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DOI: 10.1055/a-0643-4692
Thyroid Peroxidase Antibody is Associated with Plasma Homocysteine Levels in Patients with Graves’ Disease
Publikationsverlauf
received 07. April 2018
revised 10. Mai 2018
accepted 14. Juni 2018
Publikationsdatum:
02. Juli 2018 (online)
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Abstract
Purpose Homocysteine is associated with cardiovascular, inflammation and autoimmune diseases. Previous studies have shown that thyroid peroxidase antibody is associated with homocysteine levels in hypothyroidism. The relationship between thyroid antibodies and homocysteine in hyperthyroidism remains unclear. In this study, we aimed to investigate the association of thyroid antibodies with homocysteine in patients with Graves’ disease.
Methods This was a cross-sectional study including 478 Graves’ disease patients who were consecutively admitted and underwent radioiodine therapy. Homocysteine, thyroid hormones, thyroid antibodies, glucose and lipids were measured.
Results Patients with homocysteine levels above the median were older and had unfavorable metabolic parameters compared to patients with homocysteine levels below the median. Thyroglobulin antibody or thyroid peroxidase antibody was associated with homocysteine levels (β=0.56, 95%CI 0.03-1.08, p=0.04; β=0.75, 95%CI 0.23-1.27, p=0.005). The relationship between thyroid peroxidase antibody and homocysteine remained significant when additionally adjusting for free triiodothyronine (β=0.76, 95%CI 0.24-1.28, p=0.004). The presence of a homocysteine level above the median increased significantly with increasing thyroid peroxidase antibody quartiles in the logistic regression (OR=1.74, 95%CI 1.27-2.39, P for trend=0.001). Homocysteine levels increased significantly with increasing thyroid peroxidase antibody quartiles (p=0.005). Thyroid peroxidase antibody had no significant effect on other traditional cardiovascular risk factors.
Conclusions Thyroid peroxidase antibody is independently and positively associated with homocysteine levels in patients with Graves’ disease. Thyroid peroxidase antibody may be associated with the cardiovascular risk of patients with Graves’ disease through its effect on homocysteine.
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References
- 1 Marcisz C, Jonderko G, Wroblewski T. et al. Left ventricular mass in patients with hyperthyroidism. Medical science monitor: International medical journal of experimental and clinical research 2006; 12: Cr481-Cr486
- 2 Franklyn JA, Boelaert K. Thyrotoxicosis. Lancet (London, England) 2012; 379: 1155-1166
- 3 Fadel BM, Ellahham S, Ringel MD. et al. Hyperthyroid heart disease. Clinical cardiology 2000; 23: 402-408
- 4 Heeringa J, Hoogendoorn EH, van der Deure WM. et al. High-normal thyroid function and risk of atrial fibrillation: The Rotterdam study. Archives of internal medicine 2008; 168: 2219-2224
- 5 Volzke H, Alte D, Dorr M. et al. The association between subclinical hyperthyroidism and blood pressure in a population-based study. Journal of hypertension 2006; 24: 1947-1953
- 6 Hak AE, Pols HA, Visser TJ. et al. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: The Rotterdam Study. Annals of internal medicine 2000; 132: 270-278
- 7 Vargas-Uricoechea H, Bonelo-Perdomo A, Sierra-Torres CH. Effects of thyroid hormones on the heart. Clinica e investigacion en arteriosclerosis: Publicacion oficial de la Sociedad Espanola de Arteriosclerosis 2014; 26: 296-309
- 8 Wang YP, Lin HP, Chen HM. et al. Hemoglobin, iron, and vitamin B12 deficiencies and high blood homocysteine levels in patients with anti-thyroid autoantibodies. Journal of the Formosan Medical Association=Taiwan yi zhi 2014; 113: 155-160
- 9 Hankey GJ, Eikelboom JW. Homocysteine and vascular disease. Lancet (London, England) 1999; 354: 407-413
- 10 Veeranna V, Zalawadiya SK, Niraj A. et al. Homocysteine and reclassification of cardiovascular disease risk. Journal of the American College of Cardiology 2011; 58: 1025-1033
- 11 Schaffer A, Verdoia M, Cassetti E. et al. Relationship between homocysteine and coronary artery disease. Results from a large prospective cohort study. Thrombosis research 2014; 134: 288-293
- 12 Baszczuk A, Kopczynski Z. [Hyperhomocysteinemia in patients with cardiovascular disease]. Postepy higieny i medycyny doswiadczalnej (Online) 2014; 68: 579-589
- 13 Lazzerini PE, Capecchi PL, Selvi E. et al. Hyperhomocysteinemia, inflammation and autoimmunity. Autoimmunity reviews 2007; 6: 503-509
- 14 Wallberg-Jonsson S, Cvetkovic JT, Sundqvist KG. et al. Activation of the immune system and inflammatory activity in relation to markers of atherothrombotic disease and atherosclerosis in rheumatoid arthritis. The Journal of rheumatology 2002; 29: 875-882
- 15 Yxfeldt A, Wallberg-Jonsson S, Hultdin J. et al. Homocysteine in patients with rheumatoid arthritis in relation to inflammation and B-vitamin treatment. Scandinavian journal of rheumatology 2003; 32: 205-210
- 16 Lopez-Olivo MA, Gonzalez-Lopez L, Garcia-Gonzalez A. et al. Factors associated with hyperhomocysteinaemia in Mexican patients with rheumatoid arthritis. Scandinavian journal of rheumatology 2006; 35: 112-116
- 17 Dong X, Yao Z, Hu Y. et al. Potential harmful correlation between homocysteine and low-density lipoprotein cholesterol in patients with hypothyroidism. Medicine 2016; 95: e4291
- 18 Cicone F, Santaguida MG, My G et al. Hyperhomocysteinemia in acute iatrogenic hypothyroidism: The relevance of thyroid autoimmunity. Journal of endocrinological investigation 2017
- 19 Carbotta G, Tartaglia F, Giuliani A. et al. Cardiovascular risk in chronic autoimmune thyroiditis and subclinical hypothyroidism patients. A cluster analysis. International journal of cardiology 2017; 230: 115-119
- 20 Standards of medical care in diabetes--2014. Diabetes care 2014; 37 (Suppl. 01) S14-S80
- 21 Nygard O, Vollset SE, Refsum H. et al. Total plasma homocysteine and cardiovascular risk profile. The Hordaland Homocysteine Study. Jama 1995; 274: 1526-1533
- 22 Nedrebo BG, Nygard O, Ueland PM. et al. Plasma total homocysteine in hyper- and hypothyroid patients before and during 12 months of treatment. Clinical chemistry 2001; 47: 1738-1741
- 23 Orzechowska-Pawilojc A, Siekierska-Hellmann M, Syrenicz A. et al. Homocysteine, folate, and cobalamin levels in hyperthyroid women before and after treatment. Endokrynologia Polska. 2009; 60: 443-448
- 24 Mikos H, Mikos M, Obara-Moszynska M. et al. The role of the immune system and cytokines involved in the pathogenesis of autoimmune thyroid disease (AITD). Endokrynologia Polska. 2014; 65: 150-155
- 25 Czarnocka B, Janota-Bzowski M, McIntosh RS. et al. Immunoglobulin G kappa antithyroid peroxidase antibodies in Hashimoto's thyroiditis: Epitope-mapping analysis. The Journal of clinical endocrinology and metabolism 1997; 82: 2639-2644
- 26 Chiang EP, Bagley PJ, Selhub J. et al. Abnormal vitamin B(6) status is associated with severity of symptoms in patients with rheumatoid arthritis. The American journal of medicine 2003; 114: 283-287
- 27 Chen Z, Karaplis AC, Ackerman SL. et al. Mice deficient in methylenetetrahydrofolate reductase exhibit hyperhomocysteinemia and decreased methylation capacity, with neuropathology and aortic lipid deposition. Human molecular genetics 2001; 10: 433-443
- 28 Nedrebo BG, Hustad S, Schneede J. et al. Homocysteine and its relation to B-vitamins in Graves' disease before and after treatment: Effect modification by smoking. Journal of internal medicine 2003; 254: 504-512
- 29 Caplan RH, Davis K, Bengston B. et al. Serum folate and vitamin B12 levels in hypothyroid and hyperthyroid patients. Archives of internal medicine 1975; 135: 701-704
- 30 Weetman AP. Non-thyroid autoantibodies in autoimmune thyroid disease. Best Practice & Research Clinical Endocrinology & Metabolism 2005; 19: 17-32
- 31 Cabrera de Leon A, Almeida Gonzalez D, Almeida AA. et al. Factors associated with parietal cell autoantibodies in the general population. Immunology Letters 2012; 147: 63-66
- 32 Zhang Y, Weck MN, Schottker B. et al. Gastric parietal cell antibodies, Helicobacter pylori infection, and chronic atrophic gastritis: Evidence from a large population-based study in Germany. Cancer epidemiology, biomarkers & prevention: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 2013; 22: 821-826
- 33 Garcia Garcia B, Gimeno Orna JA, Aguillo Gutierrez E. et al. [Prevalence and predictive factors of parietal cell antibody positivity in autoimmune thyroid disease]. Endocrinologia y nutricion: Organo de la Sociedad Espanola de Endocrinologia y Nutricion 2010; 57: 49-53
- 34 Cicone F, Papa A, Lauri C. et al. Thyro-gastric autoimmunity in patients with differentiated thyroid cancer: A prospective study. Endocrine 2015; 49: 163-169
- 35 Sun A, Wang YP, Lin HP. et al. Do all the patients with gastric parietal cell antibodies have pernicious anemia?. Oral diseases 2013; 19: 381-386
- 36 Lin HP, Wu YH, Wang YP. et al. Anemia and hematinic deficiencies in gastric parietal cell antibody-positive and -negative oral mucosal disease patients with microcytosis. Journal of the Formosan Medical Association=Taiwan yi zhi 2017; 116: 613-619