ABSTRACT
Objective:To evaluate the efficacy and safety of mycophenolate mofetil(MMF) in patients with active moderate to severe thyroid associated ophthalmopathy(TAO) refractory to multiple intravenous glucocorticoid(GC).Methods:Fifty-two patients with active moderate to severe TAO that was refractory to multiple intravenous GC were treated with MMF 0.5g orally, 2/d. To evaluate the overall response rate of TAO patients, the improvement of more than 3 items including clinical disease activity score(CAS), soft tissue involvement, proptosis, diplopia, decrease of eye movements, visual acuity and other improvements were defined as response.Results:After 12 weeks of MMF treatment, the overall response rate of TAO patients was 75.0%, and then increased to 88.5% significantly at the 24th weeks. At the 12th weeks, CAS decreased from(5.06±1.21) to(2.52±1.13), and then continued to decrease to(2.02±0.92) at the 24th week( P<0.05), the response rates were 82.7% and 90.4%, respectively. In addition, after 12 weeks of treatment, 58.1% of patients with diplopia improved significantly, and the response rate was 74.2% at the 24th weeks. Similarly, the degree of proptosis decreased significantly at the 12th and 24th weeks, and the response rates were 53.8% and 69.2%, respectively. No serious adverse events occurred during the treatment. Conclusion:The MMF therapy is efficient and safe for patients with active moderate to severe corticosteroid-resistant TAO.
ABSTRACT
This study was aimed to investigate the association between dyslipidemia and thyroid associated ophthalmopathy (TAO). We evaluated the relationship between dyslipidemia and TAO in 218 patients with Graves′ disease (GD) and found that the serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in the GD subjects with TAO (n=110) were significantly increased [(5.32±1.39) mmol/L vs. (3.18±2.12) mmol/L, (2.98±0.75) mmol/L vs. (1.25±0.98) mmol/L] than those in the GD subjects without TAO (n=108). TC and LDL-C were positively correlated with the Clinical disease activity score (CAS) [TC (r=0.7, P=0.03),LDL-C (r=0.82, P=0.03)], and the levels of TC (OR=2.56, P=0.02) and LDL-C(OR=2.01, P=0.015) were positively associated with TAO. These suggested that high serum cholesterol level is a novel risk factor for TAO, and management of blood lipids should be included in the treatment of TAO.
ABSTRACT
The change in serum level of 8-hydroxy-deoxyguanosine (8-OHdG),an oxidative stress biomarker,in patients with active Graves' ophthalmopathy (GO) during corticosteroid treatment was observed.The serum level of 8-OHdG was significantly increased in patients with active GO as compared with that of normal controls and patients with Graves' disease (P ＜ 0.05).After systemic corticosteroid treatment,patients with GO showed significantly lowered 8-OHdG level as compared with that before treatment and patients with Graves' disease.These changes in serum 8-OHdG level were accompanied by decreases in clinical activity score (P ＜ 0.05) during corticosteroid treatment.Oxidative stress may play a role in the pathogenesis of GO.Serum 8-OHdG level may be used as an objective and quantitative parameter in patients with GO during immunosuppressive treatment.
ABSTRACT
To investigate the role played by 8-hydroxy-deoxyguanosine (8-OHdG) in patients with Graves'ophthalmopathy(GO),and the association between 8-OHdG and the disease activity of GO.Serum levels of 8-OHdG were tested in 48 cases with GO and 30 cases with Graves' disease(GD) without ophthalmopathy.30 healthy subjects participated in this study as controls.8-OHdG was detected by enzyme-linked immunosorbent assay (ELISA).Compared with the controls,the mean level of 8-OHdG in GO patients and GD patients was increased significantly [(2.98±1.33),(2.07±1.30) vs(0.72±0.93)ng/ml,P＜0.05].Mean 8-OHdG level in GO patients was markedly higher when compared to GD patients(P＜0.05).Pearson regression analysis showed that elevated levels of 8-OHdG were significantly correlated with the Clinical Activity Score of GO (r =0.54,P＜0.01).The serum level of 8-OHdG in GO patients was raised obviously,it implies that oxidative stress plays an important role in the pathogenesis of GO,and the serum level of 8-OHdG might act as an activity index of GO.
ABSTRACT
To investigate weather serum soluble intercellular adhesion molecule-1 (sICAM-1) and hyaluronic acid(HA) levels can be used in assessing the disease activity of Graves' ophthalmopathy (GO).Serum levels of sICAM-1 and HA were determined in 48 cases with GO and 30 cases with Graves' disease without GO (CON).Compared with the CON group,the levels of sICAM-1 and HA in GO cases were raised significantly( P＜0.05 ).sICAM-1 and HA levels in the subgroup of patients with active GO were markedly elevated when compared to those with stable GO(P＜0.05 ).Pearson regression analysis showed that elevated levels of slCAM-1 and HA were positively correlated with the Clinical Activity Score ( CAS ) of GO ( r =0.53,P ＜ 0.01 ; r =0.46,P ＜ 0.01 ) ; A significant correlation between sICAM-1 and HA( r=0.31,P＜0.05 ) was noted.The raised serum levels of sICAM-1and HA may serve as two activity markers of GO.
ABSTRACT
Objective To investigate the role of oxidative stress in type 2 diabetes patients with macrovascular complications. Methods Serum levels of 8-hydroxy-deoxygnan osine (8-OHdG) and hemoglobin Alc (HbAlc) in 32 cases of type 2 diabetic patients with macrovascular complications and 46 cases of patients without complications were determined. 8-OHdG was detected by enzyme linked immu-nosorbent assay (ELISA). Results The level of 8-OHdG (2.93±1.37) ng/mL in type 2 diabetic patients with macrovascular complica-tions was higher than those without complications, whose 8-OHdG level was (2.67±1.30)ng/mL, but the difference was not significant(P>0.05). Compared with all kinds of macrovascular complications in patients, the 8-OHdG levels were increased, but the difference were not significant (P>0.05). Compared with patients without complications, the duration and age of the patients with macrovascular compli-cations also increased significantly (P<0.05), but the HbAlc levels were not statistical difference between them (P>0.05). Spearman regression analysis showed that 8-OHdG level was positively correlated with the duration (r=0.33, P<0.05), while the age and HbAlc level had no obvious correlation (P>0.05). Conclusion The role of oxidative stress may not be the important reason in type 2 diabetes with macrovascular complications, but the duration and age of the patients may be closely related with the disease.