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Latent Autoimmune Thyroid Disease

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Rodríguez Velandia, Yhojan Alexis
Rojas Quintana, Manuel Eduardo
Monsalve Carmona, Diana Marcela
Acosta Ampudia, Yeny Yasbleidy
Pacheco Nieva, Yovana
Rodríguez Jiménez, Mónica María del Pilar
Ramírez Santana, Heily Carolina
Anaya, Juan-Manuel

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2020

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Elsevier

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Resumen
Objetivo Determinar la prevalencia de autoanticuerpos tiroideos y los factores asociados en sujetos eutiroideos. Métodos Se incluyeron 300 sujetos eutiroideos, elegidos por muestreo estratificado de una cohorte inicial de 1335 individuos. La función tiroidea se evaluó midiendo los niveles séricos de TSH (0.3–4.5 ?IU / mL) y FT4 (5.2–12.7?g / dL). Los anticuerpos anti-peroxidasa (TPOAbs), anti-tiroglobulina (TgAbs) y anti-receptor de TSH (TrAbs) se evaluaron con 23 autoanticuerpos adicionales, así como con niveles de vitamina D (VitD). El análisis incluyó características sociodemográficas, clínicas y ambientales. Los datos se analizaron mediante pruebas bivariadas y multivariadas. Resultados Se observó autoinmunidad tiroidea en el 15,3% de los sujetos (TPOAbs 11,3% y TgAbs 2,0%). En seis individuos, ambos autoanticuerpos fueron positivos. Los TrAbs no se detectaron en ningún individuo. Enfermedad tiroidea familiar (? = 3.4, IC 95%: 1.2–9.5, P = 0.021), la presencia de otras enfermedades autoinmunes (? = 10.8, IC 95%: 1.6–72.9, P = 0.014) Insuficiencia de VitD ( P = 0.030), nunca fume (? = 6.9, IC 95%: 1.6–30.4, P = 0.010), beba más de 4 tazas de café (? = 3.8, IC 95%: 1.1–13.1, P = 0.036), y un mayor número de años expuestos al humo de leña ( P = 0.04) se asociaron con autoinmunidad tiroidea. En el caso de TPOAbs, enfermedad de tiroides familiar (CI ? = 4,9, 95%: 1,7 a 14,0, P = 0,003), nunca fume (? = 5,7, IC 95%: 1,4 a 21,0, P = 0.002), y beber más de 4 tazas de café (? = 3.6, IC 95%: 1.1–13.1, P = 0.047) se asociaron con su positividad. Además, la presencia de anti – SS – A / Ro52 (? = 36.7, IC 95%: 2.5–549.9, P = 0.009) y anticuerpos anti-Ku (? = 10.2, IC 95%: 1.1–100.7, P = 0.046) también se asoció con TPOAbs. La presencia de ascendencia africana (? = 10.5, IC 95%: 1.7–63.2, P = 0.01), anti – SS – A / Ro52 (? = 15.8, IC 95%: 1.2–198.6, P = 0,03), y los anticuerpos anti-CENP-B (? = 31,2, IC 95%: 1,8 a 565,9 P = 0,02) se asociaron con TgAbs. Conclusión La autoinmunidad tiroidea latente no es rara. Los factores ambientales, genéticos e inmunológicos, así como los ancestros, son factores de riesgo asociados. Estos resultados facilitarían la implementación de estrategias de detección para proporcionar un diagnóstico y tratamiento oportunos.
Abstract
Objective To determine the prevalence of thyroid autoantibodies and the associated factors in euthyroid subjects. Methods 300 euthyroid subjects, chosen by stratified sampling from an inception cohort of 1335 individuals, were included. Thyroid function was evaluated by measuring the serum levels of TSH (0.3–4.5 ?IU/mL) and FT4 (5.2–12.7?g/dL). Anti-peroxidase (TPOAbs), anti-thyroglobulin (TgAbs), and anti-TSH receptor (TrAbs) antibodies were evaluated with 23 additional autoantibodies as well as vitamin D (VitD) levels. The analysis included sociodemographic, clinical, and environmental characteristics. Data were analyzed by bivariate and multivariate tests. Results Thyroid autoimmunity was observed in 15.3% of the subjects (TPOAbs 11.3% and TgAbs 2.0%). In six individuals, both autoantibodies were positive. TrAbs were not detected in any individual. Familial thyroid disease (? ?= ?3.4, 95% CI: 1.2–9.5, P ?= ?0.021), the presence of other autoimmune diseases (? ?= ?10.8, 95% CI: 1.6–72.9, P ?= ?0.014) VitD insufficiency (P ?= ?0.030), never smoke (? ?= ?6.9, 95% CI: 1.6–30.4, P ?= ?0.010), drinking more than 4 cups of coffee (? ?= ?3.8, 95% CI: 1.1–13.1, P ?= ?0.036), and a higher number of years exposed to wood smoke (P ?= ?0.04) were associated with thyroid autoimmunity. In the case of TPOAbs, familial thyroid disease (? ?= ?4.9, 95% CI: 1.7–14.0, P ?= ?0.003), never smoke (? ?= ?5.7, 95% CI: 1.4–21.0, P ?= ?0.002), and drinking more than 4 cups of coffee (? ?= ?3.6, 95% CI: 1.1–13.1, P ?= ?0.047) were associated with their positivity. In addition, the presence of anti–SS–A/Ro52 (? ?= ?36.7, 95% CI: 2.5–549.9, P ?= ?0.009) and anti-Ku antibodies (? ?= ?10.2, 95% CI: 1.1–100.7, P ?= ?0.046) was also associated with TPOAbs. The presence of African ancestry (? ?= ?10.5, 95% CI: 1.7–63.2, P ?= ?0.01), anti–SS–A/Ro52 (? ?= ?15.8, 95% CI: 1.2–198.6, P ?= ?0.03), and anti-CENP-B antibodies (? ?= ?31.2, 95% CI: 1.8–565.9 ?P ?= ?0.02) were associated with TgAbs. Conclusion Latent thyroid autoimmunity is not rare. Environmental, genetic, and immunological factors as well as ancestry are associated risk factors. These results would facilitate the implementation of screening strategies in order to provide timely diagnosis and treatment.
Palabras clave
Eutiroidismo , Autoanticuerpos anti peroxidasa , Autoanticuerpos anti-tiroglobulina , Enfermedad tiroidea autoinmune , Autoinmunidad latente
Keywords
Medical and Health Sciences , Immunology , Euthyroidism , Anti-peroxidase autoantibodies , Anti-thyroglobulin autoantibodies , Autoimmune thyroid disease , Latent autoimmunity
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