山东沿海地区碘营养状况和HLA等位基因DRB1*0301、DQB1*0602对自身免疫性甲状腺疾病发病的影响

The influence of iodine nutrition status and HLA-DRB1*0301、and DQB1*0602 alleles on the pathogenesis of autoimmune thyroid diseases in Shandong coastal area

目的 将山东沿海地区碘营养状况和HLA DRB1 0 3 0 1、DQB1 0 60 2等位基因等因素结合起来分析 ,观察它们对自身免疫性甲状腺疾病 (AITDs)发病的影响。方法 应用多聚酶链反应 序列特异性引物 (PCR SSP)技术 ,对已确诊的Graves病 (GD) 90例 ,桥本甲状腺炎 (HT) 43例和正常对照 90例 ,扩增其HLA等位基因DRB1 0 3 0 1、DQB1 0 60 2的目的DNA片段。同时采用国家标准化方法砷铈催化分光光度法测定不同人群尿碘浓度。结果 山东沿海地区GD和HT患者尿碘中位数显著高于对照组 (P <0 .0 5 )。GD和HT组尿碘浓度高于 3 0 0 μg/L者分布频率均显著高于对照组 (P <0 .0 5 )。DRB1 0 3 0 1( -)GD、HT患者尿碘中位数显著高于DRB1 0 3 0 1( -)的对照组 (P<0 .0 5 ) ;DQB1 0 60 2 ( +)GD、HT患者尿碘中位数显著高于DQB1 0 60 2 ( +)的对照组 (P <0 .0 5 )。多因素logistic回归分析发现尿碘浓度对数、DRB1 0 3 0 1与GD、HT的发病呈正相关 ,DQB1 0 60 2与GD、HT的发病呈负相关。结论 该地区GD、HT患者的碘摄入量偏高 ;碘和HLA等位基因DRB1 0 3 0 1、DQB1 0 60 2共同影响GD。

Objective To investigate the influence of iodine nutrition status and HLA- DRB1*0301、and DQB1*0602 alleles on the pathogenesis of autoimmune thyroid diseases in Shandong coastal area.Methods The HLA- DRB1*0301 and DQB1*0602 alleles were detected by polymerase chain reaction with sequence-specific primers(PCR-SSP) in 90 patients with GD and 43 patients with HT,as well as 90 health controls.The urine iodine concentration was determined by national standard method.Results The median value of urinary iodine of GD and HT patients was significantly higher than that of control group in Shandong seashore areas (P<0.05).In the subjects of DRB1*0301 allele (-),the median value of urinary iodine in GD and HT patients with hyperthyroidism was significantly higher than that in control group(P<0.05).In the subjects of DQB1*0602(+),the median value of urinary iodine in GD and HT patients was significantly higher than that in control group (P<0.05).The logarithm of urinary iodine and DRB1*0301 were positive correlated with GD and HT by multiple Logistic regression analysis;DQB1*0602 was negative correlated with GD and HT.Conclusion The intake of iodine was higher among the patients of GD and HT in this area.Iodine,HLA-DRB1*0301 and DQB1*0602 allele have cooperative effect on the pathogenesis of GD and HT.