Elkholy Aly, Efat Alaa, Shoeib Sabry, Salah Ahmed, Tahoon Marwa, Badr Hytham Reda
Hematology Unit, Internal Medicine Department, Menoufia Faculty of Medicine, Egypt.
Clinical Pathology, National Liver Institute, Menoufia University, Egypt.
Clin Med Insights Endocrinol Diabetes. 2025 Jun 13;18:11795514251349337. doi: 10.1177/11795514251349337. eCollection 2025.
Serum thyrotropin levels rise above normal while thyroid hormone levels remain within normal ranges, indicating subclinical hypothyroidism. PLT and MPV levels significantly increase in AITD patients; PLT levels are higher in hypothyroidism and Hashimoto's disease, whereas MPV levels are higher in hyperthyroidism and Graeve's disease. An increased MPV and other abnormal platelet values lead to a higher incidence of cardiovascular events. The aim was to evaluate RDW and platelet indices in Egyptian patients with subclinical Hashimo's thyroiditis using high-sensitivity CRP Hs-CRP as an indicator of inflammation.
Data for patients (60 patients) with subclinical Hashimoto's thyroiditis who visited the Menoufia University Hospital, Internal Medicine outpatient clinic included. We measured RDW, MPV, PDW, PC, LPCR, (FT3), (FT4), (TSH), lipid profile, Hs-CRP, and Antithyroid antibodies. According to Antithyroid antibodies positivity the 60 patients subdivided into 3 groups 1 (negative for Abs), 2 (positive to 1 Ab), and 3 (positive for both Abs).
Among our patients 40 (66.7%) tested positive for anti-thyroglobulin Abs while 36 (60.0%) tested positive for antiperoxidase Abs. RDW, MPV, and LPCR demonstrated positive significant correlations with serum Hs-CRP levels. The study revealed negative significant correlations between TSH levels and PDW and between T4 levels and MPV.
Early diagnosis of Hashimoto's thyroiditis can be supported by platelet indices and RDW as diagnostic tools and these markers can also offer prognostic insights into disease severity and complications to help initiate timely treatment for hypothyroidism and prevent atherosclerotic cardiovascular disease.
血清促甲状腺激素水平升高至正常范围以上，而甲状腺激素水平仍在正常范围内，提示亚临床甲状腺功能减退。AITD患者的血小板计数（PLT）和平均血小板体积（MPV）水平显著升高；甲状腺功能减退症和桥本氏病患者的PLT水平较高，而甲状腺功能亢进症和格雷夫斯病患者的MPV水平较高。MPV升高和其他血小板异常值会导致心血管事件的发生率更高。本研究旨在以高敏C反应蛋白（Hs-CRP）作为炎症指标，评估埃及亚临床桥本氏甲状腺炎患者的红细胞分布宽度（RDW）和血小板指标。
纳入在曼努菲亚大学医院内科门诊就诊的亚临床桥本氏甲状腺炎患者（60例）的数据。我们检测了RDW、MPV、血小板分布宽度（PDW）、血小板计数（PC）、淋巴细胞与血小板比率（LPCR）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、血脂谱、Hs-CRP和抗甲状腺抗体。根据抗甲状腺抗体阳性情况，将60例患者分为3组：1组（抗体阴性）、2组（一种抗体阳性）和3组（两种抗体均阳性）。
在我们的患者中，40例（66.7%）抗甲状腺球蛋白抗体检测呈阳性，36例（60.0%）抗过氧化物酶抗体检测呈阳性。RDW、MPV和LPCR与血清Hs-CRP水平呈显著正相关。研究还显示TSH水平与PDW之间以及T4水平与MPV之间呈显著负相关。
血小板指标和RDW可作为诊断工具辅助桥本氏甲状腺炎的早期诊断，这些标志物还可为疾病严重程度和并发症提供预后见解，以帮助及时启动甲状腺功能减退症的治疗并预防动脉粥样硬化性心血管疾病。
