Significance of Prediagnostic Thyroid Antibodies in Women with Autoimmune Thyroid Disease
Significance of Prediagnostic Thyroid Antibodies in Women with Autoimmune Thyroid Disease
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DOI：
10.1210/jc.2011-0228
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发表时间：
2011-09-01
影响因子：
5.8
通讯作者：
Rose, Noel R.
中科院分区：
文献类型：
--
作者：
Hutfless, Susan;Matos, Peter;Rose, Noel R.
前言：抗甲状腺球蛋白(TG)、甲状腺过氧化物酶(TPO)和促甲状腺激素受体(TSH-R)抗体广泛存在于自身免疫性甲状腺疾病中。我们的目的是评估患有Graves病或桥本甲状腺炎的女性在临床诊断前是否比年龄匹配的对照组更有可能出现甲状腺抗体，并测量抗体血清转换的时间。方法：这是一项嵌套的病例对照研究，使用1998-2007年的国防部血清库和国防医学监测系统。我们检测了522名女性现役军人血清中的甲状腺抗体，其中包括87例Graves病患者、87例桥本甲状腺炎患者和348名年龄匹配的对照组。在临床诊断时(+/-6个月)有1份血清样本；在临床诊断前7年从资料库中提取了另外3份样本，共计2088份样本。结果：在桥本甲状腺炎患者中，所有时间点都有约66%的病例检出TPO抗体。TG抗体表现出类似的平稳趋势，在所有时间点的患病率都较低，约为53%。未发现TSH-R抗体。在Graves病中，TPO抗体从确诊前的31%逐渐上升到确诊前的57%，TG抗体从18%上升到47%。TSH-R抗体在诊断前就已存在，患病率从2%、7%、20%上升到55%。结论：抗TG、TPO和TSH-R抗体比诊断自身免疫性甲状腺疾病的表型提前了多年。总体而言，表面健康的个体中甲状腺抗体的存在不应被忽视。(J临床内分泌Metab 96：E1466-E1471,2011)
Introduction: Antibodies to thyroglobulin (Tg), thyroperoxidase (TPO), and TSH receptor (TSH-R) are prevalent in autoimmune thyroid diseases. We aimed to assess whether females with Graves disease or Hashimoto thyroiditis are more likely than age-matched controls to have thyroid antibodies before clinical diagnosis and to measure the timing of antibody seroconversion.Methods: This was a nested case-control study using the Department of Defense Serum Repository and the Defense Medical Surveillance System, 1998-2007. We assessed thyroid antibodies in the serum of 522 female, active-duty, military personnel including: 87 Graves disease cases, 87 Hashimoto thyroiditis cases, and 348 age matched controls. One serum sample was available at the time of the clinical diagnosis (+/- 6 months); three additional samples were retrieved from the repository up to 7 yr before the clinical diagnosis, for a total of 2088 samples.Results: In Hashimoto thyroiditis, TPO antibodies were found in about 66% of the cases at all time points. Tg antibodies showed a similar stationary trend, at a lower prevalence of about 53% at all time points. No TSH-R antibodies were found. In Graves disease, TPO antibodies gradually increased from 31% at 5-7 yr priortodiagnosisto57% at diagnosis and Tg antibodies from 18 to 47%. TSH-R antibodies were present before diagnosis and showed an increasing prevalence from 2, 7, 20, to 55%.Conclusions: Antibodies to Tg, TPO, and TSH-R precede by years the development of the diagnostic autoimmune thyroid diseases phenotype. Overall, the presence of thyroid antibodies in apparently healthy individuals should not be neglected. (J Clin Endocrinol Metab 96: E1466-E1471, 2011)