thyroid autoimmunity

甲状腺自身免疫
  • 文章类型: Journal Article
    目的:本研究旨在评估韩国孕妇的硒状况及其对孕妇甲状腺功能和妊娠结局的影响。
    方法:“理想母乳(IBM)队列研究”包括442名参与者中的367名孕妇,并根据血浆硒水平分为三组:缺乏(<70μg/L)。次优(70-99μg/L),和最佳(≥100μg/L)。在妊娠中期或中期,各种血液参数,包括硒,促甲状腺激素,游离T4、游离T3和抗甲状腺过氧化物酶抗体水平,被测量。使用超声检查评估甲状腺实质回声作为甲状腺自身免疫的另一种替代标志物。
    结果:血浆硒中位数为98.8(范围,46.7-206.4)μg/L,和30个人(8%)被归类为缺陷,而164名(45%)被归类为次优组。硒缺乏与自身免疫性甲状腺炎的标志物有关,包括抗甲状腺过氧化物酶抗体阳性结果(13.3[缺乏]vs.4.6[最优]%,P=0.031)和超声检查的甲状腺实质异质性(33.3[缺陷]与14.6[次优]vs.17.3[最佳]%,P=0.042),与胎龄无关。重度子痫前期的发病率在不服用硒补充剂组中较高,尤其是那些双胞胎怀孕的人,与服用硒补充剂组相比(0[硒补充剂]vs.9.0[无补充]%,P=0.015)。
    结论:孕妇出现轻度硒缺乏,这可能导致重大的健康问题,包括孕妇甲状腺自身免疫和怀孕期间的产科并发症。需要根据怀孕阶段和胎儿数量适当的硒摄入量指南。
    UNASSIGNED: This study aimed to assess selenium status in South Korean pregnant women and its impact on maternal thyroid function and pregnancy outcomes.
    UNASSIGNED: \'Ideal Breast Milk (IBM) Cohort Study\' included 367 pregnant women out of 442 participants and categorized into three groups based on plasma selenium levels: deficient (< 70 μg/L), suboptimal (70-99 μg/L), and optimal (≥ 100 μg/L). During the second or third trimester, various blood parameters, including selenium, thyroid-stimulating hormone, free T4, free T3, and anti-thyroid peroxidase antibody levels, were measured. Thyroid parenchymal echogenicity was assessed as another surrogate marker for thyroid autoimmunity using ultrasonography.
    UNASSIGNED: The median plasma selenium was 98.8 (range: 46.7-206.4) μg/L, and 30 individuals (8%) were categorized as deficient, while 164 (45%) were classified in the suboptimal group. Selenium deficiency was associated with markers of autoimmune thyroiditis, including positive anti-thyroid peroxidase antibody results (13.3 (deficient) vs 4.6 (optimal) %, P = 0.031) and thyroid parenchymal heterogeneity on ultrasound (33.3 (deficient) vs 14.6 (suboptimal) vs 17.3 (optimal) %, P = 0.042), independently of gestational age. The incidence of severe preeclampsia was higher in the group not taking selenium supplements, particularly among those with twin pregnancies, compared to the group taking selenium supplements (0 (selenium supplement) vs 9.0 (no supplement) %, P = 0.015).
    UNASSIGNED: Pregnant women experience mild selenium deficiency, which can lead to significant health issues including maternal thyroid autoimmunity and obstetrical complications during pregnancy. Guidelines for appropriate selenium intake according to the stage of pregnancy and the number of fetuses are needed.
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  • 文章类型: Journal Article
    目的:孕早期孕妇甲状腺自身免疫和甲状腺功能可能影响胎儿神经发育。我们旨在调查妊娠早期甲状腺自身免疫和甲状腺功能如何与12-36个月大的后代语言习得相关。
    方法:本研究纳入前瞻性欧登塞儿童队列。如果孕妇在怀孕期间摄入甲状腺药物,则排除母婴二联。父母每三个月完成一次麦克阿瑟-贝茨交流发展清单(MB-CDI),以评估其后代的生产性词汇。每个孩子的所有完成的报告都包括在分析中。Logistic生长曲线模型评估了MB-CDI评分与母体甲状腺过氧化物酶抗体(TPOAb)水平之间的关联,游离甲状腺素(FT4),和促甲状腺激素,分别,在妊娠早期测量(中位孕周12)。所有模型均按后代性别分层,并根据母亲年龄进行调整,教育,孕前体重指数,奇偶校验,母乳喂养,和后代年龄。
    结果:该研究包括735个母子二分体。TPOAb≥11kIU/L的母亲所生的孩子,与TPOAb<11kIU/L相反,女孩在18-36个月时产生单词的概率较低(OR=0.78,p<0.001),男孩在33-36个月时产生单词的概率较低(OR=0.83,p<0.001)。在正常母亲FT4较低的30-36个月大的女孩中,产生单词的可能性更高。正常FT4(OR=0.60,p<0.001),在男孩身上也有类似的趋势。促甲状腺激素的结果不明确。
    结论:在没有已知甲状腺疾病的女性中,妊娠早期的TPOAb阳性与男孩和女孩的生产性词汇习得呈负相关。这种联系不是由甲状腺功能下降介导的,作为低正常的母亲FT4,出乎意料的是,表明词汇习得更好。我们的结果支持母体甲状腺自身免疫本身可能影响胎儿神经发育。
    UNASSIGNED: Maternal thyroid autoimmunity and thyroid function in early pregnancy may impact fetal neurodevelopment. We aimed to investigate how thyroid autoimmunity and thyroid function in early pregnancy were associated with language acquisition in offspring at 12-36 months of age.
    UNASSIGNED: This study was embedded in the prospective Odense child cohort. Mother-child dyads were excluded in case of maternal intake of thyroid medication during pregnancy. The parents completed MacArthur-Bates Communicative Development Inventories (MB-CDI) every third month to assess their offspring\'s productive vocabulary. All completed reports for each child were included in the analyses. Logistic growth curve models evaluated associations between MB-CDI scores and levels of maternal thyroid peroxidase antibodies (TPOAb), free thyroxine (FT4), and thyrotropin, respectively, measured in early pregnancy (median gestational week 12). All models were stratified by offspring sex and adjusted for maternal age, education, pre-pregnancy body mass index, parity, breastfeeding, and offspring age.
    UNASSIGNED: The study included 735 mother-child dyads. Children born to mothers with TPOAb ≥11 kIU/L, opposed to TPOAb <11 kIU/L, had a lower probability of producing words at age 18-36 months for girls (OR = 0.78, P < 0.001) and 33-36 months for boys (OR = 0.83, P < 0.001). The probability of producing words was higher in girls at 30-36 months of age with low-normal maternal FT4 vs high-normal FT4 (OR = 0.60, P < 0.001), and a similar trend was seen in boys. Results were ambiguous for thyrotropin.
    UNASSIGNED: In women without known thyroid disease, TPOAb positivity in early pregnancy was negatively associated with productive vocabulary acquisition in girls and boys. This association was not mediated by a decreased thyroid function, as low-normal maternal FT4, unexpectedly, indicated better vocabulary acquisition. Our results support that maternal thyroid autoimmunity per se may affect fetal neurodevelopment.
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  • 文章类型: Journal Article
    观察性研究报道了代谢综合征(MetS)与甲状腺自身免疫之间的可能关联。然而,甲状腺自身免疫与MetS之间的关系尚不清楚.这项研究的目的是通过利用孟德尔随机化(MR)方法评估MetS对甲状腺自身免疫的因果影响。
    我们进行了双向MR,以阐明MetS及其成分与甲状腺自身免疫(TPOAb阳性)之间的因果关系。MetS及其成分的单核苷酸多态性(SNP)是从公开可用的遗传变异摘要数据库中获得的。甲状腺组学联盟进行了全基因组关联分析,提供了与甲状腺自身免疫有关的汇总数据。这项研究包括几种统计方法,包括方差逆加权法(IVW),加权中位数,简单模式,重量模式,和MR-Egger方法,评估因果关系。此外,为了确保结果的稳定性,进行了敏感性分析。
    IVW显示MetS降低了发生甲状腺自身免疫的风险(OR=0.717,95%CI=0.584-0.88,P=1.48E-03)。对MetS成分与甲状腺自身免疫之间的因果关系的调查显示,甘油三酯水平与甲状腺自身免疫的存在之间存在统计学上的显着联系(IVW分析,OR=0.603,95CI=0.45-0.807,P=6.82E-04)。反向分析没有揭示甲状腺自身免疫与MetS之间的任何因果关系,包括五个组成部分。
    我们提供了新的遗传证据,证明MetS及其甘油三酯成分可能是对抗甲状腺自身免疫的潜在保护因子。
    UNASSIGNED: Observational studies have reported a possible association between metabolic syndrome (MetS) and thyroid autoimmunity. Nevertheless, the relationship between thyroid autoimmunity and MetS remains unclear. The objective of this research was to assess the causal impact of MetS on thyroid autoimmunity through the utilization of Mendelian randomization (MR) methodology.
    UNASSIGNED: We performed bidirectional MR to elucidate the causal relationship between MetS and their components and thyroid autoimmunity (positivity of TPOAb). Single nucleotide polymorphisms (SNPs) of MetS and its components were obtained from the publicly available genetic variation summary database. The Thyroidomics Consortium conducted a genome-wide association analysis, which provided summary-level data pertaining to thyroid autoimmunity. The study included several statistical methods, including the inverse variance weighting method (IVW), weighted median, simple mode, weight mode, and MR-Egger methods, to assess the causal link. In addition, to ensure the stability of the results, a sensitivity analysis was conducted.
    UNASSIGNED: IVW showed that MetS reduced the risk of developing thyroid autoimmunity (OR = 0.717, 95% CI = 0.584 - 0.88, P = 1.48E-03). The investigation into the causative association between components of MetS and thyroid autoimmune revealed a statistically significant link between triglycerides levels and the presence of thyroid autoimmunity (IVW analysis, OR = 0.603, 95%CI = 0.45 -0.807, P = 6.82E-04). The reverse analysis did not reveal any causal relationship between thyroid autoimmunity and MetS, including its five components.
    UNASSIGNED: We have presented new genetic evidence demonstrating that MetS and its triglyceride components may serve as potential protective factors against thyroid autoimmunity.
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  • 文章类型: Journal Article
    目的:纤维肌痛引起广泛的慢性疼痛。疼痛管理和治疗潜在疾病至关重要。最近的研究发现甲状腺自身免疫与纤维肌痛有关。很少研究抗甲状腺过氧化物酶抗体(抗TPOAb)阳性患者的疼痛管理。在基线和3个月随访时,使用数字评定量表(NRS)疼痛评分确定类固醇(deflazacort)对疼痛管理的影响。
    方法:进行了一项回顾性观察研究,招募根据2010年美国风湿病学会指南诊断为纤维肌痛并接受类固醇治疗的患者,defrazacort12毫克。排除缺少细节的患者。患者分为阴性,积极的,和强阳性抗TPOAb组。比较各组的基线和随访(3个月)疼痛评分。疼痛的减轻被认为是主要的结果变量。
    结果:该研究包括128名参与者,其中98名(76.6%)女性和30名(23.4%)男性。研究人群的年龄为48±13.29岁。hyper的比例,hypo,甲状腺功能正常为10(7.81%),42(32.81%),和76(59.38%),分别。参与者的比例为负,积极的,强阳性抗TPOAb水平为41(32.03)%,50(39.06%),和37(28.91%),分别。基线疼痛评分为7.3±1.32,随访3个月为4.7±2.46。66例(51.6%)出现类固醇反应。阴性和阳性抗TPOAb的疼痛评分比基线降低1分,p值<0.001。强阳性组减少5分,p值<0.05。
    结论:伴有甲状腺自身免疫的纤维肌痛患者对短期类固醇治疗反应良好。在抗TPOAb强阳性的人群中观察到更大的疼痛缓解。
    OBJECTIVE: Fibromyalgia causes widespread chronic pain. Pain management and treating underlying conditions are of utmost importance. Recent studies found an association of thyroid autoimmunity with fibromyalgia. Pain management of patients with anti-thyroid peroxidase antibody (anti-TPO Ab) positive was studied sparsely. To determine the effect of steroid (deflazacort) on pain management using numerical rating scale (NRS) pain score at baseline and at 3-month follow-up.
    METHODS: A retrospective observational study was undertaken, recruiting patients diagnosed with fibromyalgia as per 2010 American College of Rheumatology guidelines and treated with the steroid, deflazacort 12 mg. Patients with missing details were excluded. Patients were categorized into negative, positive, and strongly positive anti-TPO Ab groups. Baseline and follow-up (3 months) pain score was compared across the groups. Reduction in pain was considered as a primary outcome variable.
    RESULTS: The study included 128 participants with 98 (76.6%) females and 30 (23.4%) males. The age of the study population was 48±13.29 years. The proportion of hyper, hypo, and euthyroid was 10 (7.81%), 42 (32.81%), and 76 (59.38%), respectively. The proportion of participants with negative, positive, and strongly positive anti-TPO Ab levels was 41 (32.03)%, 50 (39.06%), and 37 (28.91%), respectively. Baseline pain score was 7.3±1.32 and 3-month follow-up was 4.7±2.46. Steroid response was found in 66 (51.6%). Negative and positive anti-TPO Ab had a 1-point reduction in pain score from baseline, p-value <0.001. The strongly positive group had 5 points reduction, p-value<0.05.
    CONCLUSIONS: Fibromyalgia patients with thyroid autoimmunity responded well to short courses of steroids. Greater pain relief was observed among those who are strongly positive anti-TPO Ab group.
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    文章类型: Journal Article
    目的:非节段白癜风(NSV)常与甲状腺自身免疫(TAI)相关,然而,这种关联的免疫致病机制仍有待研究。这项工作的目的是估计TAI的频率,并描述NSV患者TAI易感性中人类白细胞抗原(HLA)-DRB1和-DQB1基因座的遗传多态性。
    方法:在这项横断面研究中,通过测量抗甲状腺过氧化物酶(TPOAb)和甲状腺球蛋白(TGAb)的抗体,对97例摩洛哥NSV患者进行了TAI筛查。用单特异性引物-聚合酶链反应(PCR-SSP)分型方法测定HLA-DRB1和-DQB1。
    结果:在20例NSV患者中诊断为TAI(20.6%)。DQB1*05的表型频率(OR=5.04;P=0.006;pc=0.036)在NSV合并TAI患者中显著增高。基因型DQB1*05/DQB1*06(OR=25.33;P=0.001;pc=0.003)赋予NSV患者对TAI的易感性。TAI和早发性白癜风患者的DQB1*05等位基因(OR=14.67;P=0.001;pc=0.048)和DQB1*05/DQB1*06基因型(OR=26.55;P=0.01;pc=0.03)的表型频率极高。根据TSH和游离T4,NSV患者的TAI与临床甲状腺疾病的发作相关(6.2%)。
    结论:我们的研究结果表明,HLA-DQ多态性影响NSV受试者的TAI风险,尽管HLA不能完全解释这两种疾病的共同发生。
    OBJECTIVE: Nonsegmental vitiligo (NSV) is frequently associated with thyroid autoimmunity (TAI), however, the immunopathogenic mechanisms of such association remain to be investigated. The aims of this work were to estimate the frequency of TAI and to describe the genetic polymorphism in the human leukocyte antigen (HLA)-DRB1 and -DQB1 loci in TAI susceptibility among patients with NSV.
    METHODS: In this cross-sectional study, screening for TAI was performed in 97 Moroccan patients with NSV by measuring antibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TGAb). HLA-DRB1 and -DQB1 were determined with single specific primer-polymerase chain reaction (PCR-SSP) typing methods.
    RESULTS: TAI was diagnosed in 20 patients with NSV (20.6%). The phenotypic frequency of DQB1*05 (OR = 5.04; P = 0.006; pc = 0.036) was significantly higher in NSV patients with TAI. Genotype DQB1*05/DQB1*06 (OR = 25.33; P = 0.001; pc = 0.003) confer susceptibility to TAI in NSV patients. NSV patients with TAI and early onset vitiligo have an extremely high phenotype frequency of DQB1*05 allele (OR = 14.67; P = 0.001; pc = 0.048) and DQB1*05/DQB1*06 genotype (OR = 26.55; P = 0.01; pc = 0.03). TAI in patients with NSV was (6.2%) associated with onset of clinical thyroid disease based on TSH and free T4.
    CONCLUSIONS: Our findings suggest that HLA-DQ polymorphisms influence TAI risk in subjects with NSV, although HLA does not completely explain the co-occurrence of these two diseases.
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  • 文章类型: Journal Article
    目的:本研究的目的是分析2型糖尿病(T2DM)患者甲状腺自身免疫与骨密度(BMD)的关系。并进一步探讨甲状腺自身免疫对糖尿病骨质疏松的影响。
    方法:纳入601例T2DM患者,根据甲状腺自身抗体分为两组,即甲状腺自身免疫阳性组(TPOAb+或TGAb+)和甲状腺自身免疫阴性组(TPOAb-和TGAb-)。收集临床数据,并通过双能X射线吸收法(DXA)确定BMD。采用SPSS26.0软件进行数据分析。模型回归分析骨密度的影响因素,用ROC曲线分析甲状腺过氧化物酶抗体(TPOAb)筛查骨质疏松的最佳切点。
    结果:TPOAb和甲状腺球蛋白抗体(TGAb)与BMD和T评分呈负相关(LS,FN和WB)(P<0.01),TGAb与25(OH)D呈负相关(P<0.05)。多元线性回归分析显示,TPOAb是LS的独立影响因素,FN和WBBMD。ROC曲线分析表明,TPOAb预测骨质疏松的最佳阈值为12.35。
    结论:在T2DM患者中,TPOAb和TGAb水平与LS呈负相关,FN和WBBMD,TPOAb是糖尿病骨质疏松的独立影响因素,TPOAb对糖尿病性骨质疏松症的发生、发展具有一定的临床预测价值。
    OBJECTIVE: The purpose of this study was to analyze the relationship between thyroid autoimmunity and bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM), and to further explore the influence of thyroid autoimmunity on diabetic osteoporosis.
    METHODS: A total of 601 T2DM patients were included and divided into two groups according to thyroid autoantibodies, namely thyroid autoimmunity positive group (TPOAb+ or TGAb + ) and thyroid autoimmunity negative group (TPOAb- and TGAb-). Clinical data were collected and BMD was determined by dual-energy X-ray absorptiometry (DXA). SPSS26.0 software was used to data analysis. Model regression was used to analyze the influencing factors of BMD, and ROC curve was used to analyze the optimal cut-off point of thyroid peroxidase antibody (TPOAb) for screening osteoporosis.
    RESULTS: TPOAb and thyroglobulin antibody (TGAb) were negatively correlated with BMD and T-score (LS, FN and WB) (P < 0.01), and TGAb was negatively correlated with 25(OH)D (P < 0.05). Multiple linear regression analysis showed that TPOAb was an independent influence factor on LS, FN and WB BMD. ROC curve analysis showed that the optimal threshold of TPOAb for predicting osteoporosis was 12.35.
    CONCLUSIONS: In T2DM patients, TPOAb and TGAb levels are negatively correlated with LS, FN and WB BMD, and TPOAb is an independent influencing factor for diabetic osteoporosis, and TPOAb has a certain predictive value for the occurrence and development of diabetic osteoporosis clinically.
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  • 文章类型: Journal Article
    流产是失败妊娠的重要方面,也是患者和护理人员的担忧来源。流产的一些原因仍然未知。诸如甲状腺自身免疫的免疫学状况可以发挥重要作用。我们的目标是确定在资源不足的情况下甲状腺过氧化物酶抗体升高与妊娠早期流产之间的关系。这是卡拉巴尔大学教学医院妇科诊所的病例对照研究,尼日利亚;从2020年2月14日至2021年1月13日,涉及145例妊娠早期流产,和他们匹配的对照组,他们显然怀孕正常,在相同的胎龄。使用酶联免疫吸附测定法分析参与者和对照组的静脉血血清的甲状腺过氧化物酶抗体。并使用SPSS20版和GraphPadPrism8.4.3统计软件进行分析。身为公务员和社会地位低下,孕早期流产的可能性很大。妊娠早期甲状腺过氧化物酶抗体升高的流产几率是10倍。赔率10.34,95%CI:3.22~32.98,P值=0.0001。该检测的敏感性为89.66%,特异性为54.41%。阳性预测值为17.93%,阴性预测值为97.93%,似然比为1.966。妊娠早期甲状腺过氧化物酶抗体升高可能是流产的预测因素。这是因为妊娠早期甲状腺过氧化物酶抗体升高的患者有10倍的妊娠早期流产风险。
    Miscarriages constitute a significant aspect of failed pregnancies and a source of worry for the patient and caregiver. Some of the causes of miscarriages remain unknown. Immunological conditions such as thyroid autoimmunity could play significant roles. Our objective was to determine the relationship between raised thyroid peroxidase antibodies and first trimester miscarriages in a low resource setting. This was a case control study at the Gynaecological Clinic of the University of Calabar Teaching Hospital, Nigeria; from 14th February 2020 to 13th January 2021, involving 145 cases who had first trimester miscarriages, and their matched controls who had apparently normal pregnancies, at same gestational ages. Sera of venous blood from both participants and controls were analysed for thyroid peroxidase antibodies using enzyme-linked immunosorbent assay, and analysed using SPSS version 20, and GraphPad Prism 8.4.3 statistical software. Being a civil servant and low social status had significant odds for first trimester miscarriage. Raised thyroid peroxidase antibodies in the first trimester had 10-fold odds for miscarriage. Odds ratio 10.34, 95% CI: 3.22 to 32.98, P-value = 0.0001. The test had a sensitivity of 89.66% and specificity of 54.41%. The positive predictive value was 17.93%, while the negative predictive value was 97.93% and a likelihood ratio of 1.966. Rising thyroid peroxidase antibodies in early pregnancy could be a predictor for miscarriage. This is so because patients with raised thyroid peroxidase antibodies in the first trimester had a 10-fold risk of having a first trimester miscarriage.
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  • 文章类型: Journal Article
    目的:分析与TAI阴性ICSI周期相比,甲状腺自身免疫(TAI)对ICSI周期生殖结局参数的影响。
    方法:在这项单一IVF中心回顾性研究中,86名TPOAb或TGAb水平升高的不孕妇女,但甲状腺素替代后甲状腺功能正常(研究组),与69例无甲状腺异常的女性患者(对照)进行比较。ICSI处理后的受精率(FR),临床妊娠率(CPR),分析流产率(MR)和活产率(LBR)。
    方法:所有患有各种不孕因素的受试者均在大学IVF中心接受ICSI治疗。研究组患者接受甲状腺素替代治疗,并在IVF治疗中接受甲状腺素。在IVF周期之前,对内分泌参数进行了统一评估:甲状腺功能和抗体,生殖激素(AMH,FSH,LH,E2,PRL,睾丸激素,DHEAS,17-OHP,AD)和OGTT(0-60-120分钟葡萄糖和胰岛素)。在对实验室参数进行描述性比较之后,年龄调整后的FR分析,CPR,进行MR和LBR。
    结果:TAI阳性女性年龄较大(平均年龄35.31±4.95vs.32.15±4.87年;p=0.002),FSH较高(8.4±3.4vs.7.4±2.32U/L;p=0.024),更高的E2(53.94±47.61vs.42.93±18.92pg/ml;p=0.025)水平,而AMH(2.88±2.62vs.3.61±1.69ng/ml;p=0.0002)较低。TSH水平无差异(1.64±0.96vs.两组之间为1.66±0.65uIU/ml;p=0.652)。FT3(2.63±0.58vs.2.98±0.55pg/ml;p=0.002)较低,FT4(1.3±0.29vs.1.13±0.21ng/dl;p=0.0002)在TAI阳性组中较高,反映了临床上无关紧要的差异。卵细胞计数(6±3.8vs.7.5±3.95;p=0.015)在TAI中更低,并且在年龄调整后仍然如此。尽管总体ICSIFR没有差异(62.9%与69.1%,p=0.12),对于35岁以下TAI患者,这一数值较低,显示出与年龄相关的差异逐渐减小.CPR(36.04%vs.69.56%;p<0.001),LBR(23.25%与60.86%;p<0.001)较低,MR(35.48%与12.5%;p=0.024)在TAI组中较高,并且在年龄调整后这些差异仍然存在。
    结论:由于研究组的年龄较高可能会干扰TAI的作用,为了消除这一混杂因素,需要进行年龄调整计算。
    结论:尽管在临床或亚临床甲状腺功能减退症中补充甲状腺功能最佳,TAI的存在对临床妊娠率产生负面影响,并与较高的流产率有关,因此导致ICSI后活产率降低。TAI患者ICSI受精率降低也可能导致预后较差,尤其是年轻女性。
    OBJECTIVE: The objective of this study was to analyze the impact of thyroid autoimmunity (TAI) on reproductive outcome parameters of intracytoplasmic sperm injection (ICSI) cycles as compared to TAI-negative ICSI cycles.
    METHODS: In this single in vitro fertilization (IVF) center retrospective study, 86 infertile women with elevated thyroid peroxidase or TGAb levels, but euthyroid after thyroxine replacement (study group), were compared to 69 female patients with no thyroid abnormalities (controls). Following ICSI treatment fertilization rate (FR), clinical pregnancy rate (CPR), miscarriage rate (MR), and live birth rate (LBR) were analyzed.
    METHODS: All subjects with various infertility factors were treated with ICSI in university-based IVF center. Patients in the study group received thyroxine replacement and were euthyroid at IVF treatment. Before the IVF cycles, endocrinological parameters were uniformly assessed: thyroid function and antibodies, reproductive hormones (anti-Müllerian hormone [AMH], follicular stimulating hormone [FSH], luteinizing hormone, E2, PRL, testosterone, DHEAS, 17-OHP, AD) and OGTT (0-60-120 min glucose and insulin). Following descriptive comparison of laboratory parameters, age-adjusted analyses of FR, CPR, MR, and LBR were performed.
    RESULTS: TAI-positive women were older (mean age 35.31 ± 4.95 vs. 32.15 ± 4.87 years; p = 0.002), had higher FSH (8.4 ± 3.4 vs. 7.4 ± 2.32 U/L; p = 0.024), higher E2 (53.94 ± 47.61 vs. 42.93 ± 18.92 pg/mL; p = 0.025) levels, while AMH (2.88 ± 2.62 vs. 3.61 ± 1.69 ng/mL; p = 0.0002) was lower. There were no differences in TSH levels (1.64 ± 0.96 vs. 1.66 ± 0.65 µIU/mL; p = 0.652) between the two groups. FT3 (2.63 ± 0.58 vs. 2.98 ± 0.55 pg/mL; p = 0.002) was lower and FT4 (1.3 ± 0.29 vs. 1.13 ± 0.21 ng/dL; p = 0.0002) was higher in the TAI-positive group, reflecting clinically irrelevant differences. Egg cell counts (6 ± 3.8 vs. 7.5 ± 3.95; p = 0.015) were lower in TAI and remained so following age adjustment. Although the overall ICSI FR did not differ (62.9% vs. 69.1%, p = 0.12), it was lower for patients under 35 with TAI showing decreasing differences in line with age. The CPR (36.04% vs. 69.56%; p < 0.001) and LBR (23.25% vs. 60.86%; p < 0.001) were lower, the MR (35.48% vs. 12.5%; p = 0.024) was higher in the TAI group, and these differences remained after age adjustment.
    CONCLUSIONS: Since the higher age of the study group may interfere with the effect of TAI, age adjustment calculations were necessary to perform to eliminate this confounding factor.
    CONCLUSIONS: Despite optimal thyroid supplementation in clinical or subclinical hypothyroidism, the presence of TAI negatively influences CPR and is connected to a higher MR, thus resulting in a lower LBR after ICSI. Decreased FR with ICSI in TAI patients may also contribute to poorer outcomes, especially in younger women.
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  • 文章类型: Journal Article
    复发性自然流产(RSA)的病因仍然难以捉摸,尽管有具体的研究证实了RSA与甲状腺自身免疫(TAI)之间的关联。这项研究探讨了甲状腺抗体阳性的RSA患者的免疫和代谢特征及其与妊娠早期流产和活产率的关系。旨在为临床干预提供进一步指导。
    回顾性分析包括478例RSA患者。甲状腺剖面,甲状腺过氧化物酶抗体,在所有参与者中检测抗甲状腺球蛋白抗体.比较甲状腺自身免疫(TAI)阳性和TAI阴性患者的临床特征和妊娠结局。在TAI阳性患者中探讨了与不良妊娠结局相关的重要因素和风险预测模型。使用相关性分析来鉴定与甲状腺自身抗体相关的特定代谢或免疫生物标志物。
    TAI的患病率为18.6%。与没有TAI的女性相比,TAI阳性RSA的促甲状腺激素(TSH)浓度显着升高(2.80±2.98vs1.89±1.17,p=0.006)。28周后,TAI阳性组的活产率低于TAI阴性组,具有统计学意义(p<0.05)。RSA活产妇女和妊娠早期流产妇女之间的免疫生物标志物分别是补体C4和白细胞介素6,在TAI阴性和TAI阳性女性中。然后,本研究为AUC为0.81的TAI阳性女性构建了妊娠早期流产风险预测模型.最后,探讨了与甲状腺过氧化物酶抗体(TPO-Ab)水平相关的一些因素,发现TPO-Ab水平与游离甲状腺素呈正相关,与25羟维生素D呈负相关,RSA患者的白细胞介素-4和空腹血糖。
    TAI阳性的RSA患者妊娠早期流产率较高,活产率较低,这可能与TAI阳性RSA患者的代谢免疫变化有关。
    The etiology of recurrent spontaneous abortion (RSA) remains elusive despite specific investigations affirming the association between RSA and thyroid autoimmunity (TAI). This study explores the immunological and metabolic profiles of RSA patients exhibiting positive thyroid antibodies and their connection with the rates of first-trimester miscarriage and live births. The aim is to provide further guidance for clinical interventions.
    A retrospective analysis included 478 women with RSA. Thyroid profile, thyroid peroxidase antibodies, and anti-thyroglobulin antibodies were measured in all participants. The clinical characteristics and pregnancy outcomes of RSA women were compared between thyroid autoimmunity (TAI)-positive and TAI-negative patients. Significant factors associated with adverse pregnancy outcomes and risk prediction models were explored in TAI-positive patients. Correlation analysis was used to identify specific metabolic or immune biomarkers associated with thyroid autoantibodies.
    The prevalence of TAI was 18.6%. Compared with women without TAI, the thyroid-stimulating hormone (TSH) concentration of TAI-positive RSA was significantly higher (2.80 ± 2.98 vs 1.89 ± 1.17, p=0.006). After 28 weeks, the live birth rate of the TAI-positive group was lower than that of the TAI-negative group, with statistical significance (p<0.05). The immune biomarkers that differed between RSA women with live births and those with first-trimester miscarriages were complement C4 and interleukin-6, respectively, in TAI-negative and TAI-positive women. Then, a risk prediction model for first-trimester miscarriage was constructed for TAI-positive women with an AUC of 0.81. Finally, some factors related to thyroid peroxidase antibody (TPO-Ab) levels were explored, and it was found that TPO-Ab levels were positively correlated with free thyroxine and negatively correlated with 25 hydroxyvitamin D, interleukin-4, and fasting blood glucose in RSA patients.
    TAI-positive RSA patients have higher first-trimester miscarriage rates and a lower live birth rate, which may be related to metabolic immune shifts in TAI-positive RSA patients.
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  • 文章类型: Journal Article
    由于Th1和Th2细胞的反调节,Th1型自身免疫性疾病如甲状腺自身免疫和Th2介导的过敏性疾病如特应性皮炎(AD)应发生在相互排斥的人群中。然而,甲状腺自身免疫与慢性荨麻疹有关,特应性被认为是AD和荨麻疹的原因。
    使用SCORing特应性皮炎(SCORAD)评分评估AD患儿甲状腺自身免疫的频率,并研究AD临床严重程度之间的相关性,血清免疫球蛋白E(IgE)生化指标,嗜酸性粒细胞绝对计数,和维生素D水平。
    进行了一项基于医院的横断面研究,招募儿童(0-18岁)与AD。排除了影响甲状腺功能障碍的药物患者以及患有甲状腺功能正常综合征或免疫缺陷疾病的患者。使用SCORAD评估临床严重程度,和甲状腺的轮廓,抗甲状腺过氧化物酶抗体,抗核抗体(ANA),嗜酸性粒细胞绝对计数,血清IgE,和维生素D水平进行测量。
    在18.9%(10/53)的儿童中诊断出甲状腺自身免疫。SCORAD与血清IgE(r=0.432,P=0.002)和嗜酸性粒细胞绝对计数(r=0.575,P=<0.001)存在显著相关性。SCORAD与维生素D水平呈负相关(r=-0.373,P=0.006)。
    甲状腺自身免疫可能与AD有关,高度怀疑是必不可少的。维生素D也应在患有AD的儿童中补充,因为它经常被发现是低的。特别是在严重的情况下。需要多中心病例对照研究来确定AD患儿甲状腺自身免疫的患病率。
    UNASSIGNED: Because of the counter-regulation of Th1 and Th2 cells, Th1-type autoimmune diseases like thyroid autoimmunity and Th2-mediated allergic diseases like atopic dermatitis (AD) should occur in mutually exclusive populations. However, thyroid autoimmunity has been associated with chronic urticaria, and atopy is considered a cause of both AD and urticaria.
    UNASSIGNED: To assess the frequency of thyroid autoimmunity in children with AD and to study the correlation between the clinical severity of AD using the SCORing Atopic Dermatitis (SCORAD) score, and biochemical parameters of serum immunoglobulin E (IgE), absolute eosinophil count, and vitamin D levels.
    UNASSIGNED: A hospital-based cross-sectional study was conducted, recruiting children (0-18 years) with AD. Patients on drugs affecting thyroid dysfunction and those with sick euthyroid syndrome or an immunodeficiency disorder were excluded. Clinical severity was assessed using SCORAD, and the thyroid profile, anti-thyroid peroxidase antibodies, antinuclear antibody (ANA), absolute eosinophil count, serum IgE, and vitamin D levels were measured.
    UNASSIGNED: Thyroid autoimmunity was diagnosed in 18.9% (10/53) of children. There was a significant correlation between SCORAD and serum IgE (r = 0.432, P = 0.002) and absolute eosinophil count (r = 0.575, P = <0.001). There was a negative correlation between SCORAD and vitamin D levels (r = -0.373, P = 0.006).
    UNASSIGNED: Thyroid autoimmunity may be associated with AD, and a high index of suspicion is essential. Vitamin D also should be supplemented in children with AD as it is frequently found to be low, especially in severe cases. Multi-center case-control studies are required to determine the prevalence of thyroid autoimmunity in children with AD.
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