Expression and significance of soluble receptor for advanced glycation end products and interleukin-36γ in serum of patients with Hashimoto's thyroiditis
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摘要:目的
探讨可溶性晚期糖基化终产物受体(sRAGE)、白细胞介素-36γ(IL-36γ)在桥本甲状腺炎(HT)患者血清中的表达及其临床意义。
方法选取180例疑似HT人员作为研究对象，根据最终诊断结果分为HT组137例和非HT组43例。依据血清免疫球蛋白G4(IgG4)水平，将HT组患者进一步分为IgG4相关性HT组(IgG4≥135 mg/dL)和非IgG4相关性HT组(IgG4 < 135 mg/dL)。采用酶联免疫吸附试验(ELISA)法检测所有研究对象的血清sRAGE、IL-36γ水平; 绘制受试者工作特征(ROC)曲线，分析血清sRAGE、IL-36γ水平对HT及其IgG4表型的诊断价值。
结果HT组患者血清sRAGE水平低于非HT组，血清IL-36γ水平高于非HT组，差异有统计学意义(P < 0.001); IgG4相关性HT组患者血清sRAGE水平低于非IgG4相关性HT组，血清IL-36γ水平高于非IgG4相关性HT组，差异有统计学意义(P < 0.001)。ROC曲线分析结果显示，血清sRAGE、IL-36γ联合诊断HT的曲线下面积(AUC)为0.900(95%CI: 0.846~0.939), 诊断效能显著高于两者单独诊断(P < 0.05); 血清sRAGE、IL-36γ联合诊断HT患者IgG4表型的AUC为0.897(95%CI: 0.934~0.943)，诊断效能显著高于两者单独诊断(P < 0.05)。
结论HT患者血清sRAGE水平显著降低，血清IL-36γ水平显著升高，联合检测血清sRAGE、IL-36γ水平可有效诊断HT并评估IgG4表型。
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关键词:
- 桥本甲状腺炎 /
- 可溶性晚期糖基化终产物受体 /
- 白细胞介素-36γ /
- 免疫球蛋白G4分型
Abstract:ObjectiveTo explore expression and significance in serum levels of soluble receptor for advanced glycation end products (sRAGE) and interleukin-36 (IL-36) in patients with Hashimoto's thyroiditis (HT).
MethodsA total of 180 individuals suspected of HT were enrolled as study subjects and divided into HT group (n=137) and non-HT group (n=43) based on final diagnostic outcomes. Within the HT group, patients were further divided into serum immunoglobulin G4 (IgG4)-related HT group (IgG4≥135 mg/dL) and non-IgG4-related HT group (IgG4 < 135 mg/dL) according to serum IgG4 levels. Serum levels of sRAGE and IL-36γ were measured in all subjects using enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curves were used to analyze the diagnostic value of serum sRAGE and IL-36γ levels forHT and its IgG4 phenotype.
ResultsSerum sRAGE levels were significantly lower in the HT group compared to the non-HT group, while serum IL-36γ levels were significantly higher (P < 0.001). Patients in the IgG4-related HT group had significantly lower serum sRAGE levels and higher serum IL-36γ levels compared to those in the non-IgG4-related HT group (P < 0.001). ROC curve analysis revealed that the combined diagnosis of serum sRAGE and IL-36γ for HT had an area under the curve (AUC) of 0.900 (95%CI, 0.846 to 0.939), demonstrating significantly higher diagnostic efficiency than either indicator (P < 0.05). For the IgG4 phenotype in HT patients, the combined AUC of serum sRAGE and IL-36γ was 0.897 (95%CI, 0.934 to 0.943), which also significantly higher than individual indicator (P < 0.05).
ConclusionSerum sRAGE levels are significantly decreased, while serum IL-36γ levels are significantly increased in HT patients. Combined detection of serum sRAGE and IL-36γ levels can effectively diagnose HT and assess the IgG4 phenotype.
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表 1 HT组与非HT组临床资料比较[n(%)]
指标 分类 n HT组(n=137) 非HT组(n=43) χ2 P 性别 男 66 45(32.85) 21(48.84) 3.604 0.058 女 114 92(67.15) 22(51.16) 年龄 ≥40岁 96 69(50.36) 27(62.79) 2.030 0.154 < 40岁 84 68(49.64) 16(37.21) 吸烟史 有 73 52(37.96) 21(48.84) 1.607 0.205 无 107 85(62.04) 22(51.16) 饮酒史 有 67 50(36.50) 17(39.53) 0.129 0.719 无 113 87(63.50) 26(60.47) 合并高血压 是 54 41(29.93) 13(30.23) 0.001 0.970 否 126 96(70.07) 30(69.77) 合并糖尿病 是 48 40(29.20) 8(18.60) 1.878 0.171 否 132 97(70.80) 35(81.40) 合并高脂血症 是 51 42(30.66) 9(20.93) 1.525 0.217 否 129 95(69.34) 34(79.07) HT: 桥本甲状腺炎。 
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