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自身免疫性甲状腺疾病改变老年人手部骨关节炎的临床表现:第三次美国国家健康与营养检查调查研究

Autoimmune thyroid disease modifies the clinical expression of hand osteoarthritis in older people: a third National Health and nutrition examination survey study.

作者信息

Tagoe Clement E, Wang Wanyi, Kwon Helena H

机构信息

Division of Rheumatology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States.

Elite Research, LLC, Irving, TX, United States.

出版信息

Front Med (Lausanne). 2024 Aug 20;11:1445188. doi: 10.3389/fmed.2024.1445188. eCollection 2024.

Abstract

INTRODUCTION

The risk factors linked to hand osteoarthritis (OA) that contribute to its distinct symptoms and clinical presentation are not thoroughly understood. This study aimed to examine whether the autoimmune thyroid disease (AITD) autoantibodies, anti-thyroid peroxidase antibody (TPOAb), and anti-thyroglobulin antibody (TgAb), associate with hand OA and symptomatic hand OA in the Third National Health and Nutrition Examination Survey (NHANES III).

MATERIALS AND METHODS

We included 2,429 persons from NHANES III ≥60 years of age. Data on hand OA or symptomatic hand OA were examined with respect to their associations with TPOAb and TgAb. Log-binomial and modified Poisson regression models were fit to examine the associations between the anti-thyroid autoantibodies and hand OA or symptomatic hand OA.

RESULTS

Higher levels of TPOAb were associated with a higher prevalence of symptomatic hand OA in the unadjusted ( = 1.182,  = 0.024) and adjusted models after controlling for age, gender, and diabetes ( = 1.174,  = 0.039). This association was no longer significant when positive TPOAb was considered a categorical variable with four levels and compared with negative TPOAb. TgAb showed a trend toward being positively associated with symptomatic hand OA ( < 0.10). When positive TgAb was considered a categorical variable with four levels and compared with negative TgAb, the highest quartile was associated with a higher prevalence of symptomatic hand OA than negative TgAb in the unadjusted ( = 2.242,  = 0.008) and adjusted models ( = 2.045,  = 0.038). There was no significant association between TPOAb or TgAb and hand OA.

CONCLUSION

Higher levels of TPOAb may be associated with the presence of symptomatic hand OA in persons ≥60 years old. Persons ≥60 years old with the highest quartile levels of TgAb may be more likely to present with symptomatic hand OA.

摘要

引言

与手部骨关节炎(OA)相关的危险因素导致了其独特的症状和临床表现,但尚未被完全理解。本研究旨在调查在第三次全国健康和营养检查调查(NHANES III)中,自身免疫性甲状腺疾病(AITD)自身抗体、抗甲状腺过氧化物酶抗体(TPOAb)和抗甲状腺球蛋白抗体(TgAb)是否与手部OA及症状性手部OA相关。

材料与方法

我们纳入了NHANES III中年龄≥60岁的2429人。研究了手部OA或症状性手部OA的数据与TPOAb和TgAb的关联。采用对数二项式和修正泊松回归模型来检验抗甲状腺自身抗体与手部OA或症状性手部OA之间的关联。

结果

在未调整模型中(比值比=1.182,P=0.024)以及在控制年龄、性别和糖尿病后的调整模型中(比值比=1.174,P=0.039),较高水平的TPOAb与症状性手部OA的较高患病率相关。当将阳性TPOAb视为具有四个水平的分类变量并与阴性TPOAb进行比较时,这种关联不再显著。TgAb显示出与症状性手部OA呈正相关的趋势(P<0.10)。当将阳性TgAb视为具有四个水平的分类变量并与阴性TgAb进行比较时,在未调整模型中(比值比=2.242,P=0.008)以及调整模型中(比值比=2.045,P=0.038),最高四分位数与症状性手部OA的患病率高于阴性TgAb相关。TPOAb或TgAb与手部OA之间无显著关联。

结论

较高水平的TPOAb可能与60岁及以上人群中症状性手部OA的存在相关。TgAb处于最高四分位数水平的60岁及以上人群可能更易出现症状性手部OA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d21d/11368861/410c0767789c/fmed-11-1445188-g001.jpg

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