女性感染与自身免疫性甲状腺疾病的关联。

Association of Infection with Autoimmune Thyroid Disease in the Female Sex.

作者信息

Dore Maria Pina, Fanciulli Giuseppe, Manca Alessandra, Pes Giovanni Mario

机构信息

Dipartimento di Medicina, Chirurgia e Farmacia, University of Sassari, 07100 Sassari, Italy.

Baylor College of Medicine, Houston, TX 77030, USA.

出版信息

J Clin Med. 2023 Aug 6;12(15):5150. doi: 10.3390/jcm12155150.

DOI:10.3390/jcm12155150

PMID:37568552

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10419966/

Abstract

BACKGROUND

infection has been associated with an increased risk of thyroid diseases (TDs), although scientific evidence is conflicting. In the present study the relationship between TDs, including both autoimmune (AI) and non-autoimmune TD, and infection was investigated.

METHODS

Data from records of patients undergoing upper endoscopy and histologically evaluated for infection were retrieved. In addition to demographic information, the features of gastritis based on non-targeted biopsies collected from the antrum, angulus, and corpus were analyzed. The presence of infection and atrophy and/or metaplasia and/or dysplasia in at least one gastric specimen was defined as a long-lasting infection and the presence of a chronic-active gastritis as a current infection. Hashimoto's and Graves' diseases were included in the AITD group, and thyroid nodules, goiter, iatrogenic thyroid hypo/hyper function, and thyroidectomy in the non-autoimmune TD group.

RESULTS

A total of 8322 records from adult patients from Northern Sardinia, characterized by a similar genetic background, was analyzed. Participants were aged 18-93 years (females 5339, 64.1%), and more specifically, 562 (6.7%) had a diagnosis of AITD and 448 (5.4%) of non-autoimmune TD. A significant association between long-lasting and AITD (OR 1.34; 95%CI 1.13-1.60) was found, irrespective of age, sex, body mass index, and smoking status, while it was not associated with non-autoimmune TD. Current infection did not show significant ORs for AITD (OR 0.99; 95%CI 0.64-1.57) and non-autoimmune TD (OR 0.86; 95%CI 0.66-1.15). The association with long-lasting infection was confirmed to be significant for both Hashimoto's thyroiditis and Graves' disease by multivariable regression analysis. Stratification according to sex revealed a significant association only for females (OR 1.39; 95%CI 1.12-1.72).

CONCLUSIONS

Our results indicate that long-lasting infection is associated with AITD in the female adult population of Northern Sardinia.

摘要

背景

感染与甲状腺疾病（TDs）风险增加相关，尽管科学证据存在矛盾。在本研究中，对包括自身免疫性（AI）和非自身免疫性TD在内的TDs与感染之间的关系进行了调查。

方法

检索接受上消化道内镜检查并进行感染组织学评估的患者记录数据。除人口统计学信息外，还分析了从胃窦、胃角和胃体采集的非靶向活检的胃炎特征。至少一个胃标本中存在感染以及萎缩和/或化生和/或发育异常被定义为长期感染，存在慢性活动性胃炎被定义为当前感染。自身免疫性甲状腺疾病（AITD）组包括桥本氏病和格雷夫斯病，非自身免疫性TD组包括甲状腺结节、甲状腺肿、医源性甲状腺功能减退/亢进以及甲状腺切除术。

结果

分析了来自撒丁岛北部成年患者的8322份记录，这些患者具有相似的遗传背景。参与者年龄在18 - 93岁之间（女性5339名，占64.1%），更具体地说，562名（6.7%）被诊断为AITD, 448名（5.4%）患有非自身免疫性TD。发现长期感染与AITD之间存在显著关联（比值比[OR] 1.34；95%置信区间[CI] 1.13 - 1.60），与年龄、性别、体重指数和吸烟状况无关，而与非自身免疫性TD无关。当前感染对AITD（OR 0.99；95%CI 0.64 - 1.57）和非自身免疫性TD（OR 0.86；95%CI 0.66 - 1.15）未显示出显著的比值比。多变量回归分析证实，长期感染与桥本氏甲状腺炎和格雷夫斯病均显著相关。按性别分层显示仅女性存在显著关联（OR 1.39；95%CI 1.12 - 1.72）。