Autoimmune thyroid disease in Colombian patients with systemic lupus erythematosus
Autoimmune thyroid disease in Colombian patients with systemic lupus erythematosus
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DOI：
10.1111/cen.12662
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发表时间：
2015-12-01
影响因子：
3.2
通讯作者：
Anaya, Juan-Manuel
中科院分区：
文献类型：
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作者：
Franco, Juan-Sebastian;Amaya-Amaya, Jenny;Anaya, Juan-Manuel
目的 确定系统性红斑狼疮 (SLE) 队列中自身免疫性甲状腺功能减退症 (AH) 的患病率和预测因素，并分析有关 SLE 患者中自身免疫性甲状腺疾病 (AITD) 和甲状腺自身免疫的患病率和影响的当前信息。方法 对总共 376 名 SLE 患者进行了评估，以确定是否存在以下情况：(i) 确诊 AH，(ii) 阳性甲状腺过氧化物酶/甲状腺球蛋白抗体 [TPOAb/TgAb] 不伴有甲状腺功能减退症，(iii) 非自身免疫性甲状腺功能减退症和 (iv) 两者都没有的 SLE 患者。使用多变量分析以及分类和回归树模型来分析数据。通过系统文献综述 (SLR) 讨论了当前信息。结果 在我们的队列中，确诊 AH 的患病率为 12%。然而，在甲状腺功能正常的 SLE 患者中，观察到 TPOAb 和 TgAb 的比例分别为 21% 和 10%。确诊的 AH 患者年龄明显较大，且发病年龄较晚。吸烟（调整后比值比 (AOR) 6.93，95% CI 1.98-28.54，P = 0.004）、干燥综合征 (SS)（AOR 23.2，95% CI 1.89-359.53，P = 0.015）和抗环瓜氨酸肽（抗 CCP）阳性 (AOR) 10.35，95% CI 1.04-121.26，P = 0.047）与 AH-SLE 相关，无论性别和疾病持续时间如何。吸烟和 SS 被证实是 AH-SLE 的预测因子。在SLR中，AITD的患病率在1%到60%之间。与这种多发性自身免疫相关的因素包括女性、年龄较大、吸烟、某些自身抗体、SS以及皮肤和关节受累。 结论 AITD在SLE中常见，并且不影响SLE的严重程度。确定的风险因素将帮助临床医生寻找 AITD。我们的结果鼓励系统性红斑狼疮患者采取无烟政策。
Objectives To determine the prevalence and the predictive factors of autoimmune hypothyroidism (AH) within a systemic lupus erythematosus (SLE) cohort and to analyse the current information concerning the prevalence and impact of autoimmune thyroid disease (AITD) and thyroid autoimmunity in patients with SLE.Methods A total of 376 patients with SLE were assessed for the presence of the following: (i) confirmed AH, (ii) positive thyroperoxidase/thyroglobulin antibodies [TPOAb/TgAb] without hypothyroidism, (iii) nonautoimmune hypothyroidism and (iv) SLE patients with neither. Multivariate analysis and a classification and regression tree model were used to analyse data. The current information was discussed through a systematic literature review (SLR).Results In our cohort, the prevalence of confirmed AH was 12%. However, in euthyroid patients with SLE, TPOAb and TgAb were observed in 21% and 10%, respectively. Patients with confirmed AH were significantly older and had later age at onset of the disease. Smoking (adjusted odds ratio (AOR) 6.93, 95% CI 1.98-28.54, P = 0.004), Sjogren's Syndrome (SS) (AOR 23.2, 95% CI 1.89-359.53, P = 0.015) and positivity for anticyclic citrullinated peptide (anti-CCP) (AOR 10.35, 95% CI 1.04-121.26, P = 0.047) were associated with AH-SLE, regardless of gender and duration of the disease. Smoking and SS were confirmed as predictors of AH-SLE. In the SLR, the prevalence of AITD ranged from 1% to 60%. The factors associated with this polyautoimmunity were female gender, older age, smoking, certain autoantibodies, SS, and cutaneous and articular involvement.Conclusions AITD is frequent in SLE and does not affect the severity of SLE. Identified risk factors will assist clinicians in the search for AITD. Our results encourage smoke-free policies in patients with SLE.