亚临床甲状腺功能减退症(SCH)的潜在机制尚不清楚,及时准确的区分甲状腺功能减退症和SCH,以及严重程度评估,具有挑战性。本研究旨在探讨NFE2与bZIP转录因子2(Nrf2)、gp91phox,白细胞介素-17(IL-17)在SCH发病机制中的作用。在这项前瞻性比较研究中,105名SCH患者,105例甲状腺功能减退患者,从2022年1月至2023年8月,共纳入105名健康个体。根据促甲状腺激素(TSH)水平将SCH患者分为轻度-中度和重度组。TSH水平,自由T4(FT4),自由T3(FT3),甲状腺球蛋白抗体(TG-Ab),甲状腺过氧化物酶抗体(TPO-Ab),胆固醇(TC),甘油三酯(TG),高密度脂蛋白胆固醇(HDL-ch),测量低密度脂蛋白胆固醇(LDL-ch)。Nrf2,IL-1β,使用ELISA测试IL-6、IL-17和gp91phox水平。与健康对照组相比,SCH和甲状腺功能减退症患者的Nrf2、IL-17和gp91phox显著升高,甲状腺功能减退症患者表现出最高水平。Nrf2水平与TSH呈负相关,TG-Ab和IL-17,但不是gp91phox。Nrf2、IL-17和gp91phox可用于SCH和重度SCH的诊断。只有TG-Ab,IL-17和gp91phox是重度SCH的独立危险因素。这项研究表明血清Nrf2水平与SCH严重程度之间呈负相关。TG-Ab,IL-17和gp91phox是独立的危险因素,它们与SCH病理的关联表明它们在疾病机制中的潜在作用。这些发现提供了对SCH发病机制的见解,并强调需要进一步研究以阐明其诊断或预后意义。
The mechanisms underlying subclinical hypothyroidism (SCH) remain unclear, making timely and accurate differentiation between hypothyroidism and SCH, as well as severity assessment, challenging. This
study aimed to investigate the role of NFE2 like bZIP transcription factor 2 (Nrf2), gp91phox, and interleukin-17 (IL-17) in the pathogenesis of SCH. In this prospective comparative
study, 105 SCH patients, 105 hypothyroidism patients, and 105 healthy individuals were enrolled from January 2022 to August 2023. SCH patients were categorized into mild-moderate and severe groups based on thyroid-stimulating hormone (TSH) levels. Levels of TSH, free T4 (FT4), free T3 (FT3), thyroglobulin antibodies (TG-Ab), thyroid peroxidase antibodies (TPO-Ab), cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-ch), and low-density lipoprotein-cholesterol (LDL-ch) were measured. Nrf2, IL-1β, IL-6, IL-17, and gp91phox levels were tested using ELISA. Nrf2, IL-17 and gp91phox were significantly higher in SCH and hypothyroidism patients compared to the healthy controls, with hypothyroidism patients showing the highest levels. Nrf2 levels were negatively correlated with TSH, TG-Ab and IL-17, but not gp91phox. Nrf2, IL-17 and gp91phox could be used for diagnosis of SCH and severe SCH. Only TG-Ab, IL-17 and gp91phox were independent risk factors for severe SCH. This
study demonstrates a negative correlation between serum Nrf2 levels and SCH severity. TG-Ab, IL-17, and gp91phox are independent risk factors, and their associations with SCH pathology suggest their potential roles in the disease mechanism. These findings provide insights into SCH pathogenesis and highlight the need for further research to elucidate their diagnostic or prognostic significance.