Department of Endocrinology and Metabolism, Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, China.
Department of Physical Examination Center, The First Hospital of China Medical University, Shenyang, 110001, China.
Endocrine. 2021 Aug;73(2):331-338. doi: 10.1007/s12020-021-02731-z. Epub 2021 May 7.
Serum lipids have been shown to regulate inflammatory and immune processes, but little is known about their association with thyroid autoimmunity. This study aimed to investigate the association of serum lipids with thyroid autoantibody positivity in the general population with normal thyroid-stimulating hormone (TSH) levels.
Data regarding the 7688 subjects' baseline characteristics were retrospectively collected. All subjects were categorized into four groups according to thyroid autoantibodies against thyroglobulin (TgAb) and thyroid peroxidase (TPOAb) positivity and serum lipid levels were compared. Binary logistic regression models were used to evaluate the risk of TgAb or TPOAb positivity with increasing serum lipid levels.
In 6456 included subjects, after adjusting for confounders, the risk of TgAb positivity was positively associated with increasing low-density lipoprotein cholesterol (LDL-C) levels (OR 1.14, 95% CI 1.03-1.27, P = 0.011) and negatively correlated with the increasing high-density lipoprotein cholesterol (HDL-C) levels (OR 0.77, 95% CI 0.61-0.98, P = 0.035). In female subjects, the association between increasing LDL-C (OR 1.16, 95% CI 1.04-1.28, P = 0.007) or HDL-C levels (OR 0.77, 95% CI 0.61-0.99, P = 0.037) and TgAb positivity become more pronounced.
We have shown the associations of HDL-C and LDL-C with TgAb positivity in the general population with normal TSH levels in a gender-dependent manner. This study highlights that serum lipids may be new predictors of thyroid autoimmunity even when TSH is within the reference range.
已有研究表明血清脂质可调节炎症和免疫过程，但对于其与甲状腺自身免疫的关系知之甚少。本研究旨在调查甲状腺刺激激素（TSH）水平正常的普通人群中，血清脂质与甲状腺自身抗体阳性之间的相关性。
回顾性收集了 7688 名受试者的基线特征数据。根据甲状腺球蛋白（TgAb）和甲状腺过氧化物酶（TPOAb）抗体阳性以及血清脂质水平，将所有受试者分为四组，并比较了各组间的血清脂质水平。采用二元逻辑回归模型评估随着血清脂质水平的升高，TgAb 或 TPOAb 阳性的风险。
在纳入的 6456 名受试者中，经调整混杂因素后，随着低密度脂蛋白胆固醇（LDL-C）水平的升高，TgAb 阳性的风险呈正相关（OR 1.14，95%CI 1.03-1.27，P=0.011），而与高密度脂蛋白胆固醇（HDL-C）水平的升高呈负相关（OR 0.77，95%CI 0.61-0.98，P=0.035）。在女性受试者中，随着 LDL-C（OR 1.16，95%CI 1.04-1.28，P=0.007）或 HDL-C 水平的升高（OR 0.77，95%CI 0.61-0.99，P=0.037），与 TgAb 阳性之间的关联更加明显。
我们以性别依赖的方式表明，在 TSH 水平正常的普通人群中，HDL-C 和 LDL-C 与 TgAb 阳性有关。本研究强调，即使 TSH 在参考范围内，血清脂质也可能是甲状腺自身免疫的新预测因子。
