老年桥本氏甲状腺炎患者碘营养与SOD、IP-10及甲状腺激素水平相关研究
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摘要
目的:探讨老年桥本氏甲状腺炎(Hashimoto thyroiditis,HT)患者碘营养状况与超氧化物歧化酶(superoxide dismutase,SOD)活力、干扰素诱导蛋白-10(interferon-inducible protein 10,IP-10)和甲状腺激素水平的相关性。方法:通过检测92例唐山市工人医院内分泌科就诊的老年桥本氏甲状腺炎患者,及同期体检的40例临床健康老年人的尿碘、血清SOD活力、IP-10水平及甲状腺功能等相关指标,比较不同碘营养状况对SOD活力、IP-10水平、HT发病和甲状腺激素水平的影响,分析碘、SOD和IP-10三者之间的相关性。结果:与对照组相比,老年桥本患者尿碘(216.63μg/L)和IP-10水(194.41 ng/L)平均较高,而SOD(92.99 U/m L)活性较低。碘充足组促甲状腺激素、血清游离三碘甲状腺原氨酸、血清游离甲状腺素和IP-10水平明显升高,SOD活力明显降低。相关分析发现尿碘与SOD活性呈负相关,与血清IP-10水平成正相关,血清SOD活性与IP-10水平呈负相关(r=0.662)。结论:过量碘摄入与老年桥本氏甲状腺炎相关,高碘能够影响患者甲状腺功能、氧化应激状态和趋化因子水平。
Objective:To investigate the correlation of iodine nutritional status with superoxide dismutase(SOD)activity and levels of interferon-inducible protein 10(IP-10)and thyroid hormone in elderly patients with Hashimoto's thyroiditis(HT). Methods:A total of 92 elderly patients with HT who visited the Department of Endocrinology in Tangshan Workers' Hospital and 40 clinically healthy elderly subjects who had physical examinations during the same period were tested for their serum SOD activity,levels of urine iodine and IP-10,and other indices related to thyroid function. SOD activity,the levels of IP-10 and thyroid hormones,and the incidence of HT were compared between the subjects with different nutritional status. The correlation between iodine,SOD,and IP-10 was analyzed.Results:Compared with the control group,the elderly patients with HT had higher mean levels of urinary iodine(216.63 μg/L)and IP-10(194.41 ng/L),but lower SOD activity(92.99 U/m L). The group with adequate iodine had significantly increased levels of thyroid stimulating hormone,free triiodothyronine,free thyroxine,and IP-10,but significantly decreased SOD activity. A correlation analysis showed that urinary iodine was negatively correlated with SOD activity and positively correlated with serum IP-10 level,and serum SOD activity was negatively correlated with the IP-10 level(r=0.662). Conclusion:Excessive iodine intake is associated with HT in the elderly. High iodine level can affect the thyroid function,oxidative stress,and chemotactic factor level of patients.
Objective:To investigate the correlation of iodine nutritional status with superoxide dismutase(SOD)activity and levels of interferon-inducible protein 10(IP-10)and thyroid hormone in elderly patients with Hashimoto's thyroiditis(HT). Methods:A total of 92 elderly patients with HT who visited the Department of Endocrinology in Tangshan Workers' Hospital and 40 clinically healthy elderly subjects who had physical examinations during the same period were tested for their serum SOD activity,levels of urine iodine and IP-10,and other indices related to thyroid function. SOD activity,the levels of IP-10 and thyroid hormones,and the incidence of HT were compared between the subjects with different nutritional status. The correlation between iodine,SOD,and IP-10 was analyzed.Results:Compared with the control group,the elderly patients with HT had higher mean levels of urinary iodine(216.63 μg/L)and IP-10(194.41 ng/L),but lower SOD activity(92.99 U/m L). The group with adequate iodine had significantly increased levels of thyroid stimulating hormone,free triiodothyronine,free thyroxine,and IP-10,but significantly decreased SOD activity. A correlation analysis showed that urinary iodine was negatively correlated with SOD activity and positively correlated with serum IP-10 level,and serum SOD activity was negatively correlated with the IP-10 level(r=0.662). Conclusion:Excessive iodine intake is associated with HT in the elderly. High iodine level can affect the thyroid function,oxidative stress,and chemotactic factor level of patients.
引文
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[24]高天舒,齐腾澈.碘过量与富碘中药对碘缺乏大鼠甲状腺内氧化应激的比较研究[J].中华内分泌代谢杂志,2012,28(10):855-858.
[25]刘伟旗,刘伟玲,黎志全,等.妊娠女性尿碘和超氧化物歧化物与甲状腺激素的相关性研究[J].国际检验医学杂志,2016,37(6):769-770.
[26]Cui S,Yu J,Shoujun L.Iodine intake increases IP-10 expression in the serum and thyroids of rats with experimental autoimmune thyroiditis[J].Int J Endocrinol,2014,2014:581069.
[27]Jinquan T,Jing C,Jacobi HH,et al.CXCR3 expression and activation of eosinophils:role of IFN-gamma-inducible protein-10 and monokine induced by IFN-gamma[J].J Immunol,2000,165(3):1548-1556.
[28]Antonelli A,Ferrari SM,Giuggioli D,et al.Chemokine(C-X-C motif)ligand(CXCL)10 in autoimmune diseases[J].Autoimmun Rev,2014,13(3):272-280.
[29]Antonelli A,Ferrari SM,Corrado A,et al.Autoimmune thyroid disorders[J].Autoimmun Rev,2015,14(2):174-180.
[30]Shah D,Wanchu A,Bhatnagar A.Interaction between oxidative stress and chemokines:Possible pathogenic role in systemic lupus erythematosus and rheumatoid arthritis[J].Immunobiology,2011,216(9):1010-1017.
[2]Anand A,Singh KR,Kushwaha JK,et al.Papillary thyroid cancer and hashimoto’s thyroiditis:an association less understood[J].Indian J Surg Oncol,2014,5(3):199-204.
[3]陈明华,郝国彩.中国人口老龄化地区差异分解及影响因素研究[J].中国人口资源与环境,2014,24(4):136-141.
[4]王征,李伟汉,张浩.老年患者甲状腺结节与甲状腺功能的相关性[J].中国老年学杂志,2013,33(21):5346-5347.
[5]Ajjan RA,Weetman AP.The pathogenesis of Hashimoto’s thyroiditis:further developments in our understanding[J].Horm Metab Res,2015,47(10):702-710.
[6]单忠艳.《中国甲状腺疾病诊治指南》导读[J].中国实用内科杂志,2008,28(4):260-261.
[7]Ehlers M,Schott M.Hashimoto’s thyroiditis and papillary thyroid cancer:are they immunologically linked?[J].Trends Endocrinol Metab,2014,25(12):656-664.
[8]Hetzel BS.Iodine-deficiency disorders[J].Lancet,2008,1(8599):1386-1387.
[9]Jankovic B,Le KT,Hershman JM.Clinical review:Hashimoto’s thyroiditis and papillary thyroid carcinoma:is there a correlation?[J].J Clin Endocrinol Metab,2013,98(2):474-482.
[10]Sgarbi JA,Maciel RM.Pathogenesis of autoimmune thyroid diseases[J].Arq Bras Endocrinol Metabol,2009,53(1):5-14.
[11]Mikos'H,Mikos'M,Obara-Moszyńska M,et al.The role of the immune system and cytokines involved in the pathogenesis of autoimmune thyroid disease(AITD)[J].Endokrynol Pol,2014,65(2):150-155.
[12]Wu Q,Rayman MP,Lv H,et al.Low population selenium status is associated with increased prevalence of thyroid disease[J].J Clin Endocrinol Metab,2015,100(11):4037-4047.
[13]Laurberg P.Iodine intake as a determinant of thyroid disorders in populations[J].Best Pract Res Clin Endocrinol Metab,2010,24(1):13-27.
[14]Teng X,Shan Z,Chen Y,et al.More than adequate iodine intake may increase subclinical hypothyroidism and autoimmune thyroiditis:a cross-sectional study based on two Chinese communities with different iodine intake levels[J].Eur J Endocrinol,2011,164(6):943-950.
[15]Hu S,Rayman MP.Multiple nutritional factors and the risk of Hashimoto’s thyroiditis[J].Thyroid,2017,27(5):597-610.
[16]Kolypetri P,King J,Larijani M,et al.Genes and environment as predisposing factors in autoimmunity:acceleration of spontaneous thyroiditis by dietary iodide in NOD.H2(h4)mice[J].Int Rev Immunol,2015,34(6):542-556.
[17]房辉,阎玉芹,陈祖培,等.不同碘摄入量大鼠甲状腺功能及其TG、TPO m RNA的表达[J].中华内分泌代谢杂志,2001,17(2):83-85.
[18]聂秀玲,林来祥,叶振坤,等.高碘对大鼠甲状腺TPO、Tgm RNA表达及血清甲状腺激素的影响[J].中国地方病学杂志,2005,24(3):258-261.
[19]Teng W,Shan Z,Teng X,et al.Effect of iodine intake on thyroid diseases in China[J].N Engl J Med,2006,354(26):2783-2793.
[20]Li Y,Teng D,Shan Z,et al.Antithyroperoxidase and antithyroglobulin antibodies in a five-year follow-up survey of populations with different iodine intakes[J].J Clin Endocrinol Metab,2008,93(5):1751-1757.
[21]Li W,Fan G,Chen L,et al.A new type of natural bispecific antibody with potential protective effect in Hashimoto thyroiditis[J].J Clin Endocrinol Metab,2014,99(9):E1602-1609.
[22]Luo Y,Kawashima A,Ishido Y,et al.Iodine excess as an environmental risk factor for autoimmune thyroid disease[J].Int J Mol Sci,2014,15(7):12895-12912.
[23]Duntas LH.The role of iodine and selenium in autoimmune thyroiditis[J].Horm Metab Res,2015,47(10):721-726.
[24]高天舒,齐腾澈.碘过量与富碘中药对碘缺乏大鼠甲状腺内氧化应激的比较研究[J].中华内分泌代谢杂志,2012,28(10):855-858.
[25]刘伟旗,刘伟玲,黎志全,等.妊娠女性尿碘和超氧化物歧化物与甲状腺激素的相关性研究[J].国际检验医学杂志,2016,37(6):769-770.
[26]Cui S,Yu J,Shoujun L.Iodine intake increases IP-10 expression in the serum and thyroids of rats with experimental autoimmune thyroiditis[J].Int J Endocrinol,2014,2014:581069.
[27]Jinquan T,Jing C,Jacobi HH,et al.CXCR3 expression and activation of eosinophils:role of IFN-gamma-inducible protein-10 and monokine induced by IFN-gamma[J].J Immunol,2000,165(3):1548-1556.
[28]Antonelli A,Ferrari SM,Giuggioli D,et al.Chemokine(C-X-C motif)ligand(CXCL)10 in autoimmune diseases[J].Autoimmun Rev,2014,13(3):272-280.
[29]Antonelli A,Ferrari SM,Corrado A,et al.Autoimmune thyroid disorders[J].Autoimmun Rev,2015,14(2):174-180.
[30]Shah D,Wanchu A,Bhatnagar A.Interaction between oxidative stress and chemokines:Possible pathogenic role in systemic lupus erythematosus and rheumatoid arthritis[J].Immunobiology,2011,216(9):1010-1017.