Affiliated Hospital of China Medical University, Shenyang, China.
Department of Endocrinology, The First People's Hospital of Yunnan Province, Kunming, China.
Front Endocrinol (Lausanne). 2020 Mar 18;11:139. doi: 10.3389/fendo.2020.00139. eCollection 2020.
The expressions of antibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) are very common in the sera of patients with autoimmune thyroid diseases (AITD). The relationship between thyroid autoantibodies and the occurrence of glucose and lipid metabolic disorders remains unclear. This study was performed to investigate the correlation between the presence of serum TPOAb/TgAb and those metabolic disorders in euthyroid general population. The data of this study were derived from the Thyroid Disease, Iodine status, and Diabetes National epidemiological (TIDE) survey from all 31 provinces of mainland China. A total of 17,964 euthyroid subjects including 5,802 males (4,000 with TPOAbTgAb and 1,802 with TPOAb/TgAb) and 12,162 females (8,000 with TPOAbTgAb and 4,162 with TPOAb/TgAb) were enrolled in this study. The blood glucose and lipid levels were compared between individuals with TPOAbTgAb and those with TPOAbTgAb, TPOAbTgAb, TPOAbTgAb. Both fasting blood glucose (FBG) concentration and the proportion of individuals with impaired FBG (IFG) showed the decreased trends in TPOAbTgAb males as compared with TPOAbTgAb men. There were significantly lower FBG and higher HDL-C levels as well as tendencies toward decreased incidences of IGT and hypertriglyceridemia in TPOAbTgAb females when compared with TPOAbTgAb women. Binary logistic regression analysis further showed that serum TgAb single positivity in males was an independent protective factor for IFG with an OR of 0.691 (95% CI, 0.503-0.949). For females, serum TgAb single positivity was an independent protective factor for hypertriglyceridemia with an OR of 0.859 (95% CI, 0.748-0.987). Trend test showed that with the increase of serum TgAb level, there were significant decreases in the prevalence of IFG among the men with TSH ≤ 2.5 mIU/L and that of hypertriglyceridemia in the women, especially among non-obese females. Serum TgAb single positivity may imply a reduced risk of IFG in euthyroid men and that of hypertriglyceridemia in euthyroid women. The mechanisms for the independent protective roles of TgAb await further investigation.
甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TgAb)在自身免疫性甲状腺疾病(AITD)患者的血清中表达非常常见。甲状腺自身抗体与葡萄糖和脂质代谢紊乱的发生之间的关系尚不清楚。本研究旨在探讨甲状腺功能正常的普通人群中血清 TPOAb/TgAb 与这些代谢紊乱之间的相关性。本研究的数据来自中国大陆 31 个省的甲状腺疾病、碘状况和糖尿病全国流行病学(TIDE)调查。共纳入 17964 例甲状腺功能正常的受试者,包括 5802 名男性(4000 名 TPOAb/TgAb 阳性和 1802 名 TPOAb/TgAb 阳性)和 12162 名女性(8000 名 TPOAb/TgAb 阳性和 4162 名 TPOAb/TgAb 阳性)。比较 TPOAb/TgAb 阳性和 TPOAb/TgAb 阳性、TPOAb/TgAb 阳性个体的血糖和血脂水平。与 TPOAb/TgAb 男性相比,TPOAb/TgAb 男性的空腹血糖(FBG)浓度和空腹血糖受损(IFG)的比例均呈下降趋势。与 TPOAb/TgAb 女性相比,TPOAb/TgAb 女性的 FBG 水平较低,HDL-C 水平较高,IGT 和高甘油三酯血症的发生率也呈下降趋势。二元逻辑回归分析进一步表明,男性血清 TgAb 单项阳性是 IFG 的独立保护因素,OR 为 0.691(95%CI,0.503-0.949)。对于女性,血清 TgAb 单项阳性是高甘油三酯血症的独立保护因素,OR 为 0.859(95%CI,0.748-0.987)。趋势检验显示,随着血清 TgAb 水平的升高,TSH≤2.5mIU/L 的男性 IFG 患病率显著降低,非肥胖女性的高甘油三酯血症患病率也显著降低。血清 TgAb 单项阳性可能意味着甲状腺功能正常的男性发生 IFG 的风险降低,甲状腺功能正常的女性发生高甘油三酯血症的风险降低。TgAb 的独立保护作用的机制有待进一步研究。