白细胞介素6在低密度脂蛋白胆固醇与甲状腺相关性眼病关联中发挥中介效应

Interleukin-6 mediates the association of low density lipoprotein-cholesterol with thyroid associated ophthalmopathy

目的探究炎症因子在低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)和甲状腺相关性眼病(thyroid associated ophthalmopathy,TAO)关联中的中介效应。方法本研究为前瞻性研究,共纳入2021年1月至2022年6月于郑州大学第一附属医院内分泌科就诊的格雷夫斯病(Graves病)患者共86例,其中Graves病伴TAO患者56例,包括非活动期组30例,活动期组26例;单纯Graves病患者30例。使用二元logistic回归分析LDL-C、炎症因子与TAO发病及活动性之间的关系。采用中介分析方法探究炎症因子在LDL-C与TAO发病及活动性关联中的中介效应。结果白细胞介素(interleukin,IL)-6是介导LDL-C与TAO发病关联的潜在中介:LDL-C对TAO具有直接影响(总效应值=0.274,95%CI 0.161~0.386),IL-6(中介效应值=0.067,95%CI 0.011~0.123)、IL-17(中介效应值=0.042,95%CI 0.007~0.077)部分介导了LDL-C对TAO的影响,中介效应量分别为24.45%、15.33%。IL-6是介导LDL-C与TAO活动性关联的潜在中介:LDL-C对TAO活动性具有直接影响(总效应值=0.320,95%CI 0.204~0.435),IL-6(中介效应值=0.103,95%CI 0.021~0.185)部分介导了LDL-C对TAO活动性的影响,中介效应量为32.19%。结论IL-6在LDL-C与TAO发病及活动性关联中发挥部分中介效应。

Objective To investigate the mediating effect of inflammatory factors in the association between low density lipoprotein-cholesterol(LDL-C)and thyroid associated ophthalmopathy(TAO).Methods This study was a prospective study,which icluded a total of 86 patients with Graves′disease who attended the Department of Endocrinology of the First Affiliated Hospital of Zhengzhou University from January 2021 to June 2022.Among them,there were 56 patients with Graves′disease accompanied by TAO,including 30 cases in the inactive group and 26 in the active group.Additionally,there were 30 cases having Graves′disease alone.The relationship between LDL-C,inflammatory factors,and the onset and activity of TAO were analyzed using binary logistic regression.Mediation analysis was used to explore the mediating effect of inflammatory factors in the association between LDL-C and TAO onset and activity.Results Interleukin(IL)-6 was a potential mediator that linking the association between LDL-C and TAO onset:LDL-C had a direct effect on TAO(Total effect value=0.274,95%CI 0.161-0.386),while IL-6(mediated effect=0.067,95%CI 0.011-0.123)and IL-17(mediated effect=0.042,95%CI 0.007-0.077)partially mediated the effect of LDL-C on TAO,accounting for 24.45%and 15.33%of the total effect,respectively.IL-6 was a potential mediator of the association between LDL-C and TAO activity:LDL-C had a direct effect on TAO activity(Total effect value=0.320,95%CI 0.204-0.435),and IL-6(mediated effect=0.103,95%CI 0.021-0.185)partially mediated the effect of LDL-C on TAO activity,with a mediation effect of 32.19%.Conclusion IL-6 plays a partiall mediating role in the association of LDL-C with TAO onset and activity.