ABSTRACT
Objective@#To investigate the clinical features of Hashimoto′s thyroiditis(HT) with elevated serum IgG4 levels and to guide the clinical practice.@*Methods@#Serum IgG4 concentrations were detected in patients with HT by nephelometric immunoassay. These patients were classified into two groups according to the IgG4 levels: positive group(IgG4≥1.35 g/L), and negative group(IgG4<1.35 g/L). The clinical characteristics of these two groups, including age, gender, medical history, serological features, and ultrasound were compared.@*Results@#Nine out of 111 patients with HT were positive with IgG4(8.11%), all of them were women. There was no significant difference in gender, age, BMI, dose of levothyroxine administration, FT3, FT4, and TSH levels between the two groups. The volume of thyroid in positive group was larger than that in negative group [57.81(38.36, 74.93) ml vs 25.07(18.48, 42.14) ml, P=0.015], and the level of thyroglobulin antibodies(TgAb; P=0.011) and thyroid peroxidase antibodies(TPOAb; P=0.025) in positive group were also significantly higher than those in negative group. Moreover, the positive group had a slightly higher risk of PTC than that of negative group(11.1% vs 2.94%, P=0.290), though the difference was not significant. Correlation analysis showed that IgG4 was positively associated with TgAb, TPOAb, and thyroid volume.@*Conclusions@#The levels of TgAb and TPOAb are higher, the volume of thyroid gland is greater, and the risk of PTC with lymph node metastasis is more frequent in HT patients with elevated serum IgG4. For HT patient with elevated serum IgG4, their thyroid function and morphology should be more closely monitored.
ABSTRACT
Objective:To investigate the clinical features of Hashimoto′s thyroiditis(HT) with elevated serum IgG4 levels and to guide the clinical practice.Methods:Serum IgG4 concentrations were detected in patients with HT by nephelometric immunoassay. These patients were classified into two groups according to the IgG4 levels: positive group(IgG4≥1.35 g/L), and negative group(IgG4<1.35 g/L). The clinical characteristics of these two groups, including age, gender, medical history, serological features, and ultrasound were compared.Results:Nine out of 111 patients with HT were positive with IgG4(8.11%), all of them were women. There was no significant difference in gender, age, BMI, dose of levothyroxine administration, FT 3, FT 4, and TSH levels between the two groups. The volume of thyroid in positive group was larger than that in negative group [57.81(38.36, 74.93) ml vs 25.07(18.48, 42.14) ml, P=0.015], and the level of thyroglobulin antibodies(TgAb; P=0.011) and thyroid peroxidase antibodies(TPOAb; P=0.025) in positive group were also significantly higher than those in negative group. Moreover, the positive group had a slightly higher risk of PTC than that of negative group(11.1% vs 2.94%, P=0.290), though the difference was not significant. Correlation analysis showed that IgG4 was positively associated with TgAb, TPOAb, and thyroid volume. Conclusions:The levels of TgAb and TPOAb are higher, the volume of thyroid gland is greater, and the risk of PTC with lymph node metastasis is more frequent in HT patients with elevated serum IgG4. For HT patient with elevated serum IgG4, their thyroid function and morphology should be more closely monitored.
ABSTRACT
Objective To investigate the effect of short-term very low calorie diet on the thyroid function in patients with metabolic syndrome.Method Fifty-nine patients [(23 males and 36 females,average age (38.17 ± 9.61) years] with metabolic syndrome were received very low calorie diet for 9 days in our hospital.Anthropometric and biochemical parameters were determined before and after very low calorie diet.The level of serum FT3,FT4,TSH was measured by chemiluminescent assay,and the level of serum reverse triiodothyronine (rT3) was measured by radioimmunoassay in 31 cases.Homeostasis model assessment for insulin resistance (HOMA-IR) was employed to evaluate the severity of insulin sensitivity.Results After short-term very low calorie diet,the average body weight decreased from (76.30± 19.61)kg to (71.97 ± 18.58)kg (P＜0.01);waist circumference reduced by 6.98 cm (P＜ 0.01).The blood pressure,total cholesterol,triglycerides,low density lipoprotein-cholesterol,fasting blood glucose,fasting insulin,and HOMA-IR were all reduced significantly after very low calorie diet.The serum FT3 level decreased from (5.09 ± 0.58) pmol/L to (4.52 ± 0.58) pmol/L (P＜0.01).The changes of FT4,TSH,and rT3 were without difference.The basal FT3 levels were positively correlated with basal body weight,body mass index,waist circumference (r =0.335,0.297,and 0.262 respectively,all P＜ 0.05),and negatively correlated with HbAIC,fasting blood glucose (r=-0.293,-0.268,both P＜0.05).The basal FT4 level was negatively correlated with basal fasting insulin,HOMA-IR (r =-0.284,-0.330,both P＜0.05),while the basal TSH level was positively correlated with fasting insulin and HOMA-IR (r=0.381,0.281,both P＜0.05).The basal body weight was positively correlated with waist circumference,fasting insulin,HOMA-IR,while negatively correlated with high density lipoproteincholesterol (HDL-C;r =0.899,0.382,0.305,-0.333,all P＜0.05).After very low calorie diet,there were no more significant correlations between FT3 changes and baseline body weights,waist circumferences,and fasting blood glucose levels.The variation amplitude of body weight was positively correlated with baseline weight,waist circumference,fasting insulin,HOMA-IR,and FT3 levels (r =0.564,0.494,0.307,0.245,0.384,all P＜ 0.05).Conclusions Short-term very low calorie diet decreases the serum FT3 level and improves metabolic markers in patients with metabolic syndrome.The serum FT3 level of patients with metabolic syndrome was positively associated with body weight,whereas negatively associated with HbAIC and fasting blood glucose.Moreover,FT4 level had negative correlation with HOMA-IR,but TSH level had positive correlation with HOMA-IR.Those who had higher body weights,FT3 and HOMA-IR levels,may have more profound decrease of body weight after very low calorie diet.