Significance of thyroid stimulating antibody and thyroid stimulating-blocking antibody in children with autoimmune thyroid disease / 中华实用儿科临床杂志

ABSTRACT

Objective To study the significance of thyroid stimulating antibody (TSAb) and thyroid stimulating-blocking antibody (TSBAb) in children with Graves' disease (GD) or Hashimoto's thyroiditis (HT).Methods Five hundred and twenty-seven cases of serum from 180 children with autoimmune thyroid disease (AITD) children were divided into 282 cases of GD and 245 cases of HT.According to the status of thyroid function,they were divided into 157 cases of hyperthyroidism,91 cases of hypothyroidism and 279 cases of normal thyroid.GD group was subdivided into 127 GD hyperthyroidism and 155 GD remission;HT group was subdivided 30 HT hyperthyroidism,124 HT remission and 91 HT hypothyroidism.Seventy-nine healthy children were taken as the healthy control group.Free triiodothyronine(FT3),free thyroxine(FT4) and sensitive thyroid stimulating hormone(TSH) were detected by chemoluminescence.Serum TSAb and TSBAb were detected by serum TSAb or TSBAb enzyme linked immunosorbent assay (ELISA),respectively.The differences in TSAb and TSBAb among each group were compared and analyzed of find out the relationship between TSAb and TSBAb was performed.Beside,the correlation between TSAb and TSBAb with FT3,FT4,and TSH were analyzed.Results (1) TSAb levels were significant (F =11.995,all P =0.000)the GD group (0.727 ± 0.157) ＞ HT group (0.605 ± 0.148) ＞ healthy control group (0.350 ± 0.105);the difference was significant(F =109.165,P =0.000) among hyperthyroidism group (0.745 ± 0.169) ＞ normal thyroid group (0.647 ± 0.153) ＞hypothyroidism group(0.612 ±0.144) ＞healthy control group (0.350 ±0.105);the difference was significant(F=156.712,P =0.000) in the GD hyperthyroidism group(0.747 ±0.17) ＞ GD remission group (0.640 ± 0.16) ＞ healthy control group (0.350 ± 0.105);the difference was significant (F =109.165,P =0.000) in the HT hyperthyroidism group(0.739 ±0.140) ＞HT remission group(0.655 ±0.135) ＞ HT hypothyroidism group(0.612 ± 0.140) ＞healthy control group (0.350 ±0.105).(2) TSBAb levels were significantly different(F =15.610,P =0.000)the HT group(0.704 ±0.633) ＞ GD group(0.567 ±0.178) ＞ healthy control group (0.334 ±0.104);the difference was significant(F =13.311,P =0.000) in the hypothyroidism group (0.693 ± 0.125) ＞ remission group (0.648 ±0.446) ＞hyperthyroidism group(0.562 ±0.181) ＞healthy control group(0.334 ±0.104);the difference was significant(F =19.269,P =0.000) in the GD remission group (0.672 ±0.572) ＞ GD hyperthyroidism group (0.550 ± 0.187) ＞ healthy control group (0.334 ± 0.104);HT hypothyroidism group (0.693 ± 0.725) was higher than HT hyperthyroidism group(0.618 ±0.142) and HT remission group (0.619 ±0.199),the difference was not significant between HT hyperthyroidism group and HT remission group(F =12.208,P =0.000).(3) TSAb level was positively correlated with TSBAb,FT3 and FT4(r =0.162,0.091,0.194,all P ＜ 0.05) and was negatively correlated with TSH (r =-0.224,P ＜ 0.05).TSBAb levels were negatively correlated with FT3 (r =-0.155,P ＜ 0.05) and was positively correlated with TSH (r =0.131,P ＜ 0.05).Conclusions Thyroid function was related to the serum levels of TSAb and TSBAb.TSAb and TSBAb could be regarded as an important predictive index for children with AITD during the treatment period.