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Vitamin D and autoimmune thyroid diseases 被引量:47
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作者 Shaye Kivity Nancy Agmon-Levin +6 位作者 Michael Zisappl Yinon Shapira Endre V Nagy Katalin Danko zoltan szekanecz Pnina Langevitz Yehuda Shoenfeld 《Cellular & Molecular Immunology》 SCIE CAS CSCD 2011年第3期243-247,共5页
The role of vitamin D as an immune modulator has been emphasized in recent years,and low levels of the hormone were observed in several autoimmune diseases including multiple sclerosis and systemic lupus erythematosus... The role of vitamin D as an immune modulator has been emphasized in recent years,and low levels of the hormone were observed in several autoimmune diseases including multiple sclerosis and systemic lupus erythematosus.Vitamin D mediates its effect though binding to vitamin D receptor(VDR),and activation of VDR-responsive genes.While VDR gene polymorphism was found to associate with autoimmune thyroid diseases(AITDs),few studies examined levels of vitamin D in these patients and those that did yielded conflicting results.We therefore undertook to evaluate the levels of vitamin D in patients with AITDs compared to patients with non-AITDs and healthy controls.Serum vitamin D(25-OH)levels were measured in 50 patients with AITDs,42 patients with non-AITDs and 98 healthy subjects,utilizing the LIAISON chemiluminescence immunoassay(DiaSorin,Saluggia,Italy).VitaminD deficiency was designated at levels lower than 10 ng/ml.Antithyroid antibodies,thyroid functions and demographic parameters were evaluated in all patients.The prevalence of vitamin D deficiency was significantly higher in patients with AITDs compared with healthy individuals(72% versus 30.6%;P<0.001),as well as in patients with Hashimoto’s thyroiditis compared to patients with non-AITDs(79% versus 52%;P<0.05).Vitamin D deficiency also correlated to the presence of antithyroid antibodies(P=0.01)and abnormal thyroid function tests(P=0.059).Significantly low levels of vitamin D were documented in patients with AITDs that were related to the presence of anti thyroid antibodies and abnormal thyroid function tests,suggesting the involvement of vitamin D in the pathogenesis of AITDs and the advisability of supplementation. 展开更多
关键词 AUTOANTIBODIES autoimmune thyroid disease Graves’disease Hashimoto’s thyroiditis vitamin D
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难治性类风湿关节炎的临床特点:一项国际问卷调查研究 被引量:1
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作者 Nadia MT Roodenrijs Maria J H de Hair +14 位作者 Marlies C van der Goes Johannes WG Jacobs Paco MJ Welsing Désirée van der Heijde Daniel Aletaha Maxime Dougados Kimme L Hyrich Iain B McInnes Ulf Mueller-Ladner Ladislav Senolt zoltan szekanecz Jacob Mvan Laar Nagy Gyorgy 黄艳荣(译) 张卓莉(审校) 《英国医学杂志中文版》 2019年第2期122-122,共1页
目的尽管按照目前欧洲抗风湿联盟(EULAR)的推荐对类风湿关节炎(rheumatoid arthritis,RA)患者进行治疗,难治性RA患者的临床症状却仍然没有得到完全控制,目前EULAR指南主要关注的是RA的早期治疗和药物治疗。本研究的目的在于分析难治性R... 目的尽管按照目前欧洲抗风湿联盟(EULAR)的推荐对类风湿关节炎(rheumatoid arthritis,RA)患者进行治疗,难治性RA患者的临床症状却仍然没有得到完全控制,目前EULAR指南主要关注的是RA的早期治疗和药物治疗。本研究的目的在于分析难治性RA患者的临床特点,以及在患者管理中需要探索然而现有EULAR指南并未涉及的问题。方法对多个国家的风湿科医生进行问卷调查,分析难治性RA的临床特点。问卷包括多选题以及开放性问题,从开放性问题的回答中发现需要进一步阐明的问题以及现有EULAR指南需要增加的内容。结果410名受访者完成了调查问卷,关于难治性RA的特点:50%受访者认为基于28个关节评估的疾病活动评分(disease activity score assessing 28 joints,DAS28)>3.2或存在疾病活动的征象;42%受访者认为疲劳是其特点;48%认为至少两种传统合成改变病情抗风湿药(DMARDs)以及使用至少两种生物制剂或靶向合成DMARDs治疗失败;89%认为糖皮质激素不能减量到5 mg/天或泼尼松不能减量到10 mg/天或同等剂量的其他激素。另外,现有EULAR指南中应增加合并症和关节外表现的干预以及多种药物联合治疗等重要内容。结论目前风湿科医生对难治性RA的定义有很大争议。难治性RA患者的很多重要问题目前EULAR指南中均没有涉及。 展开更多
关键词 难治性类风湿关节炎 临床特点 问卷调查 改变病情抗风湿药 DMARDS 患者管理 糖皮质激素 国际
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