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代谢紊乱与 Tpoab/Tgab 的相关性:一项基于人群的横断面研究。

The Correlation Between Metabolic Disorders And Tpoab/Tgab: A Cross-Sectional Population-Based Study.

机构信息

From the Department of Endocrinology and Metabolism and the institute of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China; These authors contributed equally to this work.

Department of Endocrinology, the First Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China; These authors contributed equally to this work.

出版信息

Endocr Pract. 2020 Aug;26(8):869-882. doi: 10.4158/EP-2020-0008.

Abstract

OBJECTIVE

Studies have shown that metabolic abnormalities influence the immune system. Because the prevalence of metabolic and autoimmune thyroid diseases has increased synchronously, the correlation between them was worth exploring. The study objective was to investigate the relationship between metabolic disorders and thyroid auto-antibodies in euthyroid subjects.

METHODS

Data were obtained from the Thyroid Diseases and Diabetes Mellitus project survey of 55,891 subjects from 31 provinces in China. The body mass index (BMI), waist circumference (WC), blood pressure, thyroid peroxidase antibodies (TPOAbs), thyroglobulin antibodies (TgAbs), thyroid-stimulating hormone (TSH), urinary iodine concentration, blood glucose, lipid profile, and uric acid levels were evaluated. Free thyroxine and free triiodothyronine levels were measured in patients with abnormal serum TSH levels.

RESULTS

In males, the BMI, WC, systolic blood pressure (SBP), diastolic blood pressure (DBP), and 2-hour post-glucose oral glucose tolerance test results of the TPOAb-/TgAb-positive group were significantly higher than those of the TPOAb-/TgAb-negative group. In females, the BMI, WC, SBP, DBP, total cholesterol, and low-density-lipoprotein cholesterol (LDL-C) in the TPOAb-/TgAb-positive group were significantly increased compared to the TPOAb-/TgAb-negative group. Multivariate analysis showed that in males, the odds ratio (OR) of positive TgAbs in the abdominal obesity group was 1.175 (95% confidence interval [CI], 1.016 to 1.359; P = .03), and the OR of positive TPOAbs in the hyperuricemia group was 1.195 (95% CI, 1.041 to 1.372; P = .011). In females, the OR of positive TgAbs was 1.19 (95% CI, 1.068 to 1.326; P = .002) in the high LDL-C group.

CONCLUSION

Obesity, high LDL-C, and hyperuricemia were positively correlated with the prevalence of positive thyroid autoantibodies in euthyroid subjects in a gender-dependent manner. This cross-sectional survey showed that metabolic disorders are associated with increased positive thyroid autoantibody levels in euthyroid subjects in a gender-dependent manner.

ABBREVIATIONS

AIT = autoimmune thyroiditis; BMI = body mass index; CI = confidence interval; DBP = diastolic blood pressure; FPG = fasting plasma glucose; FT3 = free triiodothyronine; FT4 = free thyroxine; HbA1c = glycated hemoglobin; HDL-C = high-density-lipoprotein cholesterol; LDL-C = low-density-lipoprotein cholesterol; OGTT2hPG = oral glucose tolerance test 2-hours post-glucose; OR = odds ratio; SBP = systolic blood pressure; TC = total cholesterol; TG = triglycerides; TgAb = thyroglobulin antibody; TPOAb = thyroid peroxidase antibody; TSH = thyroid-stimulating hormone; UA = uric acid; WC = waist circumference.

摘要

目的

研究表明,代谢异常会影响免疫系统。由于代谢和自身免疫性甲状腺疾病的患病率同步增加,因此值得探讨它们之间的相关性。本研究旨在探讨甲状腺功能正常人群代谢紊乱与甲状腺自身抗体之间的关系。

方法

数据来自中国 31 个省 55891 名受试者的甲状腺疾病和糖尿病项目调查。评估了体重指数(BMI)、腰围(WC)、血压、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、促甲状腺激素(TSH)、尿碘浓度、血糖、血脂和尿酸水平。在血清 TSH 水平异常的患者中测量游离甲状腺素和游离三碘甲状腺原氨酸水平。

结果

在男性中,TPOAb-/TgAb 阳性组的 BMI、WC、收缩压(SBP)、舒张压(DBP)和 2 小时口服葡萄糖耐量试验(OGTT2hPG)结果明显高于 TPOAb-/TgAb 阴性组。在女性中,TPOAb-/TgAb 阳性组的 BMI、WC、SBP、DBP、总胆固醇和低密度脂蛋白胆固醇(LDL-C)明显高于 TPOAb-/TgAb 阴性组。多变量分析显示,在男性中,腹型肥胖组 TgAb 阳性的比值比(OR)为 1.175(95%置信区间[CI],1.016 至 1.359;P =.03),高尿酸血症组 TPOAb 阳性的 OR 为 1.195(95%CI,1.041 至 1.372;P =.011)。在女性中,高 LDL-C 组 TgAb 阳性的 OR 为 1.19(95%CI,1.068 至 1.326;P =.002)。

结论

肥胖、高 LDL-C 和高尿酸血症与甲状腺功能正常人群甲状腺自身抗体阳性的患病率呈正相关,且具有性别依赖性。本横断面研究表明,代谢紊乱与甲状腺功能正常人群甲状腺自身抗体阳性水平升高呈性别依赖性相关。

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