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泰国系统性红斑狼疮患者甲状腺功能障碍和甲状腺自身抗体的流行情况:一项年龄和性别匹配的对照研究。

Prevalence of thyroid dysfunctions and thyroid autoantibodies in Thai patients with systemic lupus erythematosus: An age- and sex-matched controlled study.

机构信息

Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

出版信息

Int J Rheum Dis. 2024 May;27(5):e15195. doi: 10.1111/1756-185X.15195.

Abstract

BACKGROUND/OBJECTIVE: To determine the prevalence of thyroid dysfunctions and thyroid autoantibodies in Thai systemic lupus erythematosus (SLE) patients, and compare them with age- and sex-matched healthy controls (HCs). Associations between thyroid dysfunctions and SLE disease activity, and associated factors for thyroid dysfunctions in SLE also were determined.

METHOD

One hundred SLE patients, without apparent clinical thyroid disease, attended the Rheumatology Clinic between November 2021 and October 2022, were enrolled into this study. HCs were matched to SLE cases by age and sex (ratio of 1:1). Clinical manifestations, SLE disease activity and medication received were collected in all SLE patients. Thyroid function tests and thyroid autoantibodies (anti-thyroglobulin: anti-TG and anti-thyroid peroxidase: anti-TPO) were collected from all participants.

RESULTS

When compared with HCs, SLE patients had higher prevalence of thyroid dysfunctions, hypothyroidism and euthyroid sick syndrome (28% vs. 7%, p < .001, and 12% vs. 2%, p = .010, and 6% vs. 0%, p = .013, respectively). Prevalence of isolated hypothyroxinemia was higher numerically in SLE patients (9% vs. 3%, p = .074). Prevalence of anti-TG or anti-TPO was no different between SLE patients and HCs (16% vs. 18%, p = .707). There was no association between SLE disease activity and abnormal thyroid functions or thyroid autoantibodies. Family history of thyroid disease and prednisolone use (>10 mg/day) were associated factors for thyroid abnormalities with adjusted OR (95% CI) of 6.13 (1.58-23.75), p = .009 and 4.00 (1.37-11.70), p = .011, respectively.

CONCLUSION

Thyroid dysfunctions were more prevalent in SLE patients. Family history of thyroid disease and prednisolone use (>10 mg/day) were independent associated factors of thyroid abnormalities.

摘要

背景/目的:确定泰国系统性红斑狼疮(SLE)患者甲状腺功能障碍和甲状腺自身抗体的患病率,并将其与年龄和性别匹配的健康对照组(HCs)进行比较。还确定了甲状腺功能障碍与 SLE 疾病活动的相关性以及 SLE 中甲状腺功能障碍的相关因素。

方法

本研究纳入了 2021 年 11 月至 2022 年 10 月期间在风湿病科就诊的 100 名无明显临床甲状腺疾病的 SLE 患者。HCs 与 SLE 病例按年龄和性别(1:1 比例)匹配。所有 SLE 患者均采集临床表现、SLE 疾病活动和用药情况。所有参与者均采集甲状腺功能检查和甲状腺自身抗体(抗甲状腺球蛋白:抗-TG 和抗甲状腺过氧化物酶:抗-TPO)。

结果

与 HCs 相比,SLE 患者甲状腺功能障碍、甲状腺功能减退和甲状腺功能正常病态综合征的患病率更高(28%比 7%,p<0.001,12%比 2%,p=0.010,6%比 0%,p=0.013)。SLE 患者孤立性低甲状腺素血症的患病率略高(9%比 3%,p=0.744)。SLE 患者和 HCs 之间抗-TG 或抗-TPO 的患病率无差异(16%比 18%,p=0.707)。SLE 疾病活动与异常甲状腺功能或甲状腺自身抗体之间无关联。甲状腺疾病家族史和泼尼松龙使用(>10mg/天)是甲状腺异常的相关因素,调整后的 OR(95%CI)分别为 6.13(1.58-23.75),p=0.009 和 4.00(1.37-11.70),p=0.011。

结论

SLE 患者甲状腺功能障碍更为常见。甲状腺疾病家族史和泼尼松龙使用(>10mg/天)是甲状腺异常的独立相关因素。

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