Qom University of Medical Sciences, Qom, Iran.
Research Center for Environmental Pollutants, Qom University of Medical Sciences, Qom, Iran.
BMC Endocr Disord. 2023 Oct 5;23(1):212. doi: 10.1186/s12902-023-01473-5.
Rheumatoid Arthritis (RA) and autoimmune thyroid disease (AITD) are the two most prevalent coexisting autoimmune diseases due to their similar pathogenesis. Considering the potential effect of AITD on the severity of RA disease, this study aimed to determine the association between thyroid dysfunction, anti-thyroid peroxidase (anti-TPO) positivity, AITD, and RA disease severity in the Iranian population.
Three hundred and fifty RA patients who presented to Shahid Beheshti tertiary care center, Qom, Iran, were included in this cross-sectional study. The data were collected through the patient's medical records, interviews, physical examinations, and laboratory tests. The RA disease activity score in 28 joints for RA with erythrocyte sedimentation rate (DAS-28-ESR) was used to divide patients into three subgroups, remission (DAS-28-ESR ⩽ 2.6), mild-to-moderate (2.6 < DAS-28-ESR ⩽ 5.1), and severe disease activity (DAS-28-ESR > 5.1).
Using the aforementioned method, 111, 96, and 138 patients were put into remission, mild-to-moderate, and severe disease activity groups, respectively. Anti-TPO antibody positivity rate was 2.93 times more prevalent among patients with severe disease compared to the remission subgroup (OR: 2.93; P-value < 0.001). Patients suffering from a more severe disease were almost 2.7 times more probable to have AITD (OR = 2.71; P-value < 0.001) and they were 82% more likely to have thyroid dysfunction compared to patients in remission (OR = 1.82; P-value = 0.006).
It was demonstrated that thyroid dysfunction, anti-TPO antibody positivity, and AITD were significantly more common among RA patients with more severe disease activity.
类风湿关节炎（RA）和自身免疫性甲状腺疾病（AITD）是两种最常见的共存自身免疫性疾病，因为它们具有相似的发病机制。鉴于 AITD 对 RA 疾病严重程度的潜在影响，本研究旨在确定伊朗人群中甲状腺功能障碍、抗甲状腺过氧化物酶（anti-TPO）阳性、AITD 和 RA 疾病严重程度之间的关联。
本横断面研究纳入了 350 名就诊于伊朗库姆沙比希特贝赫什提三级护理中心的 RA 患者。通过患者的病历、访谈、体检和实验室检查收集数据。使用红细胞沉降率（DAS-28-ESR）的 28 个关节 RA 疾病活动评分（DAS-28-ESR）将患者分为三组，即缓解组（DAS-28-ESR ⩽ 2.6）、轻度至中度（2.6 ⩽ DAS-28-ESR ⩽ 5.1）和重度疾病活动组（DAS-28-ESR ⩾ 5.1）。
采用上述方法，将 111、96 和 138 名患者分别归入缓解、轻度至中度和重度疾病活动组。与缓解亚组相比，重度疾病组患者的抗 TPO 抗体阳性率高 2.93 倍（OR：2.93；P 值 ⁇ 0.001）。患有更严重疾病的患者发生 AITD 的可能性几乎是缓解组的 2.7 倍（OR ⁇ 2.71；P 值 ⁇ 0.001），与缓解组相比，他们发生甲状腺功能障碍的可能性高 82%（OR ⁇ 1.82；P 值 ⁇ 0.006）。
结果表明，甲状腺功能障碍、抗 TPO 抗体阳性和 AITD 在 RA 疾病活动度较高的患者中更为常见。
