Sun Xiangmei, Pei Sidie, Liao Haifen, Yu Cheng, Yang Yaping, Pan Min
Department of Ultrasound, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, China.
ShenZhen University General Hospital, Shenzhen, China.
Medicine (Baltimore). 2025 Aug 1;104(31):e43531. doi: 10.1097/MD.0000000000043531.
Previous studies have yielded inconsistent results regarding the causal relationship between autoimmune thyroiditis (AIT) and thyroid function. This study employs the Mendelian randomization (MR) method to clarify the connection between AIT and thyroid function. We conducted a comprehensive statistical analysis using data from publicly available genome-wide association studies focusing on individuals of European ancestry. A 2-sample MR approach was used to explore the causal relationship between AIT and thyroid function. Single nucleotide polymorphisms served as instrumental variables, with the inverse-variance weighted (IVW) method as the primary analytical technique. Additional analyses included MR-Egger regression, the weighted median estimator, the simple-mode, and the weighted-mode. Cochran Q test assessed SNP heterogeneity, and sensitivity analyses, such as the MR-Egger intercept and leave-one-out tests, ensured the robustness and reliability of our findings. The analysis found no significant association between AIT and conditions like hyperthyroidism, hypothyroidism, free thyroxine (FT4), or thyroid-stimulating hormone (TSH). For hyperthyroidism, the weighted median estimator suggested a potential protective effect of AIT (OR = 0.989, 95% CI = 0.979-0.999, P = .034). However, the IVW method did not yield statistically significant results (OR = 0.992, 95% CI = 0.985-1.000, P = .053), and similar nonsignificant outcomes were observed with MR-Egger regression, the simple-mode, and the weighted-mode. The IVW method found no significant association between hyperthyroidism and the development of AIT (OR = 1.076, 95% CI = 0.904-1.280, P = .408) in reverse causality analysis. Consistent results across various analytical approaches indicated no significant causal relationship between hyperthyroidism, hypothyroidism, FT4, TSH, and the onset of AIT. This research suggests no causal link between autoimmune thyroiditis and thyroid function indicators.
先前的研究在自身免疫性甲状腺炎（AIT）与甲状腺功能之间的因果关系上得出了不一致的结果。本研究采用孟德尔随机化（MR）方法来阐明AIT与甲状腺功能之间的联系。我们使用来自公开可用的全基因组关联研究的数据，对欧洲血统个体进行了全面的统计分析。采用两样本MR方法来探究AIT与甲状腺功能之间的因果关系。单核苷酸多态性用作工具变量，逆方差加权（IVW）方法作为主要分析技术。额外的分析包括MR-Egger回归、加权中位数估计器、简单模式和加权模式。 Cochr an Q检验评估SNP异质性，敏感性分析，如MR-Egger截距和留一法检验，确保了我们研究结果的稳健性和可靠性。分析发现AIT与甲状腺功能亢进、甲状腺功能减退、游离甲状腺素（FT4）或促甲状腺激素（TSH）等情况之间无显著关联。对于甲状腺功能亢进，加权中位数估计器表明AIT有潜在的保护作用（OR = 0.989，95%CI = 0.979 - 0.999，P = 0.034）。然而，IVW方法未得出具有统计学意义的结果（OR = 0.992，95%CI = 0.985 - 1.000，P = 0.053），并且在MR-Egger回归、简单模式和加权模式下也观察到类似的无显著结果。在反向因果关系分析中，IVW方法发现甲状腺功能亢进与AIT的发生之间无显著关联（OR = 1.076，95%CI = 0.904 - 1.280，P = 0.408）。各种分析方法的一致结果表明，甲状腺功能亢进、甲状腺功能减退、FT4、TSH与AIT的发病之间无显著因果关系。本研究表明自身免疫性甲状腺炎与甲状腺功能指标之间无因果联系。
