确诊时的TSH受体抗体水平在年轻Graves病患者中能更好地预测病情和复发风险

TRAbs at diagnosis may better predict disease severity and relapse in younger patients with Graves′ disease

TSH受体抗体(TRAb)是Graves病的致病性抗体。TRAb水平与Graves病的严重程度有关,并且是Graves病复发的预测因子。但是目前仍不清楚哪些因素可能影响TRAb与甲状腺激素水平和Graves病复发风险的相关性。2018年12月The Journal of Clinical Endocrinology & Metabolism杂志在线发表了1篇文章[Bano A, Gan E, Addison C, et al. Age may influence the impact of TRAbs on thyroid function and relapse-risk in patients with Graves′ disease. J Clin Endocrinol Metab, 2019,104(5):1378-1385. DOI: 10.1210/jc.2018-01738]。在获得原文杂志授权同意后,对该文进行中文编译。该文研究了Graves病患者诊断时TRAb水平与甲状腺激素和疾病复发风险之间的相关性,以及影响这种相关性的潜在因素。结果显示,基线TRAb水平与血清甲状腺激素水平和Graves病复发风险呈正相关;年龄会影响其相关性,但性别、种族、吸烟和甲状腺过氧化物酶抗体水平不会影响二者的关系。该研究表明就甲状腺激素水平和Graves病复发风险而言,诊断时的TRAb水平在年轻患者中可能比在老年患者中具有更好的预测价值。

Thyrotropin receptor antibodies (TRAbs) are pathognomonic for Graves′ disease. Previous studies have linked serum titers of TRAbs to severity of Graves′ disease and likelihood of Graves′ disease relapse. However, we know little about factors that may be involved in the impact of TRAbs on Graves′ disease patients. In December 2018," The Journal of Clinical Endocrinology & Metabolism" online published an article [Bano A, Gan E, Addison C, et al. Age may influence the impact of TRAbs on thyroid function and relapse-risk in patients with Graves′ disease. J Clin Endocrinol Metab, 2019, 104(5): 1378-1385. DOI: 10.1210/jc.2018-01738]. With the permission of the original journal, we translated the article into Chinese. This article aimed to investigate the association of TRAbs at diagnosis with thyroid hormones and risk of relapse, and to study the influencing factors on these associations. The results showed that TRAbs at diagnosis were positively associated with circulating thyroid hormone levels and risk of relapse, and these associations were influenced by age, but not by sex, race, smoking or thyroid peroxidase antibody levels. This study indicates TRAbs at diagnosis can better predict severity of elevated thyroid hormone levels and risk of relapse in younger patients with Graves′ disease.