溶解素E1、可诱导共刺激分子、载脂蛋白A-IV在甲状腺功能减退症患者血清中的表达及相关性

Expression and correlation of resolvin E1,inducible costimulator,and apolipoprotein A-IV in serum of patients with hypothyroidism

目的探究甲状腺功能减退症(甲减)患者血清中溶解素E1(RvE1)、可诱导共刺激分子(ICOS)、载脂蛋白A-IV(Apo-AIV)表达水平,并分析其与疾病的相关性。方法选择2023年5月-2024年5月本院收治的234例甲减患者作为甲减组,另选同期240名甲状腺功能正常体检者作为对照组。依据垂体促甲状腺激素(TSH)及游离甲状腺素(FT4)水平将甲减组分为亚临床甲减组(103例)及临床甲减组(131例)。采用酶联免疫吸附法(ELISA)检测血清RvE1、ICOS、Apo-AIV水平,比较不同类型甲减患者甲状腺激素及血清RvE1、ICOS、Apo-AIV水平,采用Pearson法相关性分析血清RvE1、ICOS、Apo-AIV水平与甲状腺激素水平的相关性,采用多因素Logistic回归分析甲减发生的影响因素,采用受试者工作特征(ROC)曲线分析血清RvE1、ICOS、Apo-AIV水平对甲减的诊断价值。结果甲减组血清RvE1水平及游离三碘甲状腺原氨酸(FT3)、FT4水平低于对照组,血清ICOS、Apo-AIV水平及TSH水平高于对照组(P<0.05);亚临床甲减组患者血清RvE1水平及FT3、FT4水平高于临床甲减组,血清ICOS、Apo-AIV水平及TSH水平低于临床甲减组(P<0.05);血清RvE1水平与FT3、FT4水平正相关,与TSH水平负相关,血清ICOS、Apo-AIV水平与FT3、FT4水平负相关,与TSH水平正相关(P<0.05);血清RvE1(95%CI=0.464~0.692)、ICOS(95%CI=2.772~35.012)、Apo-AIV(95%CI=2.977~13.154)水平及FT3(95%CI=0.623~0.966)、FT4(95%CI=0.448~0.921)、TSH(95%CI=1.827~14.701)水平是甲减发生的影响因素(P<0.05);血清RvE1、ICOS、Apo-AIV水平联合诊断甲减发生的曲线下面积(AUC)高于血清RvE1水平单独诊断的AUC(Z=2.601,P=0.009),高于血清ICOS水平单独诊断的AUC(Z=7.638,P<0.05),高于血清Apo-AIV水平单独诊断的AUC(Z=5.391,P<0.05)。结论甲减患者血清RvE1水平降低,血清ICOS、Apo-AIV水平升高,与甲状腺激素水平相关,联合诊断甲减的价值较高。

Objective To investigate the expression levels of resolvin E1(RvE1),inducible costimulator(ICOS),and apolipoprotein A-IV(Apo-AIV)in the serum of patients with hypothyroidism,and analyze their correlation with the disease.Methods A total of 234 patients with hypothyroidism admitted to our hospital from May 2023 to May 2024 were selected as the hypothyroidism group,and 240 individuals with normal thyroid function served as the control group.Based on the levels of thyroid-stimulating hormone(TSH)and free thyroxine(FT4),the hypothyroidism group was divided into subclinical hypothyroidism group(103 cases)and clinical hypothyroidism group(131 cases).Enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of RvE1,ICOS,and Apo-AIV.The levels of thyroid hormones and serum RvE1,ICOS,and Apo-AIV were compared between patients with different types of hypothyroidism.Pearson's correlation method was used to analyze the correlation between serum RvE1,ICOS,Apo-AIV levels and thyroid hormone levels.Multivariate logistic regression was used to analyze the influencing factors of hypothyroidism occurrence.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum RvE1,ICOS,and Apo-AIV levels for hypothyroidism.Results The serum levels of RvE1,free triiodothyronine(FT3),and FT4 in the hypothyroidism group were lower than those in the control group,while the serum levels of ICOS,Apo-AIV,and TSH were higher than those in the control group(P<0.05).The serum levels of RvE1,FT3,and FT4 in the subclinical hypothyroidism group were higher than those in the clinical hypothyroidism group,while the serum levels of ICOS,Apo-AIV,and TSH were lower than those in the clinical hypothyroidism group(P<0.05).Serum RvE1 levels were positively correlated with FT3 and FT4 levels,and negatively correlated with TSH levels,while serum ICOS and Apo-AIV levels were negatively correlated with FT3 and FT4 levels,and positively correlated with TSH levels(P<0.05).The levels of serum RvE1(95%CI=0.464~0.692),ICOS(95%CI=2.772~35.012),Apo-AIV(95%CI=2.977~13.154),FT3(95%CI=0.623~0.966),FT4(95%CI=0.448~0.921),and TSH(95%CI=1.827~14.701)were influencing factors for the occurrence of hypothyroidism(P<0.05).The combination of serum RvE1,ICOS,and Apo-AIV levels in the diagnosis of hypothyroidism resulted in a higher area under the curve(AUC)than serum RvE1 levels alone(Z=2.601,P=0.009),serum ICOS levels alone(Z=7.638,P<0.05),and serum Apo-AIV levels alone(Z=5.391,P<0.05).Conclusions Serum RvE1 levels in patients with hypothyroidism are decreased,while serum ICOS and Apo-AIV levels are increased,and these are correlated with thyroid hormone levels.The value of combined diagnosis for hypothyroidism is high.