Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, P.R. China.
Liaocheng People's Hospital, Liaocheng, Shandong Province, P.R. China.
Medicine (Baltimore). 2022 Sep 30;101(39):e30881. doi: 10.1097/MD.0000000000030881.
Studies on the association of thyroid autoimmunity with cardiometabolic risk and coronary artery disease (CAD) have produced conflicting results. This study aimed to investigate the relationship of thyroid autoimmune bodies (thyroid peroxidase antibody [TPOAb] and thyroglobulin antibody [TgAb]) with CAD in euthyroid subjects undergoing coronary angiography. A total of 307 subjects who underwent coronary angiography were included. The severity of coronary atherosclerosis was evaluated by using Gensini score. Serum TSH, total T3, total T4, TPOAb, TgAb, lipid levels et al were measured and compared between the groups with and without CAD. Logistic multivariate regression analysis were performed to assess the associations. Levels of thyroid hormones were comparable between the two groups. The positive percentage of anti-Tg antibodies was higher in non-CAD group (15.22% vs 7.91%, χ2 = 3.95, p = .047) while no significant difference was observed for anti-TPO antibodies (19.57% vs 17.21%, χ2 = 0.243, p = .622). The natural log-transformed Gensini score (ln (Gensini score)) was lower in the TgAb+ group (2.94 ± 1.11 vs 2.41 ± 1.18, P = .015). There was no significant difference for ln (Gensini score) between TPOAb- and TPOAb+ group (2.90 ± 1.14 vs 2.85 ± 1.09, P = .782). Logistical regression analysis revealed that positive TgAb was inversely associated with the presence of CAD (OR: 0.387, 95% CI: 0.157-0.952, p = .039) independent of other risk factors. The results showed that TgAb positivity might be an independent protective factor for CAD.
在甲状腺自身免疫与心血管代谢风险和冠状动脉疾病 (CAD) 的相关性研究中，结果相互矛盾。本研究旨在探讨甲状腺自身抗体（甲状腺过氧化物酶抗体 [TPOAb] 和甲状腺球蛋白抗体 [TgAb]）与行冠状动脉造影的甲状腺功能正常患者 CAD 的关系。共纳入 307 例行冠状动脉造影的患者。采用 Gensini 评分评估冠状动脉粥样硬化严重程度。比较 CAD 组与非 CAD 组之间的血清 TSH、总 T3、总 T4、TPOAb、TgAb、血脂等水平。采用多因素 Logistic 回归分析评估相关性。两组甲状腺激素水平无差异。非 CAD 组抗-Tg 抗体阳性率较高（15.22%比 7.91%，χ2 = 3.95，p =.047），而抗-TPO 抗体无显著差异（19.57%比 17.21%，χ2 = 0.243，p =.622）。TgAb+ 组的自然对数转化 Gensini 评分（ln (Gensini 评分)）较低（2.94 ± 1.11 比 2.41 ± 1.18，P =.015）。TPOAb-和 TPOAb+组之间的 ln (Gensini 评分) 无显著差异（2.90 ± 1.14 比 2.85 ± 1.09，P =.782）。Logistic 回归分析表明，阳性 TgAb 与 CAD 的存在呈负相关（OR：0.387，95%CI：0.157-0.952，p =.039），独立于其他危险因素。结果表明，TgAb 阳性可能是 CAD 的独立保护因素。
