斑秃与甲状腺疾病及其相关指标相关性的荟萃分析

A meta-analysis of the correlation between alopecia areata and thyroid disease and related indicators

目的探讨斑秃与甲状腺疾病及相关指标的关系。方法检索万方数据库、中国知网、CBM、维普网、SCIE、PubMed,检索范围为1989年4月至2019年4月,选择符合纳入及排除标准的相关文献,质量评价后运用R软件进行分析,明确斑秃与甲状腺疾病及甲状腺自身抗体、甲状腺功能的相关性。结果共纳入18篇文献,斑秃组268713例,对照组1345687例。荟萃分析结果显示斑秃与以下疾病及指标相关:桥本甲状腺炎1.21(1.13-1.29),格雷夫斯病1.53(1.43-1.63),抗甲状腺过氧化物酶抗体(TPOAb)4.39(2.75-7.01),抗甲状腺球蛋白抗体(TGAb)2.82(1.45-5.47),四碘甲状素原氨酸(T4)升高2.92(1.15-7.43);斑秃与以下疾病及指标不相关:甲状腺功能亢进(甲亢)0.47(0.16-1.41)、甲状腺功能减退(甲减)1.86(0.63-5.51)、三碘甲状素原氨酸(T3)升高2.00(0.64-6.27)、促甲状腺激素(TSH)升高1.07(0.56-2.04);T4下降、T3下降、THS下降的研究仅纳入一例,未进行荟萃分析。结论斑秃与桥本甲状腺炎、格雷夫斯病、TPOAb、TGAb、T4升高相关;与甲亢、甲减、T3升高、TSH升高不相关。

Objective To explore the correlation between alopecia areata and thyroid diseases and related indicators.Methods Literature published from April 1989 to April 2019 was retrieved via a literature search of Wanfang Database,CNKI,CBM,VIP,SC IE and Pub Med.The relevant literatures,which met the inclusion and exclusion criteria,were selected.After quality evaluation,R software was used to analyze the correlation between alopecia areata and thyroid disease,thyroid autoantibodies,and thyroid function.Results A total of 18 papers were included,involving 268713 patients with alopecia areata and 1345687 people without alopecia areata.Meta-analysis results showed that alopecia areata was correlated with the following diseases and indicators:Hashimoto’s thyroiditis 1.21(1.13,1.29),Graves’disease 1.53(1.43,1.63),thyroid peroxidase antibody(TPOAb)4.39(2.75,7.01),thyroglobulin antibody(TGAb)2.82(1.45,5.47),increased thyroxine(T4)2.92(1.15,7.43);alopecia areata was uncorrelated with the following diseases and indicators:hyperthyroidism 0.47(0.16,1.41),hypothyroidism 1.86(0.63,5.51),increased triiodothyronine(T3)2.00(0.64,6.27),increased thyroid stimulating hormone(TSH)1.07(0.56,2.04).There was only one included case with declined T4,T3 and TSH,thus no metaanalysis was conducted.Conclusion Alopecia areata was associated with Hashimoto’s thyroiditis,Graves’disease,TPOAb,TGAb,and increased T4.It was not related to hyperthyroidism,hypothyroidism,increased T3 and increased TSH.