食物特异性IgG抗体与桥本甲状腺炎相关性的研究

Correlation between food specific IgG antibody and Hashimoto thyroiditis

目的探讨食物特异性IgG抗体与桥本甲状腺炎(Hashimoto thyroiditis,HT)之间的相关性,为桥本甲状腺炎的诊治提供新的思路。方法选取2022年6月—2022年9月在同济大学附属杨浦医院确诊为桥本甲状腺炎患者96例为HT组,依据血清甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)增高程度分为轻(TPOAb≤100 IU/mL)、中(TPOAb 101300 IU/mL)、高(TPOAb>300 IU/mL)共3组,每组32例,并选取同时期甲状腺功能正常的健康体检者30名为对照组,对4组人员分别进行14种常见食物的特异性IgG抗体检测,对比各组之间食物特异性IgG抗体的表达情况以及不同TPOAb组中IgG抗体滴度的情况,并分析异常增高的食物特异性IgG抗体与TPOAb的相关性。结果HT组中鸡蛋的IgG抗体滴度明显高于对照组(Z=1.604,P=0.012);TPOAb轻、中、高度增高组及对照组食物特异性IgG抗体的表达情况(阳性例数/检测例数)分别为(19/32、25/32、24/32、11/30),HT组中共发现有12种食物的特异性IgG抗体阳性,其中鸡蛋的发生率最高为58.3%(56/96),其次为蘑菇(8/96)、小麦(7/96)、牛奶(5/96)、大豆(6/96)、玉米(6/96)等。食物特异性IgG抗体检测阳性率HT组为70.8%(68/96),对照组为36.7%(11/30),两组对比差异有统计学意义(χ^(2)=11.409,P=0.001),中、高度增高组与对照组比较食物特异性IgG抗体阳性发生率差异有统计学意义。HT组中食物IgG抗体阳性与阴性组之间性别、年龄差异均无统计学意义(P=0.796、0.413);在HT各组中鸡蛋IgG抗体滴度有较大差异,TPOAb高、中、轻度增高组分别为[113.1(38.69,211.4)U/mL、48.47(31.44,84.62)U/mL、57.1(11.73,118.2)U/mL],高度增高组与后两组比较差异均有统计学意义(P=0.038、0.019);鸡蛋IgG抗体滴度与TPOAb呈弱正相关(r=0.235,P=0.021)。结论在桥本甲状腺炎患者中存在多种食物特异性IgG抗体增高的现象;食物特异性IgG抗体滴度增高的发生率在TPOAb中、高度增高组中明显高于对照组,其中鸡蛋特异性IgG抗体与桥本甲状腺炎具有相关性;食物特异性IgG抗体反映了桥本甲状腺炎患者甲状腺受损的程度,可能是HT发病的因素之一。

Objective To investigate the correlation between food-specific IgG antibody and Hashimoto thyroiditis(HT).Methods Ninety-six patients with Hashimoto thyroiditis diagnosed in our hospital from June 2022 to September 2022 were enrolled.According to the increased levels of thyroid peroxidase antibody(TPOAb),patients were divided into mild(TPOAb≤100 IU/mL),moderate(TPOAb 101300 IU/mL)and high TPOAb groups(TPOAb>300 IU/mL).Thirty healthy subjects with normal thyroid function were selected as the control group.The specific IgG antibodies of 14 common foods were detected and compared among 4 groups.The correlation between food-specific IgG antibody and TPOAb levels was analyzed.Results The IgG antibody titer of eggs in HT group was significantly higher than that in control group(Z=1.604,P=0.012).The positive rate of food-specific IgG antibodies in mild,moderate and high TPOAb groups and the control group were(19/32,25/32,24/32,11/30),respectively.A total of 12 food-specific IgG antibodies was detected in HT group.The positive rate of specific IgG antibodies of eggs was the highest(58.3%,56/96),followed by that of mushrooms(8/96),wheat(7/96),milk(5/96),soybean(6/96)and corn(6/96).The positive rate of food-specific IgG antibody in HT group was significantly higher than that in the control group[70.8%(68/96)vs 36.7%(11/30),χ^(2)=11.409,P=0.001].There were significant differences in the positive rate of food-specific IgG antibody among the medium TPOAb group,high TPOAb group and the control group.In the HT group there was no significant difference in gender and age distribution between the positive and negative food IgG antibody groups(P=0.796,0.413).The IgG antibody titers of eggs in HT groups were significantly different between high group and moderate/mild TPOAb groups[113.1(38.69,211.4)U/mL,48.47(31.44,84.62)U/mL and 57.1(11.73,118.2)U/mL,respectively,P=0.038 and 0.019].The egg IgG antibody titer was correlated with TPOAb level(r=0.235,P=0.021).Conclusion In Hashimoto thyroiditis patients the positive rate of food-specific IgG antibodies is increased.The titer of food-specific IgG antibody in HT patients is significantly higher than that in control group,and egg-specific IgG antibody is correlated with TPOAb in HT patients.Food-specific IgG antibody may be one of the factors related to HT development and may reflect the extent of thyroid damage in HT patients.