Thyroid antibodies in Hashimoto's thyroiditis patients are positively associated with inflammation and multiple symptoms

Abstract

Hashimoto's thyroiditis (HT) is an autoimmune disease, characterized by abnormal elevation in thyroid peroxidase antibody (TPO-Ab) and/or thyroglobulin antibody (TG-Ab). Patients have multiple symptoms despite adequate hormone substitution. In the present study, we aimed to quantify the relationship between thyroid antibodies and multiple symptoms, inflammation and health-related life quality. A total of 108 HT patients with clinical euthyroid status and 57 heathy controls were recruited. Clinical parameters were determined by laboratory examination, and the symptoms burden and life quality were obtained by a Hashimoto's Thyroiditis Symptom Questionnaire and a SF-36 Questionnaire, respectively. Compared with healthy controls, multiple extrathyroidal symptoms were significantly more serious in HT patients despite euthyroid status, mainly including that related to digestive system (abdominal distension, constipation and diarrhea), endocrine system (chilliness, gain weight and facial edema), neuropsychiatric system (forgetfulness, anxiety, depressed, fatigue, insomnia, irritability, and indifferent) and mucocutaneous system (dry skin, pruritus, and hair loss). Furthermore, serum TPO-Ab and TG-Ab were both inversely correlated with health-related life quality of general health and vitality parameters, and positively correlated with pro-inflammatory factors of TNF-α and IFN-γ, as well as severity of abdominal distension, diarrhea, chilliness, forgetfulness and fatigue. Moreover, TG-Ab level was positively associated with depressed, insomnia and indifferent. HT patients suffered from a variety of symptoms, and the elevated thyroid antibodies were inversely associated with health-related life quality and positively associated with inflammation and multiple extrathyroidal symptoms.

Keywords: Extrathyroidal symptoms; Hashimoto’s thyroiditis; Inflammation; SF-36; Thyroid antibody.

Fig. 1

The correlation between thyroid antibodies and the 36-Item Short Form Health Survey scores. (A, B): Serum TPO-Ab levels and general health and vitality scores. (C-F): Serum TG-Ab levels and bodily pain, general health, vitality, and social functioning scores. Abbreviations: TPO-Ab, thyroid peroxidase antibody; TG-Ab, thyroglobulin antibody.

Fig. 2

The correlation between thyroid antibodies and inflammatory factors. (A, B): Serum TPO-Ab levels and TNF-α and IFN-γ. (C, D): Serum TG-Ab levels and TNF-α and IFN-γ. Abbreviations: TPO-Ab, thyroid peroxidase antibody; TG-Ab, thyroglobulin antibody; IFN-γ, interferon-γ; TNF-α, tumor necrosis factor-α.

Fig. 3

The correlation between thyroid antibodies and systematic symptom scores. (A-C): Serum TPO-Ab levels and endocrine system symptom scores, neuropsychiatric system symptom scores, and movement system symptom scores. (D-H): Serum TG-Ab levels and endocrine system symptom scores, neuropsychiatric system symptom scores, mucocutaneous system symptom scores, digestive system scores, movement system scores. Abbreviations: TPO-Ab, thyroid peroxidase antibody; TG-Ab, thyroglobulin antibody.

Fig. 4

The correlation between TPO-Ab and multiple symptom scores. Serum TPO-Ab levels and abdominal distension (A), diarrhea (B), chilliness (C), facial edema (D), forgetfulness (E), swelling (F), gain weight (G), dry skin (H) and menorrhagia (I). Abbreviations: TPO-Ab, thyroid peroxidase antibody.

Fig. 5

The correlation between TG-Ab and multiple symptom scores. Serum TG-Ab levels and abdominal distension (A), diarrhea (B), chilliness (C), gain weight (D), forgetfulness (E), depressed (F), fatigue (G), insomnia (H) and indifferent (I). Abbreviations: TG-Ab, thyroglobulin antibody.