Is thyroid autoimmunity a risk factor for developing primary myelodysplastic syndrome?
Is thyroid autoimmunity a risk factor for developing primary myelodysplastic syndrome?
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DOI：
10.1007/s10552-007-9096-3
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发表时间：
2008-05-01
影响因子：
2.3
通讯作者：
Dionyssiou-Asteriou, Amalia
中科院分区：
文献类型：
--
作者：
Dalamaga, Maria;Lekka, Antigoni;Dionyssiou-Asteriou, Amalia
目的甲状腺疾病常与白血病、淋巴瘤有关。以前没有使用临床和实验室数据的研究探讨甲状腺疾病，特别是自身免疫性甲状腺疾病（ATD）是否与骨髓增生异常综合征（MDS）风险相关。在这个病例对照研究中，我们调查了ATD与MDS的关系。方法我们的研究包括101例经组织学和细胞遗传学证实的原发性MDS患者，和101例性别和年龄匹配的对照组，非肿瘤性和非感染性疾病。所有受试者提交临床，超声甲状腺评估和血清游离T3，游离T4，TSH，甲状腺球蛋白，和甲状腺过氧化物酶抗体determination.Results调整年龄，性别和体重指数，有统计学意义的证据表明，ATD与MDS的风险增加（OR = 2.58，95%CI 1.29-5.16）。有趣的是，ATD从遥远的过去（超过10年从MDS发病）开始与MDS风险呈正相关（OR = 5.73。95% CI 2.03-16.16）。MDS患者血清fT 3、fT 4和甲状腺抗体水平显著高于对照组，TSH水平显著低于对照组（P < 0.05）。甲状腺自身免疫与白血病发生的相关机制尚需进一步研究。
Objective Thyroid disease has been associated with leukemia and lymphoma. No previous study using clinical and laboratory data has explored whether thyroid disease and especially autoimmune thyroid disease (ATD) is associated with myelodysplastic syndrome (MDS) risk. In this case-control study, we investigated the association of ATD with MDS.Methods Our study included 101 cases with incident primary MDS confirmed by histology and cytogenetics, and 101 controls matched on gender and age, admitted for non-neoplastic and non-infectious diseases. All subjects were submitted to clinical, ultrasound thyroid evaluation and serum free T3, free T4, TSH, thyroglobulin, and thyroperoxidase antibodies determination.Results Adjusting for age, gender, and body mass index, there was statistically significant evidence that ATD is associated with increased risk of MDS (OR = 2.58, 95% CI 1.29-5.16). Interestingly, ATD starting from the remote past (more than 10 years from MDS onset) was positively associated with MDS risk (OR = 5.73. 95% CI 2.03-16.16). Mean serum levels of fT3, fT4, and thyroid antibodies were significantly higher in MDS patients and mean TSH serum levels were significantly lower in MDS patients than in controls (p < 0.05).Conclusion Biological plausibility and empirical evidence highlights the importance of ATD in MDS etiopathogenesis. Further studies are needed to explore underlying mechanisms associating thyroid autoimmunity with leukemogenesis.