thyroid autoimmunity

甲状腺自身免疫
  • 文章类型: Journal Article
    桥本甲状腺炎(HT)是一种甲状腺自身免疫性疾病,其特征是淋巴细胞浸润和甲状腺破坏。夏枯草(PV)是一种传统的中草药,具有治疗HT的临床疗效。我们先前报道了PV在甲状腺细胞中的免疫调节作用;然而,PV的生物活性成分尚不清楚。本研究旨在阐明PV治疗HT的关键成分及其作用机制。
    网络药理学用于预测HT的关键PV成分。测试预测的成分以确定它们是否可以在人甲状腺细胞中发挥PV的免疫调节作用。有限的蛋白水解质谱(Lip-MS)用于探索人甲状腺细胞中与PV成分相互作用的蛋白质。使用微尺度热电泳结合测定来评估PV组分与靶蛋白的亲和力。
    从公共数据库中收集了具有192个组分靶标和3415个HT相关基因的11个PV组分。有了网络药理学,建立了一个“成分-目标-疾病”网络,其中包括槲皮素,木犀草素,山奈酚,Morin,和植物甾醇,β-谷甾醇被预测为HTPV的关键成分。在受刺激的原代人甲状腺细胞或Nthy-ori-31细胞中,关键成分抑制炎性细胞因子肿瘤坏死因子α(TNF-α)的基因表达,白细胞介素-6(IL-6),和干扰素-β(IFN-β),细胞凋亡,核因子κB(NF-κB)和干扰素调节因子3(IRF-3)的激活。热休克蛋白90α,A类,成员1(HSP90AA1),被Lip-MS鉴定为与PV中的类黄酮相互作用。Morin与HSP90AA1的亲和力最高(KD=122.74μM),其次是山奈酚(KD=168.53μM),木犀草素(KD=293.94μM),和槲皮素(KD=356.86μM)。
    槲皮素,木犀草素,山奈酚,Morin,β-谷甾醇在受刺激的人甲状腺细胞中再现了PV的抗炎和抗凋亡作用,这可能有助于PV在HT中的治疗效果。
    UNASSIGNED: Hashimoto\'s thyroiditis (HT) is a thyroid autoimmune disease characterized by lymphocytic infiltration and thyroid destruction. Prunella vulgaris (PV) is a traditional Chinese herbal medicine with documented clinical efficacy in treating HT. We previously reported an immunoregulatory effect of PV in thyrocytes; however, the bioactive components of PV remained unclear. This study aimed to elucidate key components of PV for treating HT and their acting mechanisms.
    UNASSIGNED: Network pharmacology was used to predict key PV components for HT. The predicted components were tested to determine whether they could exert an immunoregulatory effect of PV in human thyrocytes. Limited proteolysis-mass spectrometry (Lip-MS) was used to explore interacting proteins with PV components in human thyrocytes. Microscale thermophoresis binding assay was used to evaluate the affinity of PV components with the target protein.
    UNASSIGNED: Eleven PV components with 192 component targets and 3415 HT-related genes were gathered from public databases. With network pharmacology, a \'component-target-disease\' network was established wherein four flavonoids including quercetin, luteolin, kaempferol, morin, and a phytosterol, β-sitosterol were predicted as key components in PV for HT. In stimulated primary human thyrocytes or Nthy-ori-31 cells, key components inhibited gene expressions of inflammatory cytokines including tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and interferon-β (IFN-β), cellular apoptosis, and activation of nuclear factor κB (NF-κB) and interferon regulatory factor 3 (IRF-3). Heat shock protein 90 alpha, class A, member 1 (HSP90AA1), was identified to interact with flavonoids in PV by Lip-MS. Morin had the highest affinity with HSP90AA1 (KD = 122.74 μM), followed by kaempferol (KD = 168.53 μM), luteolin (KD = 293.94 μM), and quercetin (KD = 356.86 μM).
    UNASSIGNED: Quercetin, luteolin, kaempferol, morin, and β-sitosterol reproduced an anti-inflammatory and anti-apoptosis effect of PV in stimulated human thyrocytes, which potentially contributed to the treatment efficacy of PV in HT.
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  • 文章类型: Journal Article
    背景:系统性红斑狼疮(SLE)患者比一般人群更容易患甲状腺疾病。主要目标是评估埃及SLE儿童由于免疫因素引起的甲状腺功能障碍,以及它们与疾病的病程和严重程度的关系。
    方法:本横断面观察性研究包括50名SLE儿童和青少年。每位患者都接受了全面的体检和全面的病史记录。使用酶联免疫吸附测定(ELISA)方法评估甲状腺概况,抗甲状腺球蛋白(抗TG),和抗甲状腺过氧化物酶(抗TPO)抗体。
    结果:在50名患者中,女性:男性比例(F:M=7:1)为44女性和6男性(12%)。他们年龄在5到17岁之间。在病人中,32例(64%)有甲状腺功能障碍,19人(38%)患有甲状腺功能正常病态综合征,十个(20%)有明显的甲状腺功能减退症,3人(6%)患有亚临床甲状腺功能减退症,也没有甲状腺功能亢进.在50名患者中,一个(2%)增加了抗TPO,而所有其他患者的抗TG水平正常。在疾病持续时间和游离甲状腺素(FT4)之间观察到统计学上显着的负相关(p值0.007)。此外,当将病程与甲状腺抗体(抗TG和抗TPO)进行比较时,发现显著负相关(p值0.015和0.028).
    结论:在青少年系统性红斑狼疮(JSLE)中,甲状腺功能障碍可以识别。疾病持续时间而不是其活动与甲状腺抗体显着相关。对于患有JSLE的儿童,应定期进行甲状腺功能检查。必要时,最好进行额外的甲状腺抗体测试。
    BACKGROUND: Systemic Lupus Erythematosus (SLE) patients are more likely than the general population to suffer from thyroid illness. The major goal was to assess the thyroid dysfunctions due to immunological factors in Egyptian SLE children and how they are related to the course and severity of the illness.
    METHODS: Fifty children and adolescents with SLE are included in this cross-sectional observational study. Every patient underwent a thorough physical examination and a comprehensive history taking. An enzyme-linked immunosorbent assay (ELISA) approach was used to evaluate the thyroid profile, anti-thyroglobulin (Anti-TG), and anti-thyroid peroxidase (anti-TPO) antibodies.
    RESULTS: Of the 50 patients, the female: male ratio (F: M = 7:1) was 44 females and 6 males (12%). They were between the ages of 5 and 17. Out of the patients, thirty-two (64%) had thyroid dysfunctions, 19 (38%) had euthyroid sick syndrome, ten (20%) had overt hypothyroidism, three (6%) had subclinical hypothyroidism, and none had hyperthyroidism. Of the 50 patients, one (2%) had increased anti-TPO, whereas all other patients had normal anti-TG levels. A statistically significant negative correlation (p-value 0.007) was seen between the disease duration and free thyroxine (FT4). Furthermore, a significant negative correlation (p-values 0.015 and 0.028) was found when comparing the disease duration with thyroid antibodies (anti-TG and anti-TPO).
    CONCLUSIONS: In Juvenile Systemic Lupus Erythematosus (JSLE), thyroid dysfunctions can be identified. The disease duration but not its activity was significantly correlated with thyroid antibodies. For children with JSLE, thyroid function testing should be done on a regular basis. It is preferable to carry out additional thyroid antibody tests when necessary.
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  • 文章类型: Journal Article
    背景:甲状腺自身免疫(TAI)可能存在于1-17%的孕妇中。建议监测抗甲状腺过氧化物酶抗体(TPOAb)阳性的正常甲状腺孕妇的甲状腺功能。
    目的:确定妊娠期第二次采血时生化进展(血清TSH升高>2.5mU/L)的患病率和可能的临床和生物学危险因素,根据TPOAb状态,甲状腺功能正常的女性(TSH≤2.5mU/L)。
    方法:本研究包括两个先前发表的队列的人口统计学和生物学数据(n=274名妇女,1996年8月至1997年5月哥本哈根队列,2013年1月至2014年12月的66名女性,布鲁塞尔队列)在自发性单胎妊娠期间进行了至少两次TSH和游离甲状腺素(FT4)以及至少一次TPOAb的测量。
    结果:研究的大多数女性没有出现生化进展。只有4.2%的进步,在TPOAb+女性中更频繁,与TPOAb组相比(9.4%vs2.7%,p=0.015)。在第二次采样时没有观察到血清TSH>4mU/L的升高。较高的基线TSH水平与TPOAb+(p=0.05)和TPOAb-女性(p<0.001)的生化进展有关,而母亲的年龄,BMI,多重奇偶校验,吸烟,FT4和TPOAb浓度在有和没有进展的女性之间没有显着差异。
    结论:只有少数甲状腺自身免疫正常的妇女出现生化进展,没有TSH>4mU/L。需要进行更大规模的研究,以更好地针对怀孕期间从重复甲状腺功能监测中受益最大的女性子集。
    UNASSIGNED: Thyroid autoimmunity (TAI) may be present in 1-17% of pregnant women. Monitoring of thyroid function in euthyroid pregnant women positive for anti-thyroperoxidase antibodies (TPOAb+) is recommended.
    UNASSIGNED: To determine the prevalence and possible clinical and biological risk factors of biochemical progression (rise in serum thyroid-stimulating hormone (TSH) > 2.5 mU/L) at second blood sampling during pregnancy, in euthyroid women (TSH ≤ 2.5 mU/L) according to their TPOAb status.
    UNASSIGNED: This study included demographic and biological data from two previously published cohorts (n = 274 women from August 1996 to May 1997 Copenhagen cohort, and n = 66 women from January 2013 to December 2014 Brussels cohort) having at least two measurements of TSH and free thyroxine (FT4) and at least one of TPOAb during spontaneously achieved singleton pregnancies.
    UNASSIGNED: The majority of women studied did not show biochemical progression. Only 4.2% progressed, significantly more frequently among TPOAb+ women, as compared to TPOAb- group (9.4 vs 2.7%, P = 0.015). No rise in serum TSH > 4 mU/L at 2nd sampling was observed. Higher baseline TSH levels were associated with biochemical progression in both TPOAb+ (P = 0.05) and TPOAb- women (P < 0.001), whereas maternal age, BMI, multiparity, smoking, FT4, and TPOAb concentrations were not significantly different between women with and without progression.
    UNASSIGNED: Only a minority of euthyroid women with thyroid autoimmunity presented biochemical progression and none with a TSH > 4 mU/L. Larger studies are needed to better target the subset of women who would benefit most from repeated thyroid function monitoring during pregnancy.
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  • 文章类型: Journal Article
    这项研究的目的是评估甲状腺自身免疫(TAI)与获取的卵母细胞数(NOR)的关联,受精率(FR),甲状腺功能正常的不孕和卵巢储备(DOR)减少的女性的胚胎质量(EQ)。
    这项回顾性队列研究涉及1,172名年龄在20-40岁的甲状腺功能正常的女性,患有不孕症和DOR,他们经历了一个取卵周期。在血清甲状腺过氧化物酶抗体(TPOAb)浓度高于34IU/ml和/或血清甲状腺球蛋白抗体(TgAb)浓度超过115.0IU/ml的情况下诊断为TAI。在这些女性中,147例TAI患者被归类为TAI阳性组,而1,025例无TAI的患者被归类为TAI阴性组。使用针对混杂因素进行调整的广义线性模型(GLM),我们评估了TAI与血清TPOAb和TgAb浓度和NOR的关系,FR,和EQ在这项研究的主题。对TPOAb和TGAb值进行log10转化以减少偏度。使用Logistic回归模型来估计TPOAb和TgAb浓度对实现高NOR(≥7)和高FR(>60%)的概率的影响。
    对于整个研究人群,与没有TAI的女性相比,患有TAI的女性的NOR和EQ显著降低(两者均P<0.001).有趣的是,在TSH≤2.5亚组中,与TAI阴性组相比,TAI阳性组的NOR和EQ也显著降低(两者均P<0.001).此外,在log10(TPOAb)浓度和NOR与优质胚胎和可用胚胎数量之间观察到负相关(全部P<0.05).log10(TgAb)浓度与NOR和高质量胚胎数量呈负相关(均P<0.05)。在回归分析中,log10(TPOAb)浓度达到高NOR的概率较低[校正比值比(aOR):0.56;95%置信区间(95%CI)0.37,0.85;P=0.007].
    TAI和较高的TPOAb和TgAb浓度显示与研究人群中NOR和EQ的降低相关。我们的发现提供了进一步的证据,以支持甲状腺功能正常的不孕和DOR女性TAI的系统筛查和治疗。
    UNASSIGNED: The aim of this study was to evaluate the associations of thyroid autoimmunity (TAI) with the number of oocytes retrieved (NOR), fertilization rate (FR), and embryo quality (EQ) in euthyroid women with infertility and diminished ovarian reserve (DOR).
    UNASSIGNED: This retrospective cohort study involved 1,172 euthyroid women aged 20-40 years with infertility and DOR who underwent an oocyte retrieval cycle. TAI was diagnosed in the presence of serum thyroperoxidase antibody (TPOAb) concentrations higher than 34 IU/ml and/or serum thyroglobulin antibody (TgAb) concentrations exceeding 115.0 IU/ml. Among these women, 147 patients with TAI were classified as the TAI-positive group, while 1,025 patients without TAI were classified as the TAI-negative group. Using generalized linear models (GLMs) adjusted for confounding factors, we evaluated the associations of TAI and the serum TPOAb and TgAb concentrations and NOR, FR, and EQ in this study\'s subjects. The TPOAb and TGAb values were subjected to log10 transformation to reduce skewness. Logistic regression models were used to estimate the effects of TPOAb and TgAb concentrations on the probabilities of achieving a high NOR (≥7) and high FR (>60%).
    UNASSIGNED: For the whole study population, women with TAI had a significantly lower NOR and poorer EQ than women without TAI (P < 0.001 for both). Interestingly, in the TSH ≤2.5 subgroup, the TAI-positive group also had a significantly lower NOR and poorer EQ than the TAI-negative group (P < 0.001 for both). Furthermore, negative associations were observed between log10(TPOAb) concentrations and NOR and the number of high-quality embryos and available embryos (P < 0.05 for all). The log10(TgAb) concentrations were inversely associated with NOR and the number of high-quality embryos (P < 0.05 for all). In the regression analysis, the log10(TPOAb) concentrations had lower probabilities of achieving a high NOR [adjusted odds ratio (aOR): 0.56; 95% confidence interval (95% CI) 0.37, 0.85; P = 0.007].
    UNASSIGNED: TAI and higher TPOAb and TgAb concentrations were shown to be associated with reductions in the NOR and EQ in the study population. Our findings provide further evidence to support systematic screening and treatment for TAI in euthyroid women with infertility and DOR.
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  • 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
    这项前瞻性出生队列研究评估了PM2.5(直径≤2.5μm)暴露的相关性,PM1-2.5(1-2.5μm),和PM1(≤1μm)与妊娠早期母体甲状腺自身免疫和功能有关。从2018年到2020年,中国共有15664名孕妇在6至13+6孕周被纳入。使用广义线性模型(GLMs)的单污染物模型表明,PM2.5和PM1-2.5每增加10μg/m3,与甲状腺自身免疫风险增加6%(比值比[OR]=1.06,95%置信区间[CI]:1.01,1.12)和15%(OR=1.15,95%CI:1.08,1.22)相关,分别。随着PM2.5和PM1-2.5暴露的四分位间距增加,甲状腺自身免疫的几率显着增加(P<0.001)。PM1暴露与甲状腺自身免疫无显著相关性。GLM与自然立方样条表明,PM2.5和PM1-2.5暴露的增加与较低的母体FT4水平有关,而当暴露量超过32.13μg/m3时,发现PM1和FT4水平之间呈负相关。只有PM2.5暴露与促甲状腺激素(TSH)水平呈正相关。我们的研究结果表明,在妊娠早期,高PM暴露与母体甲状腺功能紊乱有关。
    This prospective birth cohort study evaluated the association of exposure to PM2.5 (diameter ≤2.5 μm), PM1-2.5 (1-2.5 μm), and PM1 (≤1 μm) with maternal thyroid autoimmunity and function during early pregnancy. A total of 15,664 pregnant women were included at 6 to 13+6 gestation weeks in China from 2018 to 2020. Single-pollutant models using generalized linear models (GLMs) showed that each 10 μg/m3 increase in PM2.5 and PM1-2.5 was related with 6% (odds ratio [OR] = 1.06, 95% confidence interval [CI]: 1.01, 1.12) and 15% (OR = 1.15, 95% CI: 1.08, 1.22) increases in the risk of thyroid autoimmunity, respectively. The odds of thyroid autoimmunity significantly increased with each interquartile range increase in PM2.5 and PM1-2.5 exposure (P for trend <0.001). PM1 exposure was not significantly associated with thyroid autoimmunity. GLM with natural cubic splines demonstrated that increases in PM2.5 and PM1-2.5 exposure were associated with lower maternal FT4 levels, while a negative association between PM1 and FT4 levels was found when exposure exceeded 32.13 μg/m3. Only PM2.5 exposure was positively associated with thyrotropin (TSH) levels. Our findings suggest that high PM exposure is associated with maternal thyroid disruption during the early pregnancy.
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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
    背景:累积活产率(CLBR)被认为是评估婴儿在完整的体外受精/卵胞浆内单精子注射(IVF/ICSI)治疗周期中的可能性的最重要终点。许多先前的研究都集中在甲状腺自身免疫(TAI)与第一个胚胎移植周期后的活产率之间的关联。然而,缺乏关于TAI的存在是否影响CLBR的证据。这项研究的目的是调查TAI对CLBR的影响在一个完整的IVF/ICSI周期。
    方法:这项回顾性研究包括2019年1月至2021年2月期间接受首次IVF/ICSI治疗的12,796名妇女。根据甲状腺抗体的水平,2,603名妇女被分配到TAI组,10,193名女性被分配到对照组。根据不育的不同原因进行亚组分析(仅包括男性因素,排卵障碍,输卵管因素,子宫内膜异位症和无法解释的不孕症)以及甲状腺抗体的不同类型和滴度。这项研究的主要结果是CLBR,其中包括来自新鲜胚胎移植周期的活产和2021年12月之前进行的所有随后的冻融胚胎移植周期.
    结果:TAI组和对照组之间的CLBR没有显着差异,即使在调整了相关的混杂因素,包括年龄,身体质量指数,不孕的原因,甲状腺功能,控制性卵巢刺激的方案,转移类型(新鲜与冻结),移植胚胎的类型(卵裂期胚胎与胚泡),和受精方法(试管婴儿与ICSI)(累计活产:50.6%52.1%,OR0.94,95%CI0.86-1.02,调整后OR0.97,95CI0.89-1.06)。亚组分析显示,TAI组和对照组在所有不孕原因的CLBR中没有观察到显著差异,除了由子宫内膜异位症引起的不孕症。在子宫内膜异位症的女性中,TAI组的CLBR明显低于对照组;在调整了包括年龄在内的潜在混杂因素后,这一差异并不显著,身体质量指数,甲状腺功能,控制性卵巢刺激的方案,转移类型(新鲜与冻结),移植胚胎的类型(卵裂期胚胎与胚泡),和受精方法(试管婴儿与ICSI)(累计活产:43.1%51.0%,OR0.73,95%CI0.53-0.99,调整后OR0.74,95%CI0.53-1.02)。另一个亚组分析表明,甲状腺抗体的类型和滴度不影响TAI女性的CLBR。
    结论:在我们的研究中,有TAI的女性和没有TAI的女性之间的CLBR没有显着差异,这表明TAI不会影响在完整的IVF/ICSI治疗周期中生育婴儿的机会。
    BACKGROUND: Cumulative live birth rate (CLBR) is considered as the most important endpoint for assessing the probability of having a baby in a complete in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment cycle. Many previous studies have focused on the association between thyroid autoimmunity (TAI) and live birth rate after first embryo transfer cycle, however, evidence on whether the presence of TAI affects the CLBR is lacking. The purpose of this study is to investigate the impact of TAI on the CLBR in a complete IVF/ICSI cycle.
    METHODS: This retrospective study included 12,796 women who underwent their first IVF/ICSI treatment between January 2019 and February 2021. Based on the levels of thyroid antibodies, 2,603 women were assigned to the TAI group, and 10,193 women were assigned to the control group. Subgroup analysis was performed according to the different causes of infertility (including male factor only, ovulation disorder, tubal factor, endometriosis and unexplained infertility) and different types and titres of thyroid antibodies. The primary outcome in this study was CLBR, which included live births from the fresh embryo transfer cycle and all subsequent frozen-thawed embryo transfer cycles performed before December 2021.
    RESULTS: There was no significant difference in the CLBR between the TAI and control groups, even after adjusting for relevant confounders including age, body mass index, cause of infertility, thyroid function, protocols of controlled ovarian stimulation, type of transfer (fresh vs. frozen), type of transferred embryo (cleavage-stage embryo vs. blastocyst), and fertilization method (IVF vs. ICSI) (cumulative live birth: 50.6% vs. 52.1%, OR 0.94, 95% CI 0.86-1.02, adjusted OR 0.97, 95%CI 0.89-1.06). Subgroup analysis showed that no significant difference was observed in CLBR between the TAI and control groups for all causes of infertility, except for infertility attributed to endometriosis. Among women with endometriosis, the CLBR was significantly lower in the TAI group than that in the control group; however, this difference was not significant after adjusting for potential confounders including age, body mass index, thyroid function, protocols of controlled ovarian stimulation, type of transfer (fresh vs. frozen), type of transferred embryo (cleavage-stage embryo vs. blastocyst), and fertilization method (IVF vs. ICSI) (cumulative live births: 43.1% vs. 51.0%, OR 0.73, 95% CI 0.53-0.99, adjusted OR 0.74, 95% CI 0.53-1.02). Another subgroup analysis demonstrated that the type and titre of thyroid antibody did not affect CLBR in women with TAI.
    CONCLUSIONS: In our study, there was no significant difference in the CLBR between women with TAI and those without TAI, which suggests that TAI did not affect the chances of having a baby in a complete IVF/ICSI treatment cycle.
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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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