Thyroid peroxidase and thyroglobulin auto-antibodies in patients with newly diagnosed overt hypothyroidism
Thyroid peroxidase and thyroglobulin auto-antibodies in patients with newly diagnosed overt hypothyroidism
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DOI：
10.1080/08916930600907913
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发表时间：
2006-09-01
期刊：
影响因子：
3.5
通讯作者：
Pedersen, Inge Bulow
中科院分区：
文献类型：
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作者：
Carle, Allan;Laurberg, Peter;Pedersen, Inge Bulow
目的：甲状腺自身免疫是引起甲状腺功能减退的主要原因。我们描述了甲状腺自身抗体在不同疾病分类学亚型的甲状腺功能减退症患者中的人群研究。设计：以人群为基础的随访研究，在一个开放队列中识别所有新发甲状腺功能减退症病例。方法：我们建立了一个监测系统，并在一个明确定义的人群队列中确定了4年内所有原发性显性甲状腺功能减退症（n = 685）的新发病例（2，027，208人-年观察）。患者被细分为：自发性甲状腺功能减退症，推测为自身免疫性（n 578）;非自发性甲状腺功能减退症（与药物、分娩、颈部照射或亚急性甲状腺炎相关，n 97）;和先天性甲状腺功能减退症（n 10）。共有186名成人患者（61%）接受了甲状腺超声检查和甲状腺过氧化物酶（TPOAb）和甲状腺球蛋白（TgAb.Results）抗体的测量：在自发性甲状腺功能减退患者中：> 99%的抗体阳性（TPOAb或TgAb），TPOAb比TgAb更经常可测量（95.9vs.80.7%，p < 0.001）。在两种抗体之间观察到统计学显著但适度的相关性（Pearson’s r（2）= 0.11，p < 0.001）。在多元回归模型中，TPOAb和TgAb均与甲状腺肿大呈正相关（p，0.001），而与性别、年龄、碘缺乏水平或血清TSH水平无关。我们发现，那些谁主要开发TPOAb与那些谁优先窝藏TgAb.Conclusions：自身免疫发挥了主导作用，几乎所有的患者归类为自发性甲状腺功能减退症的患者之间的患者特征没有差异。甲状腺肿大与高水平的TPOAb和TgAb相关。我们没有发现为什么一些自发性甲状腺功能减退患者主要产生TPOAb，而其他人主要产生TgAb的线索。
Objectives: Thyroid autoimmunity is a major cause for hypothyroidism. We describe thyroid auto-antibodies in patients with various nosological subtypes of hypothyroidism identified in a population study.Design: Population-based follow-up study identifying all new cases of hypothyroidism in an open cohort.Methods: We established a monitoring system, and identified all new cases with primary overt hypothyroidism (n = 685) in a 4 year period in a well-defined population cohort (2,027,208 person-years of observation). Patients were sub-classified into: spontaneous hypothyroidism, presumably of autoimmune origin ( n 578); non-spontaneous hypothyroidism ( associated with medication, delivery, neck-irradiation or subacute thyroiditis, n 97); and congenital hypothyroidism ( n 10). A total of 186 adult patients (61% of those invited) underwent thyroid ultrasonography and measurements of antibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb).Results: In spontaneously hypothyroid patients: > 99% were antibody-positive ( TPOAb or TgAb), TPOAb were more often measurable than TgAb (95.9 vs. 80.7%, p, < 0.001). A statistically significant but modest correlation was observed between the two antibodies (Pearson's r(2) = 0.11, p < 0.001). In a multivariate regression model both TPOAb and TgAb were positively associated with thyroid enlargement ( p, 0.001), whereas no association was found with sex, age, iodine deficiency level or serum TSH level. We found no differences in patient characteristics between those who mainly developed TPOAb vs. those who preferentially harboured TgAb.Conclusions: Autoimmunity played a dominant role in practically all patients classified as spontaneously hypothyroid. Thyroid enlargement was associated with high levels of TPOAb and TgAb. We found no clue to why some spontaneously hypothyroid patients predominantly developed TPOAb whereas others mainly generated TgAb.