Association of autoimmune thyroid disease with type 1 diabetes mellitus and its ultrasonic diagnosis and management

As a common hyperglycemic disease,type 1 diabetes mellitus(T1DM)is a complicated disorder that requires a lifelong insulin supply due to the immunemediated destruction of pancreaticβcells.Although it is an organ-specific autoimmune disorder,T1DM is often associated with multiple other autoimmune disorders.The most prevalent concomitant autoimmune disorder occurring in T1DM is autoimmune thyroid disease(AITD),which mainly exhibits two extremes of phenotypes:hyperthyroidism[Graves'disease(GD)]and hypothyroidism[Hashimoto's thyroiditis,(HT)].However,the presence of comorbid AITD may negatively affect metabolic management in T1DM patients and thereby may increase the risk for potential diabetes-related complications.Thus,routine screening of thyroid function has been recommended when T1DM is diagnosed.Here,first,we summarize current knowledge regarding the etiology and pathogenesis mechanisms of both diseases.Subsequently,an updated review of the association between T1DM and AITD is offered.Finally,we provide a relatively detailed review focusing on the application of thyroid ultrasonography in diagnosing and managing HT and GD,suggesting its critical role in the timely and accurate diagnosis of AITD in T1DM.

Autoimmune hepatitis-primary biliary cholangitis overlap syndrome complicated by various autoimmune diseases:A case report

BACKGROUND Autoimmune hepatitis(AIH)and primary biliary cholangitis(PBC)are two common clinical autoimmune liver diseases,and some patients have both diseases;this feature is called AIH-PBC overlap syndrome.Autoimmune thyroid disease(AITD)is the most frequently overlapping extrahepatic autoimmune disease.Immunoglobulin(IgG)4-related disease is an autoimmune disease recognized in recent years,characterized by elevated serum IgG4 levels and infiltration of IgG4-positive plasma cells in tissues.CASE SUMMARY A 68-year-old female patient was admitted with a history of right upper quadrant pain,anorexia,and jaundice on physical examination.Laboratory examination revealed elevated liver enzymes,multiple positive autoantibodies associated with liver and thyroid disease,and imaging and biopsy suggestive of pancreatitis,hepatitis,and PBC.A diagnosis was made of a rare and complex overlap syndrome of AIH,PBC,AITD,and IgG4-related disease.Laboratory features improved on treatment with ursodeoxycholic acid,methylprednisolone,and azathioprine.CONCLUSION This case highlights the importance of screening patients with autoimmune diseases for related conditions.

Enzyme-linked immunosorbent assay of 3 Screen Islet Cell Autoantibody in patients with autoimmune thyroid disease

BACKGROUND In recent years,the emergence of multiplex technology that can simultaneously measure multiple anti-islet autoantibodies has become particularly valuable for the staging and early diagnosis of immune-mediated type 1 diabetes(T1D).While it has been established that 20%-30%of T1D patients suffer from autoimmune thyroid disease(AITD),there is limited available data regarding the presence of anti-islet autoantibodies in AITD patients.Among commercially available anti-islet autoantibodies,glutamic acid decarboxylase 65 autoantibodies(GADAs)are often the first marker measured in general clinical practice.AIM To investigate the frequency of anti-islet autoantibodies in AITD patients.METHODS Our study involved four hundred ninety-five AITD patients,categorized into three distinct groups:AITD with T1D(n=18),AITD with phenotypic type 2 diabetes(T2D)(n=81),and AITD without diabetes(n=396),and the enzyme-linked immunosorbent assay(ELISA)was employed to determine the frequencies of 3 Screen Islet Cell Autoantibody(3 Screen ICA),GADA,insulinoma-associated antigen-2 autoantibodies(IA-2As),and zinc transporter 8 autoantibodies(ZnT8As)within these groups.RESULTS The frequency of 3 Screen ICA in AITD patients with T1D,T2D,and those without diabetes were 88.9%,6.2%,and 5.1%,respectively,with no significant difference seen between the latter two groups.Notably,the frequency of 3 Screen ICA was 11.1%higher in AITD patients with T1D,1.3%higher in AITD patients with T2D,and 1.1%higher in AITD patients without diabetes compared to GADA,respectively.Furthermore,12.5%,20.0%,and 20.0%of the 3 Screen ICA-positive patients were negative for GADA.Additionally,1.3%of the AITD patients who tested negative for 3 Screen ICA in both the AITD with T2D and non-diabetic AITD groups were found to be positive for individual autoantibodies.Among the 3 Screen ICA-positive patients,there was a significantly higher proportion of individuals with multiple autoantibodies in AITD patients with T1D compared to those without diabetes(37.5%vs 5.0%,P<0.05).However,this proportion was similar to that in AITD patients with T2D(20.0%).Nevertheless,there was no significant difference in 3 Screen ICA titers between AITD patients with T1D and those without diabetes(436.8±66.4 vs 308.1±66.4 index).Additionally,no significant difference in 3 Screen ICA titers was observed between Graves’disease and Hashimoto’s thyroiditis in any of the groups.CONCLUSION Our findings reveal that some AITD patients without diabetes exhibit 3 Screen ICA titers comparable to those in AITD patients with T1D.Thus,3 Screen ICA outperforms GADA in identifying latent anti-islet autoantibody-positive individuals among AITD patients.

AITD患者妊娠早期T细胞水平变化及妊娠结局

目的探讨妊娠早期合并自身免疫性甲状腺疾病(AITD)患者的调节性T细胞(Treg)和T细胞亚群水平变化及不良妊娠结局的影响因素。方法选取2018年12月至2021年12月在广西壮族自治区人民医院产前检查的合并AITD妊娠早期患者124例为观察组,另选取同期健康的妊娠早期孕妇80例为对照组。比较两组患者Treg细胞和T细胞亚群水平,采用多因素Logistic回归分析妊娠早期合并AITD患者不良妊娠结局的影响因素。结果观察组Treg、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)显著低于对照组,CD8^(+)显著高于对照组(t值分别为3.542、4.259、5.192、8.499、5.090,P<0.05)。多因素Logistic回归分析发现,年龄、孕前体质量指数(BMI)、CD8^(+)是妊娠早期合并AITD患者不良妊娠结局的危险因素,OR值及其95%CI分别为1.232(1.058~2.614)、2.493(1.181~3.429)、2.368(1.269~3.558);Treg、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)是其保护因素,OR值及其95%CI分别为0.886(0.327~0.935)、0.717(0.518~0.972)、0.935(0.764~0.993)、0.848(0.406~0.946),P<0.05。结论妊娠早期合并AITD患者的Treg、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平下降,CD8^(+)水平升高,更容易发生不良妊娠结局。

Selenium Supplementation Alleviates Autoimmune Thyroiditis by Regulating Expression of Th1/Th2 Cytokines

Selenium （Se） is an essential trace element. Autoimmune thyroid diseases （AITD） are destructive inflammatory or anti-receptor autoimmune diseases characterized by reactivity to self-thyroid antigens. However, the effects of Se on the cytokines in AITD are still unclear. So we researched the role of Selenium （Se） and Thl/Th2 cytokine productions in the pathogenesis of autoimmune thyroid diseases （AITD）.

Autoimmune thyroiditis presenting as psychosis

桥本氏甲状腺炎系一种罕见的自身免疫性疾病,血液中含有大量的自体抗体,主要表现为神经系统症状。有文献报道桥本氏甲状腺炎会出现一些行为症状,而没有明显的神经症状。我们报告的病例较少见,与其他的桥本氏甲状腺炎的常见临床表现不同。

Prevalence of coeliac disease in patients with autoimmune thyroiditis in a Turkish population

AIM:To investigate the prevalence of coeliac disease in a series of Turkish patients with autoimmune thyroiditis.METHODS:Sera from 136 consecutive patients with newly diagnosed autoimmune thyroiditis and 119 healthy blood donors were tested for IgA tissue transglutaminase antibody with enzyme-linked immunosorbent assay.Endoscopic mucosal biopsy from the second part of duodenum was performed in patients with positive antibody test.RESULTS:Eight patients(5.9%)and one control subject(0.8%)were positive for IgA tissue transglutaminase antibody(OR:7.38,95% CI:0.91-59.85,P = 0.04).Six patients and one control agreed to take biopsies.Histopathological examination revealed changes classified as Marsh Ⅲa in one,Marsh Ⅱ in one,Marsh Ⅰ in two,and Marsh 0 in two patients with autoimmune throiditis,and MarshⅠin one blood donor.CONCLUSION:Turkish patients with autoimmune thyroiditis have an increased risk of coeliac disease and serological screening may be useful for early detection of coeliac disease in these patients.Our findings need to be confirmed in a larger series of patients.

Interferon-induced progression of autoimmune thyroiditis with enlarged thyroid glands in gynecological patient: A case report and literature review

A case report presents a progression of autoimmune thyroiditis with an abnormal enlargement of the thyroid glands and increased thyreotropin hormone concentration-associated with interferon treatment in human papillomavirus infected patient with the autoimmune thyroiditis and a daily L-thyroxin hormone replacement therapy background. Observation was supplemented with a brief review of literature and discussion. On the basis of this observation and a brief review of literature authors suggested that the potential adverse effects of interferon therapy are overbalanced than its benefits for gynecological patients, therefore any interferon treatment should be recommended with strict indications as well as after screening of conditions and functions of thyroid glands and other interferon target organs to avoid interferon treatment side effects. Practitioners especially gynecologists should inform their patients about pleiotropic interferon effects and its high frequent and wide range side effects before to start such kind of treatment.

Intervention and immune regulation of Fuzheng Xiaoying Decoction on experimental autoimmune thyroiditis model rats

Objective:To investigate the effect of Fuzheng Xiaoying Decoction on experimental autoimmune thyroiditis(EAT)model rats and explore its possible mechanism of immune regulation.Methods:Among the 40 female SD rats,10 were randomly selected as the blank group,and the rest were immunized with pig thyroglobulin and Freund's adjuvant combined with high iodine feeding to make the EAT model.After the model was established,they were randomly divided into three groups:the model group,the selenium yeast tablet group and the Fuzheng Xiaoying Decoction group,which were continuously gavaged for 2 months.The anti thyroid autoantibodies,thyroid function,IL-38 and Th17/Treg distribution were measured.The pathological changes of thyroid tissue were observed by HE staining.Results:Compared with the blank group,the levels of TPOAb and TGAb in the model group were significantly higher(P<0.05).Lymphocyte infiltration was seen in the thyroid tissue of the model group,and also the thyroid follicles were partially destroyed,the shape was irregular,and the colloid distribution was uneven,indicating that the modeling was successful.Compared with the model group,the levels of TPOAb and TGAb in the selenium yeast tablet group and the Fuzheng Xiaoying Decoction group decreased significantly(P<0.05).And the Fuzheng Xiaoying Decoction group had more significant improvement in thyroid follicle destruction and lymphocyte infiltration than the selenium yeast tablet group(P<0.05).Compared with the blank group,the levels of T3,T4,FT3 and FT4 in the model group increased,the level of IL-38 decreased,the proportion of Th17 increased,and the ratio of Th17/Treg increased(P<0.05).Compared with the model group,T4 level decreased,IL-38 level increased in the selenium yeast tablet group and the Fuzheng Xiaoying Decoction group(P<0.05).But there was no statistically significant difference in the reduction of Th17 proportion and Th17/Treg ratio between the above two groups and the model group(P>0.05).There was no significant difference in Treg ratio among the groups.Conclusion:Fuzheng Xiaoying Decoction can significantly reduce the level of anti thyroid autoantibodies in EAT rats by regulating the immunity of EAT rats,and improve the follicular destruction and lymphocyte infiltration of thyroid tissue in rats.

The Role of Vitamin D on Thyroid Antibodies in Patients with Chronic Autoimmune Thyroiditis

Vitamin D deficiency is a global problem,which has taken the form of a pandemic.Existing data indicate that vitamin D is not only a nutrient.It has also a hormone-specific activity.Vitamin D is characterized by anti-inflammatory and immunomodulatory properties.Chronic autoimmune thyroiditis is a disease of autoimmune genesis,in which lymphocytic infiltration gradually destroys thyroid tissue.There are some evidences about vitamin D deficiency and the development of chronic autoimmune thyroiditis.The article has reviewed the current literature about the impact and the benefits of vitamin D on thyroid antibodies levels.

Immune checkpoint inhibitor therapy-induced autoimmune polyendocrine syndrome typeⅡand Crohn's disease:A case report

BACKGROUND The development of immune checkpoint inhibitors(ICIs)has heralded a new era in cancer treatment,enabling the possibility of long-term survival in patients with metastatic disease.Unfortunately,ICIs are increasingly implicated in the development of autoimmune diseases.CASE SUMMARY We present a man with squamous cell carcinoma of the oropharynx on a combination of teriprizumab,docetaxel,and cisplatin therapy who developed autoimmune polyendocrine syndrome typeⅡ(APS-2)including thyroiditis and type 1 diabetes mellitus and Crohn’s disease(CD).He developed thirst,abdominal pain,and fatigue after two-week treatment with the protein 1 ligand inhibitor teriprizumab.Biochemistry confirmed APS-2 and thyrotoxicosis.He was commenced on an insulin infusion.However,his abdominal pain persisted.Follow-up surgery confirmed CD and his abdominal pain was relieved by mesalazine.He was continued on insulin and mesalazine therapy.CONCLUSION Immunotherapy can affect all kinds of organs.When clinical symptoms cannot be explained by a single disease,clinicians should consider the possibility of multisystem damage.

从“脾藏意”论治自身免疫性甲状腺炎(AIT)伴认知功能障碍

自身免疫性甲状腺炎(AIT)是一种机体的自身免疫性疾病,自身免疫性甲状腺炎表现为抗体升高、甲状腺功能正常,随着其病情发展常会伴发轻度认知功能障碍等并发症。治疗方面西医治疗具有局限性,相比之下中医药的治疗更占据优势,在缓解临床症状、降低抗体、预防疾病等处都独有特色。“脾藏意”出自《素问·宣明五气篇》,脾藏意中的“意”有记忆、思维两方面寄义。基于“脾藏意”理论,以脾为切入点论治疾病,为自身免疫性甲状腺炎伴认知功能障碍的中医临床防治提供了新的指导思想。

海藻玉壶汤治疗桥本甲状腺炎临床研究

目的:探讨海藻玉壶汤对桥本甲状腺炎疗效及对甲状腺自身免疫性抗体、Th1/Th2相关细胞因子的影响。方法:将94例桥本甲状腺炎患者按随机数字表法分为观察组和对照组各47例。对照组患者服用硒酵母片和左旋甲状腺素钠片进行治疗,观察组在此基础上服用海藻玉壶汤,两组疗程均为3个月。比较两组中医症状积分、治疗总有效率,以及甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPO-Ab)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺激素(TSH)、白细胞介素-10(IL-10)、白细胞介素-12(IL-12)、γ干扰素(IFN-γ)水平,并观察不良反应情况。结果:治疗后两组甲状腺肿大、咽部异物感、胸闷胁痛、乏力评分,以及血清TGAb、TPO-Ab、TSH、IL-12、IFN-γ水平均较治疗前降低,且观察组低于对照组(均P<0.05);两组血清FT3、FT4、IL-10水平均较治疗前升高,且观察组高于对照组(均P<0.05);观察组治疗总有效率95.74%,对照组82.98%,观察组疗效优于对照组(P<0.05);两组均未出现不良反应事件。结论:海藻玉壶汤联合常规西药治疗桥本甲状腺炎疗效较好,可降低甲状腺自身抗体水平并恢复甲状腺功能,其机制可能是通过下调Th1型细胞因子、上调Th2型细胞因子以改善甲状腺功能。

中医药治疗自身免疫性甲状腺疾病网络药理学研究进展

自身免疫性甲状腺疾病是一种常见的自身免疫性疾病,发病率呈上升趋势,但其发病机制仍未明晰,临床在改善患者临床症状及提高生活质量方面仍有欠缺,网络药理学通过分析药物、靶点及疾病之间“多成分、多靶点、多途径”协同作用关系,目前已被应用于对自身免疫性甲状腺疾病的治疗指导。通过对相关文献进行分析,总结当前利用网络药理学方法进行中医药治疗自身免疫性甲状腺疾病的研究,阐明单药或者中药复方中的活性成分、作用靶点、生物过程及通路分析,为临床提供参考。此外,总结网络药理学的不足,以期中医药可以通过此法得到更好的发展。

AITDs与HLA等位基因DQA_1*0301、DR9的相关性研究

目的 探讨山东沿海地区自身免疫性甲状腺病 (AITDs)与HLA DQA1 0 30 1、DR9的相关性。方法 采用多聚酶链式反应序列特异引物分析 (PCR SSP)技术 ,扩增HLA等位基因DQA1 0 30 1、DR9的目的DNA片段 (分别为 199、2 36bp) ,分析 2对等位基因在不同人群中表达频率的差异 (χ2 检验 )。结果 山东沿海地区GD和HT女性患者组DQA1 0 30 1等位基因频率均显著高于对照组 (分别为P <0 .0 0 1,OR =4 .89;P <0 .0 1,OR =4 .95 ) ;DR9等位基因频率仅HT女性组显著高于对照女性组(P <0 .0 5 ,OR =3.90 )。DQA1 0 30 1/DR9共同表达的频率 ,GD和HT女性组较对照女性组均显著性增高 (分别为P <0 .0 5 ,P <0 .0 1)。GD组和HT组 2组间均无显著性差异 (P >0 .0 5 )。结论 HLA DQA1 0 30 1等位基因是山东沿海地区女性GD患者的易感基因 ;DQA1 0 30 1、DR9等位基因均是该地区女性HT患者的易感基因 ;

不同含碘剂量中药复方对AIT大鼠甲状腺组织超微结构及病理形态学影响的研究

目的:观察不同剂量含碘中药(海藻、昆布)复方对实验性自身免疫性甲状腺炎(AIT)大鼠甲状腺自身抗体、甲状腺组织超微结构及病理形态学的影响,探讨其作用机制;筛选中药复方中含碘中药的最佳剂量。方法:选用普通级SD雌性大鼠75只,取15只为正常组,其余60只进行造模,造模完成后分成4组:模型组、含碘中药低剂量组、中剂量组、高剂量组。实验结束称取各组大鼠体重,取大鼠双侧甲状腺,计算每100g大鼠体重的甲状腺mg数,作为甲状腺的重量指数(mg/100g);酶联免疫法检测各组大鼠甲状腺抗体水平;电镜下观察各组大鼠甲状腺滤泡上皮细胞超微结构变化;光镜下观察各组大鼠甲状腺组织病理形态学变化。结果:含碘中药各治疗组与模型组相比,大鼠甲状腺重量指数明显降低(P<0.01),甲状腺自身抗体水平均降低(P<0.01);治疗组组间比较,高、中剂量组优于低剂量组(P<0.05),高、中剂量组之间无明显差异(P>0.05);各治疗组甲状腺组织病理损伤较模型组减轻。结论:含碘中药复方具有缓解AIT大鼠甲状腺肿,降低甲状腺自身抗体水平,减轻甲状腺组织病理损伤的作用;含碘中药海藻、昆布的最佳剂量为20～30g。

自身免疫性甲状腺炎合并不孕症中医证候分布规律及临床特征研究

目的探讨自身免疫性甲状腺炎(AIT)合并不孕症患者的中医证候分布规律和临床特征。方法参照育龄期妇女AIT不孕症中医证候分布规律相关文献,制定《AIT合并不孕症患者中医证候调查表》。回顾性分析2019年6月-2020年12月在中国科学技术大学附属第一医院生殖中心行体外受精-胚胎移植(IVF-ET)的256例AIT合并不孕症患者,对其基本信息、中医证候、基础促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(TG-Ab)等资料进行采集。利用频数分析、系统聚类分析方法,归纳AIT合并不孕症患者的中医证候分布规律。结果AIT患者常见的5个证候要素分别为气虚、肝郁、脾虚、肾虚和血瘀,多见复合证候。系统聚类分析得到的主要中医证候分别为气虚肝郁证(69例,26.9%)、脾肾两虚证(45例,17.6%)、脾气虚证(38例,14.8%)、气虚血瘀证(36例,14.1%)、肾虚肝郁证(32例,12.5%)和其他证(36例,14.1%)。基础TSH水平在气虚肝郁证、脾气虚证、气虚血瘀证中均高于其余各证候,差异有统计学意义(P<0.05)。不同证候患者TPO-Ab、TG-Ab滴度差异无统计学意义(P>0.05)。结论AIT合并不孕症患者主要中医证候为气虚肝郁证、脾肾两虚证、脾气虚证、气虚血瘀证、肾虚肝郁证、其他证,证候要素以气虚为主,病位涉及脾、肾、肝三脏,瘀血为主要的病理产物。针对有气虚表现的本病患者有必要关注其甲状腺功能。

软坚消瘿颗粒对AIT大鼠甲状腺组织形态及血清抗体水平影响的研究

目的:观察软坚消瘿颗粒对自身免疫性甲状腺炎(AIT)大鼠甲状腺组织病理形态的变化及血清抗体甲状腺球蛋白抗体(TGAb)、过氧化物酶抗体(TpoAb)水平的影响。方法:将猪甲状腺球蛋白与弗氏佐剂溶合免疫注射配合饮用高碘碘水建立AIT大鼠模型,分为模型组及软坚消瘿颗粒高、中、低剂量组,分别给予蒸馏水及高、中、低剂量的软坚消瘿颗粒灌胃6周。采用电化学发光法检测大鼠血清TGAb、TpoAb的水平。光镜下观察甲状腺组织病理形态学改变。结果:模型组与正常组比较TGAb、TpoAb具有显著性差别(P<01),软坚消瘿高、中剂量组与模型组比较TGAb、TpoAb有显著差别(P<0.05)。光镜下观察雷公藤组及各中药治疗组甲状腺组织结构损伤轻于模型组。结论:软坚消瘿颗粒可能通过降低AIT大鼠血清抗体水平,改善自身免疫性甲状腺炎的免疫紊乱状况,从而起到减轻甲状腺病理损伤的作用。

2型糖尿病伴桥本甲状腺炎患者甲状腺抗体滴度与胰岛功能的相关性研究

目的 探究2型糖尿病(T2DM)伴甲状腺功能正常的桥本甲状腺炎(HT)患者的甲状腺特异性抗体滴度与胰岛功能的相关性。方法 选择2021年1月至2023年5月于安徽医科大学附属安庆市立医院内分泌科就诊的92例甲状腺功能正常的HT伴T2DM患者,根据C肽水平将其分为低C肽水平组(50例)和高C肽水平组(42例)。比较两组性别、年龄、糖尿病病程、糖化血红蛋白(Hb A1c)、体重指数(BMI)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、25羟维生素D[25(OH)D]等指标。采用二元logistic回归模型分析胰岛功能的独立危险因素。结果 两组TPOAb、TGAb、糖尿病病程、25(OH)D、Hb A1c、BMI比较,差异有统计学意义(P<0.05)。二元logistic回归分析结果显示,TPOAb(OR=1.005,95%CI:1.001~1.009)、TGAb(OR=1.007,95%CI:1.000~1.014)、糖尿病病程(OR=1.455,95%CI:1.118~1.895)、BMI(OR=0.693,95%CI:0.517~0.928)、25(OH)D(OR=0.848,95%CI:0.726~0.991)是胰岛功能的影响因素(P<0.05)。结论 在T2DM合并HT患者中,TPOAb、TGAb的滴度水平与胰岛功能损伤有关,甲状腺自身免疫性抗体滴度是胰岛功能衰竭的独立危险因素。

山东沿海地区碘营养状况和HLA等位基因DQA1*0501、DQA1*0201对AITDs发病的影响

目的探讨山东沿海地区自身免疫性甲状腺病(AITDs)与HLA等位基因DQA1*0501、DQA1*0201及碘营养状况对AITDs发病的影响。方法HLA等位基因测定采用PCR-SSP技术,尿碘浓度测定采用砷铈催化分光光度法。结果①DQA1*0501等位基因为AITDs易感基因(GD和HT的OR值=2.14、2.5);而DQA1*0201为女性AITDs保护基因(GD和HT的OR值=0.33、0.27)。②AITDs组尿碘浓度高于300μg/L患者分布频率均显著高于对照组(P<0.05),且DQA1*0501(+)发生AITDs的OR值为2.7,DQA1*0201(+)的OR值为0.42;AITDs组碘正常组DQA1*0501(+)OR值为5.12,DQA1*0201(+)的OR值为0.21。③logistic回归分析发现尿碘浓度对数、DQA1*0501为AITDs的易感因素,DQA1*0201为保护因素。结论HLA-DQA1*0501等位基因与该地区AITDs的发病易感性相关,而DQA1*0201与女性患者的保护性相关。碘和HLA等位基因DQA1*0501、DQA1*0201共同影响GD、HT的发病。