0.829
IF
20
MNiSW
166.26
ICV
RESEARCH PAPER
 
CC BY-NC-ND 3.0
 
 

Anti-thyroidal peroxidase antibodies are associated with thyrotropin levels in hypothyroid patients and in euthyroid individuals

Gabriel Bromiński 1  ,  
Maciej Owecki 1,  
 
1
Department of Endocrinology, Metabolism and Internal Medicine, University of Medical Sciences, Poznań, Poland
2
Department of Informatics and Statistics, University of Medical Sciences, Poznań, Poland
Ann Agric Environ Med 2017;24(3):431–434
KEYWORDS:
ABSTRACT:
Objective:
The study was designed to evaluate the relationship between thyroid antibodies and gland dysfunction, with the aim of finding a clinically useful threshold value of thyreoperoxidase antibodies, which could prove to be predictive for thyroid failure.

Material and Methods:
The study was conducted on 99 women, ages ranging from 18–91 years (mean age: 45.5 ±17.0), were treated as outpatients in the Department of Endocrinology, Metabolism and Internal Medicine. Analysis of serum samples for TSH concentration and anti-TPO titers was conducted.

Results:
The most common disorder was hypothyroidism. Anti-TPO titers above reference range values were observed in 35 patients (35.4%): 21 (60%) were hypothyroid and 11 (31.4 %) were euthyroid. The anti-TPO and TSH serum levels correlated both in patients with high thyroid antibody titers, and in the anti-TPO negative groups. To find the threshold value of anti- TPO that would help predict hypothyroidism, receiver operating curves were used. With this approach, TPO antibody titers over 17 IU/ml indicated hypothyroidism with a 90% sensitivity and 75% sensibility.

Conclusions:
It can be postulated that the cutoff values of anti-TPO in the general population should be decreased in order to improve autoimmune thyroid disorder screening. Obviously, using that margin may lead initially to the detection of some false positive subjects. However, with lower cut-off values, more patients can be enrolled into thyroid follow-up groups. In this way, many people could avoid complications of undiagnosed, insidious thyroid failure.

CORRESPONDING AUTHOR:
Gabriel Bromiński   
Department of Endocrinology, Metabolism and Internal Medicine, University of Medical Sciences, Poznań, Poland
 
REFERENCES (24):
1. Weetman A P.Thyroid peroxidase as antigen in autoimmune thyroiditis. Clin Exp Immunol. 1990; 80(1): 1–3. 2. Ruf J, Carayon P. Structural and functional aspects of thyroid peroxidase. Arch Biochem Biophys. 2006; 445(2): 269–277.
2. Bjoro T, Holmen J, Krüger O, Midthjell K, Hunstad K, Schreiner T et al. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trùndelag (HUNT). Eur J Endocrinol 2000; 143(5): 639–647.
3. Dhanwal DK. Thyroid disorders and bone mineral metabolism. Indian J Endocrinol Metab. 2011; 15(Suppl 2): S107–112.
4. Kostoglou-Athanassiou I, Ntalles K. Hypothyroidism – new aspects of an old disease. Hippokratia. 2010; 14(2):82–87.
5. Estienne V, Duthoit C, Costanzo VD, Lejeune PJ, Rotondi M, Kornfeld S et al. Multicenter study on TGPO autoantibody prevalence invarious thyroid and non-thyroid diseases; relationships with thyroglobulin and thyroperoxidase autoantibody parameters. Eur J Endocrinol. 1999; 141(6): 563–569.
6. Bülow Pedersen I, Laurberg P, Knudsen N, Jørgensen T, Perrild H, Ovesen L et al. A population study of the association between thyroid autoantibodies in serum and abnormalities in thyroid function and structure. Clin Endocrinol (Oxf). 2005; 62(6): 713–720.
7. Gabryel B, Brominski G, Owecki M, Michalak M, Ruchala M. The prevalence of thyroid nodular disease in patients with increased titers of anti-thyroidal peroxidase antibodies. Neuro Endocrinol Lett. 2012; 33(4): 442–445.
8. Stagnaro-Green A. Postpartum thyroiditis. Best. Pract. Res. Clin. Endocrynol. Metab. 2004; 18(2): 303–316.
9. Ruchała M, Zybek A, Bromińska B, Szczepanek-Parulska E. Thyroid autoimmunity in pregnancy- a problem of mother and child. Arch Perinat Med. 2012; 18(2): 86–91.
10. Prummel MF, Strieder T, Wiersinga WM. The environment and autoimmune thyroid diseases. Eur J Endocrinol. 2004; 150(5): 605–618.
11. Ajjan RA, Weetman AP. Thyroid Autoantibody Measurement. In: Brent GA (ed.) Thyroid Function Testing, Nowy Jork 2010 p. 109–124.
12. O’Leary PC, Feddema PH, Michelangeli VP, Leedman PJ, Chew GT, Knuiman M et al. Investigations of thyroid hormones and antibodies based on a community health survey: the Busselton thyroid study. Clin Endocrinol (Oxf). 2006; 64(1): 97–104.
13. Prummel MF, Wiersinga WM. Thyroid peroxidase autoantibodies in euthyroid subjects. Best Pract Res Clin Endocrinol Metab. 2005; 19(1): 1–15.
14. Szybiński Z, Jarosz M, Hubalewska-Dydejczyk A, Stolarz-Skrzypek K, Kawecka-Jaszcz K, Traczyk I et al. Iodine-deficiency prophylaxis and the restriction of salt consumption — a 21st century challenge. Endokrynol Pol. 2010; 61(1): 135–140.
15. Laurberg P, Pedersen KM, Hreidarsson A, Sigfusson N, Iversen E, Knudsen PR. Iodine intake and the pattern of thyroid disorders: a comparative epidemiological study of thyroid abnormalities in the elderly in Iceland and in Jutland, Denmark. J Clin Endocrinol Metab. 1998; 83(3): 765–769.
16. Vanderpump MP. Epidemiology of Thyroid Dysfunction – Hypothyroidism and Hyperthyroidism. Thyroid international. 2009; 2: 1–14.
17. Kim M, Ladenson P. Thyroid. In: Goldman L, Schafer AI (eds.) Cecil Medicine, Philadelphia 2011 chapter 233.
18. Ruchala M, Kosowicz J, Baumann-Antczak A, Skiba A, Zamyslowska H, Sowinski J. The prevalence of autoantibodies to: myosin, troponin, tropomyosin and myoglobin in patients with circulating triiodothyronine and thyroxine autoantibodies (THAA). Neuro Endocrinol Lett. 2007; 28(3): 259–266.
19. Vanderpump MP, Tunbridge WM. Epidemiology and Prevention of Clinical and Subclinical Hypothyroidism. Thyroid. 2002; 12(10): 839–847.
20. Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA et al. Serum TSH, T4, and Thyroid Antibodies in the United States Population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002; 87(2): 489–499.
21. Vanderpump MP. The epidemiology of thyroid disease. Br Med Bull. 2011; 99: 39–51.
22. Hoogendoorn EH, Hermus AR, de Vegt F, Ross HA, Verbeek AL, Kiemeney LA et al. Thyroid function and prevalence of anti-thyroperoxidase antibodies in a population with borderline sufficient iodine intake: influences of age and sex. Clin Chem. 2006; 52(1): 104–111.
23. Kaczur V, Vereb G, Molnár I,, Krajczár G, Kiss E, Farid NR et al. Effect of anti-thyroid peroxidase (TPO) antibodies on TPO activity measured by chemiluminescence assay. Clin Chem. 1997; 43(8 Pt 1): 1392–1396.
24. Zöphel K, Saller B, Wunderlich G, Grüning T, Koch R, Wilde J et al. Autoantibodies to thyroperoxidase (TPOAb) in a large population of euthyroid subjects: implications for the definition of TPOAb reference intervals. Clin Lab. 2003; 49(11–12): 591–600.
eISSN:1898-2263
ISSN:1232-1966