血清25(OH)D、MCP-1与甲状腺功能正常桥本甲状腺炎患者轻度认知功能障碍的关系研究

Study on the Relationship between Serum 25(OH)D,MCP-1 and Mild Cognitive Impairment in Patients with Hashimoto's Thyroiditis with Normal Thyroid Function

目的:探讨血清25羟维生素D[25(OH)D]、巨噬细胞炎症蛋白-1(MCP-1)与甲状腺功能正常桥本甲状腺炎(HT)患者轻度认知功能障碍(MCI)的关系,以期为甲状腺功能正常的HT患者发生MCI提供辅助预测指标。方法:选取2021年1月~2023年5月重庆大学附属三峡医院收治的甲状腺功能正常HT患者167例为HT组,另选取同期体检健康志愿者87例为对照组,根据是否发生MCI将甲状腺功能正常HT患者分为MCI组(n=71)和非MCI组(n=96)。采用酶联免疫吸附法检测血清25(OH)D、MCP-1水平。建立多因素Logistic回归模型分析甲状腺功能正常HT患者MCI的影响因素,绘制受试者工作特征(ROC)曲线分析血清25(OH)D、MCP-1水平对甲状腺功能正常HT患者MCI的预测价值。结果:与对照组比较,HT组血清25(OH)D水平降低,MCP-1水平升高(P<0.05)。167例甲状腺功能正常HT患者MCI发生率为42.51%(71/167)。多因素Logistic回归分析显示,甲状腺过氧化物酶抗体(TPOAb)升高、MCP-1升高为影响甲状腺功能正常HT患者MCI的独立危险因素,25(OH)D升高为独立保护因素(P<0.05)。ROC曲线分析显示,血清25(OH)D联合MCP-1预测甲状腺功能正常HT患者MCI的曲线下面积为0.892,大于血清25(OH)D、MCP-1单独预测的0.785、0.770。结论:甲状腺功能正常HT患者血清25(OH)D水平降低和MCP-1水平升高与MCI发生密切相关,血清25(OH)D、MCP-1联合预测甲状腺功能正常HT患者MCI的价值较高。

Objective:To investigate the relationship between serum 25 hydroxyvitamin D[25(OH)D],macrophage inflammatory protein-1(MCP-1)and mild cognitive impairment(MCI)in patients with Hashimoto's thyroiditis(HT)with normal thyroid function,in order to provide auxiliary predictive indicators for the occurrence of MCI in HT patients with normal thyroid function.Methods:167 HT patients with normal thyroid function who were admitted to the Three Gorges Hospital affiliated to Chongqing University from January 2021 to May 2023 were selected as HT group,another 87 healthy volunteers who underwent physical examination during the same period were selected as control group,HT patients with normal thyroid function were divided into MCI group(n=71)and non-MCI group(n=96)according to whether the occurrence of MCI.Serum 25(OH)D and MCP-1 levels were detected by enzyme-linked immunosorbent assay.The factors affecting MCI in HT patients with normal thyroid function were analyzed by established multivariate Logistic regression model,the predictive value of serum 25(OH)D and MCP-1 levels for MCI in HT patients with normal thyroid function were analyzed by drawn receiver operating characteristic(ROC)curve.Results:Compared with control group,the serum 25(OH)D level in HT group was decreased,and the MCP-1 level was increased(P<0.05).The incidence of MCI in 167 HT patients with normal thyroid function was 42.51%(71/167).Multivariate Logistic regression analysis showed that,elevated thyroid peroxidase antibody(TPOAb)and elevated MCP-1 were independent risk factors for MCI in HT patients with normal thyroid function,and elevated 25(OH)D was an independent protective factor(P<0.05).ROC curve analysis showed that,the area under the curve of serum 25(OH)D combined with MCP-1 in predicting MCI in HT patients with normal thyroid function was 0.892,which was greater than 0.785 and 0.770 predicted by serum 25(OH)D and MCP-1 alone.Conclusion:The decrease of serum 25(OH)D level and the increase of MCP-1 level in HT patients with normal thyroid function are closely relate to the occurrence of MCI,the combination of serum 25(OH)D and MCP-1 has a higher value in predicting MCI in HT patients with normal thyroid function.