Shift work and autoimmune thyroid disorders.
Shift work and autoimmune thyroid disorders.
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轮班工作和自身免疫性甲状腺疾病。
DOI：
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发表时间：
2006
影响因子：
3.5
通讯作者：
A. Bergamaschi
中科院分区：
文献类型：
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作者：
A. Magrini;A. Pietroiusti;L. Coppeta;A. Babbucci;E. Barnaba;C. Papadia;U. Iannaccone;P. Boscolo;E. Bergamaschi;A. Bergamaschi
应激通过影响免疫反应调节诱发自身免疫性疾病。最近的研究表明，轮班工作压力可能会增加自身免疫性格雷夫斯甲亢的发病。另一方面，职业压力与自身免疫性甲状腺功能减退之间的可能联系尚未被调查。为了检测轮班工作与亚临床自身免疫性甲状腺功能减退之间的可能联系，我们调查了220名轮班工人和422名白班工人中分离的抗过氧化物酶甲状腺（TPO）自身抗体的流行情况。亚临床自身免疫性甲状腺功能减退症的诊断是同时存在高抗tpo值和高于2.51 mU/l的TSH水平。采用化学发光技术（Advia Centaur）检测抗TPO抗体（高于60 IU/l视为改变）。7.7%的轮班工人和3.8%的日间工人被诊断为亚临床自身免疫性甲状腺功能减退症，差异有统计学意义：优势比（OR） 2.12, 95%可信区间（CI） 1.05至4.29；p = 0.03。考虑到年龄、性别、吸烟习惯、饮酒、自身免疫性甲状腺疾病家族史和辐射暴露等可能的混杂因素，多因素分析后，差异仍然存在。2.24, 95% CI.1.01至4.94,p 0.05。在轮班工人和白班工人中分别有13.6%和8.6%的TPO抗体发生改变。1.64, 95% CI.1.03 ~ 2.74, p=0.05。多因素分析后仍可发现显著性差异：OR。1.95, 95%可信区间。1.09 ~ 3.48, p=0.02。我们的数据显示轮班工作与自身免疫性甲状腺功能减退之间存在显著关联。这一发现可能会对健康监测项目产生影响。
Stress induces autoimmune disorders by affecting the immune response modulation. Recent studies have shown that shift work stress may enhance the onset of the autoimmune Graves hyperthyroidism. On the other hand, the possible association between occupational stress and autoimmune hypothyroidism has not yet been investigated. In order to detect the possible association between shift work and subclinical autoimmune hypothyroidism we investigated the prevalence of isolated anti-peroxidase thyroid (TPO) autoantibodies in 220 shift workers and in 422 day-time workers. Subclinical autoimmune hypothyroidism was diagnosed by the concomitant presence of high anti-TPO values and TSH levels higher than 2.51 mU/l. Anti TPO antibodies were measured by chemiluminescent technology (Advia Centaur) (a value above 60 IU/l was considered altered). Subclinical autoimmune hypothyroidism was diagnosed in 7.7 percent shift workers and in 3.8 percent day-time workers with a statistically significant difference: Odds Ratio (OR) 2.12, 95 percent Confidence Interval (CI) 1.05 to 4.29; p=0.03. The difference persisted after multivariate analysis taking into account age, sex, smoking habits, alcohol intake, familial history of autoimmune thyroid disease and exposure to radiation as possible confounders: OR. 2.24, 95 percent CI.1.01 to 4.94, p 0.05. Altered anti- TPO autoantibodies were found in 13.6 percent shift workers and in 8.6 percent day-time workers OR. 1.64, 95 percent CI.1.03 to 2.74, p=0.05. The significant difference was still detectable after multivariate analysis: OR. 1.95, 95 percent CI. 1.09 to 3.48, p=0.02. Our data show a significant association between shift work and autoimmune hypothyroidism. This finding may have implications in the health surveillance programs.