Thyroid function and anti-thyroid antibodies in MS patients screened for interferon treatment. A multicenter study
Thyroid function and anti-thyroid antibodies in MS patients screened for interferon treatment. A multicenter study
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DOI：
10.1016/s0022-510x(01)00637-2
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发表时间：
2001-12-15
影响因子：
4.4
通讯作者：
Faggiano, F
中科院分区：
文献类型：
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作者：
Durelli, L;Oggero, A;Faggiano, F
多发性硬化症(MS)的β干扰素(IFNB)治疗与甲状腺疾病(TD)有关，尤其是在开始治疗前有亚临床TD或抗甲状腺(AT)自身抗体(AutoAb)的患者。为了确定MS患者是否存在亚临床甲状腺功能异常或抗甲状腺自身免疫异常易发生TD，我们对152例接受IFNB治疗的复发缓解(RR)MS患者和437例正常对照进行了前瞻性多中心甲状腺功能和自身免疫筛查。甲状腺相关激素和抗TMA自身抗体检测采用灵敏的免疫放射分析或层析分析。根据促甲状腺激素(TSH)递减或递增的不同界值(0.3、0.2、0.1、3和5mIU/L)和OR(95%可信区间)进行分层，根据性别、年龄和抗TMA自身抗体阳性进行Logistic回归分析。MS患者中TSH水平低于或高于TSH临界值的例数与对照组无显著差异，即使抗TMA自身抗体阳性(OR为0.35~0.85；CI为0.04~3.00)，MS患者发生TSH水平异常的风险也无显著增加(OR为0.37~0.84；CI为0.05~3.01)。然而，MS男性亚临床甲状腺功能减退症和抗TMA自身抗体阳性的频率(5-7%)高于对照组(0%)。在IFNB治疗期间，MS患者没有增加微小的甲状腺功能异常、亚临床TD或抗TMA自身抗体阳性的风险，这些可能会导致甲状腺功能障碍。然而，亚临床甲状腺功能减退症和抗TMA自身抗体阳性的阳性趋势建议在IFNB治疗期间对甲状腺功能和自身免疫进行纵向研究，以了解基线亚临床甲状腺功能障碍患者在治疗过程中是否发生临床显著变化。(C)2001 Elsevier Science B.V.保留所有权利。
Interferon beta (IFNB) treatment for multiple sclerosis (MS) has been associated with thyroid disorders (TD), in particular in patients with sublinical TD or anti-thyroid (AT) autoantibodies (autoAb) before starting treatment. TD and AT autoAb frequency was reported increased in MS. To determine whether MS patients have subclinical thyroid function abnormalities or anti-thyroid autoimmunity predisposing to develop TD, we performed a prospective multicenter screening of thyroid function and autoimmunity in 152 relapsing-remitting (RR) MS patients selected to receive IFNB treatment and in 437 healthy normothyroidal controls. Thyroid-related hormones and anti-thyroid microsomal antigen (anti-TMA) autoAb were tested with sensitive immunoradiometric or chromatographic assays. Cases were stratified for different progressively decreasing or increasing cutoff values of thyroid-stimulating hormone (TSH) (0.3, 0.2, 0.1, 3 and 5 mIU/l), and odds ratios (OR) with 95% confidence intervals (Cl) calculated using logistic regression adjusted for gender, age, and anti-TMA autoAb positivity. The frequency of cases below or above the TSH cutoff values was not significantly different in MS patients and controls, and the risk to have an abnormal TSH level was not significantly increased in MS patients (OR ranging 0.37-0.84; CI, 0.05-3.01), even if anti-TMA autoAb positive (OR ranging 0.35-0.85; CI, 0.04-3.00). Frequencies of subclinical hypothyroidism and of anti-TMA autoAb positivity were, however, trending higher in MS men (ranging 5-7%) than in controls 0%). MS patients do not have an increased risk of subtle thyroid function abnormalities, subclinical TD, or anti-TMA autoAb positivity that may predispose to develop thyroid dysfunction during IFNB treatment. The positive trend for subclinical hypothyroidism and anti-TMA autoAb positivity, however, advises a longitudinal study of thyroid function and autoimmunity during IFNB treatment to see whether patients with baseline subclinical thyroid dysfunction develop clinically significant alteration during treatment. (C) 2001 Elsevier Science B.V. All rights reserved.