Balbaba Mehmet, Ulaş Fatih, Nahırsüren Tarım Zehra Nur, Yıldırım Hakan, Kılınç Faruk, İlhan Nevin, Canleblebici Mehmet, Erdağ Murat, Mızrak Mithat
Department of Ophthalmology, Faculty of Medicine, Fırat University, Elazığ, Turkey.
Department of Ophthalmology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
Int Ophthalmol. 2025 Mar 22;45(1):117. doi: 10.1007/s10792-025-03501-w.
To evaluate tear and serum clusterin levels in thyroid eye disease (TED) patients.
The study included 21 patients with Graves disease with TED, 20 patients with Graves disease without TED, and 21 healthy control subjects matched for sex and age. Clusterin and lysozyme C levels of tear and serum were detected using enzyme-linked immunosorbent assays. In addition, free triiodothyronine, free thyroxine, thyroid stimulating hormone (TSH), and autoantibody (anti thyroid peroxidase, anti thyroglobulin and TSH receptor antibody) levels were measured in all groups.
The mean concentrations of tear clusterin and lysozyme C levels were 15.99 ± 4.07 ng/mL and 54.54 ± 27.58 ng/mL in Graves patients with TED, 26,28 ± 15,98 ng/mL and 50,13 ± 46,59 ng/mL in Graves patients without TED, and 55,53 ± 45,99 ng/mL and 44,86 ± 27,42 ng/mL in control subjects, respectively. The mean concentrations of serum clusterin and lysozyme C levels were 23.15 ± 4.25 ng/mL and 93.14 ± 51.38 ng/mL in Graves patients with TED, and 26.73 ± 15.93 ng/mL and 74.22 ± 55.73 ng/mL in Graves patients without TED, and 27.47 ± 12.83 ng/mL and 76.13 ± 65.24 ng/mL in control subjects, respectively. The tear clusterin levels showed significant differences in Graves patients with and without TED than in the control group (p < 0.001). In Graves patients with TED group, tear clusterin levels were lower than in Graves patients without TED, however this difference was not statistically significant (p = 0.431). There was a statistically significant low-grade correlation between tear clusterin and clinical activity score, retraction, and Hertel measurements (range of r value: -0.299 and -0.279, and range of p values:0.024-0.034).
The tear clusterin levels were decreased in Graves patients with and without TED. The results suggest that a local reduction in the amount of clusterin may play an important role in the pathogenesis of Graves disease and might be used as a local biomarker.
评估甲状腺眼病（TED）患者泪液和血清中簇集素水平。
本研究纳入21例患有TED的Graves病患者、20例无TED的Graves病患者以及21名年龄和性别匹配的健康对照者。采用酶联免疫吸附测定法检测泪液和血清中簇集素和溶菌酶C水平。此外，还测量了所有组的游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺激素（TSH）以及自身抗体（抗甲状腺过氧化物酶、抗甲状腺球蛋白和TSH受体抗体）水平。
患有TED的Graves病患者泪液中簇集素和溶菌酶C的平均浓度分别为15.99±4.07 ng/mL和54.54±27.58 ng/mL；无TED的Graves病患者分别为26.28±15.98 ng/mL和50.13±46.59 ng/mL；对照组分别为55.53±45.99 ng/mL和44.86±27.42 ng/mL。患有TED的Graves病患者血清中簇集素和溶菌酶C的平均浓度分别为23.15±4.25 ng/mL和93.14±51.38 ng/mL；无TED的Graves病患者分别为26.73±15.93 ng/mL和74.22±55.73 ng/mL；对照组分别为27.47±12.83 ng/mL和76.13±65.24 ng/mL。与对照组相比，患有和未患有TED的Graves病患者泪液中簇集素水平存在显著差异（p<0.001）。在患有TED的Graves病患者组中，泪液簇集素水平低于无TED的Graves病患者，但这种差异无统计学意义（p=0.43）。泪液簇集素与临床活动评分、眼球后徙和Hertel测量值之间存在统计学上的低度相关性（r值范围：-0.299至-0.279，p值范围：0.024至0.034）。
患有和未患有TED的Graves病患者泪液中簇集素水平均降低。结果表明，簇集素量的局部减少可能在Graves病的发病机制中起重要作用，并可能用作局部生物标志物。
