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自身免疫性甲状腺疾病的分子流行病学

Molecular epidemiology of autoimmune thyroid disease.

作者信息

Dorman J, Kramer M K, O'Lear L A, Burke J P, McCanlies E, McCarthy B J, Trucco M, Swan J S, Steenkiste A R, Koehler A N, Foley T P

机构信息

Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA 15261, USA.

出版信息

Gac Med Mex. 1997;133 Suppl 1:97-103.

PMID:9504111
Abstract

This paper presents preliminary data regarding the prevalence and risk factors for autoimmune thyroid disease in IDDM probands ascertained from the Children's Hospital of Pittsburgh IDDM Registry for 1950-1965 (n = 669). Living IDDM probands who participated in the 1990 follow-up survey (n = 380) were recruited for the Familial Autoimmune and Diabetes Study. Siblings and parents were also invited to participate. To date, 255 IDDM probands and 597 parents and siblings have been evaluated. The diagnosis of autoimmune thyroid disease was based on a clinical evaluation, medical history, and laboratory determinations. Graves disease was rare in this cohort (n = 5). However, Hashimoto's thyroiditis was common among women. Prevalence rates ranged from 54% for IDDM women age < 40 years to 75% for those > 50 years. Corresponding age-specific estimates for female relatives were 22% and 44%, respectively. Approximately one-half of the Hashimoto's individuals were euthyroid; they were more likely to have other autoantibodies and a positive family history than those who were hypothyroid or had no thyroid disease. Genetic analyses revealed a 2-fold increase in DQA10501-DQB10201 among the Hashimoto's compared to the non-Hashimoto's haplotypes. These findings suggested that Hashimoto's thyroiditis was common in IDDM families, which may be due, in part, to common disease susceptibility genes.

摘要

本文呈现了关于1950 - 1965年从匹兹堡儿童医院IDDM登记处确诊的IDDM先证者自身免疫性甲状腺疾病患病率及危险因素的初步数据(n = 669)。参与1990年随访调查的在世IDDM先证者(n = 380)被招募进入家族性自身免疫与糖尿病研究。其兄弟姐妹及父母也被邀请参与。迄今为止,已对255名IDDM先证者以及597名父母和兄弟姐妹进行了评估。自身免疫性甲状腺疾病的诊断基于临床评估、病史及实验室检测。该队列中格雷夫斯病罕见(n = 5)。然而,桥本甲状腺炎在女性中常见。患病率从年龄小于40岁的IDDM女性中的54%到年龄大于50岁者中的75%不等。女性亲属相应的年龄特异性估计值分别为22%和44%。约一半的桥本甲状腺炎患者甲状腺功能正常;相较于甲状腺功能减退或无甲状腺疾病的患者,他们更易出现其他自身抗体且家族史呈阳性。基因分析显示,与非桥本甲状腺炎单倍型相比,桥本甲状腺炎患者中DQA10501 - DQB10201增加了2倍。这些发现表明桥本甲状腺炎在IDDM家族中常见,这可能部分归因于共同的疾病易感基因。

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