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子宫内膜异位症和甲状腺自身免疫之间是否存在关联?

Is there an association between endometriosis and thyroid autoimmunity?

机构信息

University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Department of Obstetrics and Gynecology - Istanbul, Turkey.

Central Hospital, Department of Obstetrics and Gynecology - Kristianstad, Sweden.

出版信息

Rev Assoc Med Bras (1992). 2023 May 29;69(6):e20221679. doi: 10.1590/1806-9282.20221679. eCollection 2023.

Abstract

OBJECTIVE

It has been suggested that non-uterine endometrial implants can express thyroid-stimulating hormone receptors, thus inducing the formation of thyroid-stimulating immunoglobulin. We aimed to compare the autoantibody positivity in patients with and without endometriosis and to determine whether there is a difference in the incidence of thyroid diseases.

METHODS

This prospective observational study was conducted on 102 women who had been operated on for benign gynecological diseases. Cases enrolling in the study were divided into two groups: the study group with endometriosis (n=51) and the control group without endometriosis (n=51). The blood tests for thyroid-stimulating hormone, free thyroxine (fT4), thyroid-stimulating immunoglobulin, and anti-thyroid peroxidase antibody levels were checked.

RESULTS

The mean thyroid-stimulating immunoglobulin level was found to be higher in the endometriosis group than in the control group. However, this difference was not statistically significant. No significant difference was detected between endometriosis and control groups in terms of anti-thyroid peroxidase antibody and thyroid-stimulating hormone levels. The mean fT4 value (0.97±0.13 ng/dL) of the endometriosis patients was found to be significantly lower than the control group (1.08±0.21 ng/dL) (p=0.002; p<0.05). The mean anti-thyroid peroxidase antibody value of cases with bilateral endometrioma (82.21±252.29 IU/mL) was significantly higher than cases with unilateral endometrioma (15.81±83.13 IU/mL) (p=0.028; p<0.05). There is a positive and significant relationship between the size of endometriosis and anti-thyroid peroxidase antibody values (p=0.011; p<0.05).

CONCLUSION

This study points to an association between endometrioma diameter and anti-thyroid peroxidase antibody values which can be a stepping stone for new studies evaluating this hypothesis further.

摘要

目的

有研究表明,非子宫内的子宫内膜植入物可以表达促甲状腺激素受体,从而诱导甲状腺刺激免疫球蛋白的形成。我们旨在比较子宫内膜异位症患者和非子宫内膜异位症患者的自身抗体阳性率,并确定甲状腺疾病的发病率是否存在差异。

方法

本前瞻性观察性研究纳入了 102 名因良性妇科疾病接受手术的女性。入组病例分为两组:子宫内膜异位症组(n=51)和非子宫内膜异位症组(n=51)。检测甲状腺刺激激素、游离甲状腺素(fT4)、甲状腺刺激免疫球蛋白和抗甲状腺过氧化物酶抗体水平。

结果

发现子宫内膜异位症组的甲状腺刺激免疫球蛋白水平高于对照组,但差异无统计学意义。在抗甲状腺过氧化物酶抗体和甲状腺刺激激素水平方面,子宫内膜异位症组与对照组之间未检测到显著差异。子宫内膜异位症患者的平均 fT4 值(0.97±0.13ng/dL)明显低于对照组(1.08±0.21ng/dL)(p=0.002;p<0.05)。双侧卵巢子宫内膜异位囊肿患者(82.21±252.29IU/mL)的平均抗甲状腺过氧化物酶抗体值明显高于单侧卵巢子宫内膜异位囊肿患者(15.81±83.13IU/mL)(p=0.028;p<0.05)。子宫内膜异位症的大小与抗甲状腺过氧化物酶抗体值呈正相关(p=0.011;p<0.05)。

结论

本研究表明,卵巢子宫内膜异位囊肿的直径与抗甲状腺过氧化物酶抗体值之间存在关联,这可能为进一步评估这一假设的新研究提供契机。

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