可溶性晚期糖基化终产物受体、白细胞介素-36γ在桥本甲状腺炎患者血清中的表达及意义

Expression and significance of soluble receptor for advanced glycation end products and interleukin-36γin serum of patients with Hashimoto′s thyroiditis

目的探讨可溶性晚期糖基化终产物受体(sRAGE)、白细胞介素-36γ(IL-36γ)在桥本甲状腺炎(HT)患者血清中的表达及其临床意义。方法选取180例疑似HT人员作为研究对象,根据最终诊断结果分为HT组137例和非HT组43例。依据血清免疫球蛋白G4(IgG4)水平,将HT组患者进一步分为IgG4相关性HT组(IgG4≥135 mg/dL)和非IgG4相关性HT组(IgG4<135 mg/dL)。采用酶联免疫吸附试验(ELISA)法检测所有研究对象的血清sRAGE、IL-36γ水平;绘制受试者工作特征(ROC)曲线,分析血清sRAGE、IL-36γ水平对HT及其IgG4表型的诊断价值。结果HT组患者血清sRAGE水平低于非HT组,血清IL-36γ水平高于非HT组,差异有统计学意义(P<0.001);IgG4相关性HT组患者血清sRAGE水平低于非IgG4相关性HT组,血清IL-36γ水平高于非IgG4相关性HT组,差异有统计学意义(P<0.001)。ROC曲线分析结果显示,血清sRAGE、IL-36γ联合诊断HT的曲线下面积(AUC)为0.900(95%CI:0.846~0.939),诊断效能显著高于两者单独诊断(P<0.05);血清sRAGE、IL-36γ联合诊断HT患者IgG4表型的AUC为0.897(95%CI:0.934~0.943),诊断效能显著高于两者单独诊断(P<0.05)。结论HT患者血清sRAGE水平显著降低,血清IL-36γ水平显著升高,联合检测血清sRAGE、IL-36γ水平可有效诊断HT并评估IgG4表型。

Objective To explore expression and significance in serum levels of soluble receptor for advanced glycation end products(sRAGE)and interleukin-36(IL-36)in patients with Hashimoto′s thyroiditis(HT).Methods A total of 180 individuals suspected of HT were enrolled as study subjects and divided into HT group(n=137)and non-HT group(n=43)based on final diagnostic outcomes.Within the HT group,patients were further divided into serum immunoglobulin G4(IgG4)-related HT group(IgG4≥135 mg/dL)and non-IgG4-related HT group(IgG4<135 mg/dL)according to serum IgG4 levels.Serum levels of sRAGE and IL-36γwere measured in all subjects using enzyme-linked immunosorbent assay(ELISA).Receiver operating characteristic(ROC)curves were used to analyze the diagnostic value of serum sRAGE and IL-36γlevels forHT and its IgG4 phenotype.Results Serum sRAGE levels were significantly lower in the HT group compared to the non-HT group,while serum IL-36γlevels were significantly higher(P<0.001).Patients in the IgG4-related HT group had significantly lower serum sRAGE levels and higher serum IL-36γlevels compared to those in the non-IgG4-related HT group(P<0.001).ROC curve analysis revealed that the combined diagnosis of serum sRAGE and IL-36γfor HT had an area under the curve(AUC)of 0.900(95%CI,0.846 to 0.939),demonstrating significantly higher diagnostic efficiency than either indicator(P<0.05).For the IgG4 phenotype in HT patients,the combined AUC of serum sRAGE and IL-36γwas 0.897(95%CI,0.934 to 0.943),which also significantly higher than individual indicator(P<0.05).Conclusion Serum sRAGE levels are significantly decreased,while serum IL-36γlevels are significantly increased in HT patients.Combined detection of serum sRAGE and IL-36γlevels can effectively diagnose HT and assess the IgG4 phenotype.