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自身免疫性甲状腺疾病患者抗磷脂抗体阳性的患病率更高:一项系统评价和荟萃分析

Patients with Autoimmune Thyroid Diseases Have Higher Prevalence of Positive Antiphospholipid Antibodies: A Systematic Review and Meta-Analysis.

作者信息

Lu Difei, Song Zhibo, Gao Ying, Zhang Junqing, Guo Xiaohui

机构信息

Department of Endocrinology, Peking University First Hospital, Beijing, China.

Department of Rheumatology and Clinical Immunology, Peking University First Hospital, Beijing, China.

出版信息

Int J Endocrinol. 2022 Aug 27;2022:8271951. doi: 10.1155/2022/8271951. eCollection 2022.

Abstract

INTRODUCTION

Autoimmune thyroid diseases (AITDs) and antiphospholipid syndrome (APS) are commonly seen in childbearing-age women and can lead to recurrent miscarriages. Studies with a relatively small sample size were conducted and concluded inconsistent results on the relationship between AITDs and APS or the presence of antiphospholipid (aPL) antibodies. This meta-analysis aimed to provide evidence on the possible association between AITDs and APL using primary data from all relevant studies.

METHODS

Literature databases including PubMed, Embase, and Cochrane were searched from the time when the databases were established to March 2022. A total of 7 studies that met all inclusion criteria were selected in this meta-analysis, with 475 AITD patients and 764 healthy controls. After data extraction, the pooled odds ratio (OR) and the 95% confidence interval (95% CI) were calculated.

RESULTS

The risk of positive APL in AITD patients was approximately 3 folds higher in AITD patients compared with those in healthy controls (OR 3.41, 95% CI 2.29-5.08, < 0.001). There was no significant association between the risk of Graves' disease (GD) and positive APL (OR 9.3, 95% CI 0.10-824.73, =0.33). The risk of positive APL in patients with Hashimoto's thyroiditis (HT) increased over 2 folds compared with healthy controls (OR 3.35, 95% CI 1.55-7.23, =0.002).

CONCLUSIONS

The result of this meta-analysis proved that the presence of APL was significantly increased in patients with AITD compared with healthy individuals, especially in patients with Hashimoto's thyroiditis.

摘要

引言

自身免疫性甲状腺疾病(AITD)和抗磷脂综合征(APS)在育龄妇女中较为常见,且可导致反复流产。以往针对AITD与APS或抗磷脂(aPL)抗体存在之间关系的研究样本量相对较小,得出的结果并不一致。本荟萃分析旨在利用所有相关研究的原始数据,为AITD与aPL之间的可能关联提供证据。

方法

检索了包括PubMed、Embase和Cochrane在内的文献数据库,检索时间从数据库建立至2022年3月。本荟萃分析共纳入7项符合所有纳入标准的研究,其中AITD患者475例,健康对照764例。数据提取后,计算合并比值比(OR)和95%置信区间(95%CI)。

结果

与健康对照相比,AITD患者中aPL阳性的风险高出约3倍(OR 3.41,95%CI 2.29-5.08,<0.001)。Graves病(GD)风险与aPL阳性之间无显著关联(OR 9.3,95%CI 0.10-824.73,P=0.33)。与健康对照相比,桥本甲状腺炎(HT)患者中aPL阳性的风险增加了2倍多(OR 3.35,95%CI 1.55-7.23,P=0.002)。

结论

本荟萃分析结果证明,与健康个体相比,AITD患者中aPL的存在显著增加,尤其是桥本甲状腺炎患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/095a/9440846/84bfe8907ffc/IJE2022-8271951.001.jpg

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