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Enfermedad tiroidea autoinmune en pacientes colombianos con lupus eritematoso sistémico

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dc.contributor.advisorAnaya, Juan-Manuel
dc.contributor.advisorRojas-Villarraga, Adriana
dc.contributor.advisorMolano González, Nicolás
dc.creatorFranco Aristizabal, Juan Sebastian
dc.creatorAmaya-Amaya, Jenny
dc.creatorMolano González, Nicolás
dc.creatorRodríguez Jiménez, Mónica María del Pilar
dc.creatorAcosta Ampudia, Yeny Yasbleidy
dc.creatorAnaya, Juan-Manuel
dc.creator.degreeEspecialista en Epidemiología (en Convenio con el CES)
dc.date.accessioned2015-06-09T19:18:59Z
dc.date.available2015-06-09T19:18:59Z
dc.date.created2015-05-16
dc.date.issued2015
dc.descriptionObjetivos: Determinar la prevalencia y los factores asociados con el desarrollo de hipotiroidismo autoinmune (HA) en una cohorte de pacientes con lupus eritematoso sistémico (LES), y analizar la información actual en cuanto a la prevalencia e impacto de la enfermedad tiroidea autoinmune y la autoinmunidad tiroidea en pacientes con LES. Métodos: Este fue un estudio realizado en dos pasos. Primero, un total de 376 pacientes con LES fueron evaluados sistemáticamente por la presencia de: 1) HA confirmado, 2) positividad para anticuerpos tiroperoxidasa/tiroglobulina (TPOAb/TgAb) sin hipotiroidismo, 3) hipotiroidismo no autoinmune, y 4) pacientes con LES sin hipotiroidismo ni positividad para TPOAb/TgAb. Se construyeron modelos multivariados y árboles de regresión y clasificación para analizar los datos. Segundo, la información actual fue evaluada a través de una revisión sistemática de la literatura (RLS). Se siguieron las guías PRISMA para la búsqueda en las bases de datos PubMed, Scopus, SciELO y Librería Virtual en Salud. Resultados: En nuestra cohorte, la prevalencia de HA confirmado fue de 12% (Grupo 1). Sin embargo, la frecuencia de positividad para TPOAb y TgAb fue de 21% y 10%, respectivamente (Grupo 2). Los pacientes con LES sin HA, hipotiroidismo no autoinmune ni positividad para TPOAb/TgAb constituyeron el 40% de la corhorte. Los pacientes con HA confirmada fueron estadísticamente significativo de mayor edad y tuvieron un inicio tardío de la enfermedad. El tabaquismo (ORA 6.93, IC 95% 1.98-28.54, p= 0.004), la presencia de Síndrome de Sjögren (SS) (ORA 23.2, IC 95% 1.89-359.53, p= 0.015) y la positividad para anticuerpos anti-péptido cíclico citrulinado (anti-CCP) (ORA 10.35, IC 95% 1.04-121.26, p= 0.047) se asociaron con la coexistencia de LES-HA, ajustado por género y duración de la enfermedad. El tabaquismo y el SS fueron confirmados como factores predictivos para LES-HA (AUC del modelo CART = 0.72). En la RSL, la prevalencia de ETA en LES varío entre 1% al 60%. Los factores asociados con esta poliautoinmunidad fueron el género femenino, edad avanzada, tabaquismo, positividad para algunos anticuerpos, SS y el compromiso articular y cutáneo. Conclusiones: La ETA es frecuente en pacientes con LES, y no afecta la severidad del LES. Los factores de riesgo identificados ayudarán a los clínicos en la búsqueda de ETA. Nuestros resultados deben estimular políticas para la suspensión del tabaquismo en pacientes con LES.spa
dc.description.abstractObjective: To determine the prevalence and the associated factors of autoimmune hypothyroidism (AH) within a systemic lupus erythematosus (SLE) cohort, and to analyze the current information concerning the prevalence and impact of autoimmune thyroid disease (AITD) and thyroid autoimmunity in patients with SLE. Methods: This was a two/step study. First, a total of 376 patients with SLE were assessed for the presence of the following: 1) confirmed AH, 2) positive thyroperoxidase antibodies/thyroglobulin antibodies [TPOAb/TgAb] without hypothyroidism, 3) non-autoimmune hypothyroidism and 4) SLE patients with neither. Multivariate analysis and a classification and regression tree model were used to analyze data. Second, the current information was evaluated through a systematic literature review (SLR). The PRISMA guidelines were followed to search in PubMed, Scopus, SciELO and Virtual Health Library databases. Results: In our cohort, the prevalence of confirmed AH was 12% (Group 1). However, the TPOAb and TgAb-positive frequencies were 21% and 10%, respectively (Group 2). SLE patients with neither comprised 40% of the cohort. Patients with confirmed AH were significantly older and had later age at onset of the disease. Smoking (AOR 6. 93, 95% CI 1. 98-28. 54, p= 0. 004), Sjögren’s Syndrome (SS) (AOR 23. 2, 95% CI 1. 89-359. 53, p= 0. 015) and positivity for anti-cyclic citrullinated peptide (anti-CCP) (AOR 10. 35, 95% CI 1. 04-121. 26, p= 0. 047) were associated with AH-SLE, regardless of gender and duration of the disease. Smoking and SS were confirmed as predictors of AH-SLE. In the SLR, the prevalence of AITD ranged from 1% to 60%. The factors associated with this polyautoimmunity were female gender, older age, smoking, certain autoantibodies, SS, and, cutaneous and articular involvement. Conclusions: AITD is frequent in SLE, and it does not affect the severity of SLE. Identified risk factors will assist clinicians in the search for AITD. Our results encourage smoke-free policies in patients with SLE. eng
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dc.identifier.doihttps://doi.org/10.48713/10336_10555
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/10555
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de medicinaspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto completo)spa
dc.rights.ccAtribución-NoComercial-SinDerivadas 2.5 Colombiaspa
dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectpoliautoinmunidadspa
dc.subjectlupus eritematoso sistémicospa
dc.subjectenfermedad tiroidea autoimmunespa
dc.subjectanticuerpos tiroideos.spa
dc.subject.ddcEnfermedades
dc.subject.decsEpidemiologíaspa
dc.subject.decsEnfermedades de la tiroidesspa
dc.subject.decsGlándula tiroidesspa
dc.subject.decsLupus eritematoso sistémicospa
dc.subject.keywordpolyautoimmunityeng
dc.subject.keywordsystemic lupus erythematosuseng
dc.subject.keywordautoimmune thyroid diseaseeng
dc.subject.keywordthyroid autoantibodieseng
dc.titleEnfermedad tiroidea autoinmune en pacientes colombianos con lupus eritematoso sistémicospa
dc.typebachelorThesiseng
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de gradospa
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