Adipocytokines in Graves’ orbitopathy and the effect of high-dose corticosteroids

Graves’ orbitopathy (GO) is a serious, progressive eye condition seen in patients with autoimmune thyroid disease. GO is characterized by inflammation and swelling of soft orbital tissues. Adipose tissue produces cytokine mediators called adipokines. The present study focuses on the relationship between serum levels of selected adipokines in patients with GO, comparing them with the control group, and uniquely describes the effect of high-dose systemic corticosteroids (HDSC) on their levels. For the purposes of this study, we collected blood samples before and after the treatment with HDSC from 60 GO patients and 34 control subjects and measured serum levels of adiponectin, AIF-1, A-FABP and FGF-21. Levels of adiponectin significantly differed among the three study groups (ANOVA p = 0.03). AIF-1 levels were also significantly different among the study groups (ANOVA p < 0.0001). AIF-1 was significantly associated with the presence of GO after adjusting for clinical factors (age, sex, smoking and BMI) and level of TSH (odds ratio 1.003, p < 0.01). This finding could enforce targeting macrophages in treatment strategies for GO since AIF-1 is considered as a marker of their activation.

格雷夫斯眼病（Graves’ orbitopathy, GO）是一类发生于自身免疫性甲状腺疾病患者体内的严重进行性眼部疾病，以眼眶软组织的炎症与肿胀为核心特征。脂肪组织可分泌一类名为脂肪因子（adipokines）的细胞因子介质。本研究聚焦于格雷夫斯眼病患者血清中选定脂肪因子的水平，并与对照组进行对比，同时首次阐明了大剂量全身糖皮质激素（high-dose systemic corticosteroids, HDSC）对这些脂肪因子水平的影响。本研究共收集60例格雷夫斯眼病患者与34例对照受试者在接受大剂量全身糖皮质激素治疗前后的血液样本，检测了血清脂联素（adiponectin）、同种异体炎症因子1（AIF-1）、脂肪细胞型脂肪酸结合蛋白（A-FABP）及成纤维细胞生长因子21（FGF-21）的水平。方差分析（ANOVA）结果显示，脂联素水平在三组研究对象间存在显著差异（p=0.03）；同种异体炎症因子1的水平在各组间亦存在显著统计学差异（ANOVA p<0.0001）。在校正年龄、性别、吸烟史与体质量指数（BMI）等临床因素及促甲状腺激素（TSH）水平后，同种异体炎症因子1与格雷夫斯眼病的患病状态显著相关（比值比（odds ratio）=1.003，p<0.01）。鉴于同种异体炎症因子1可作为巨噬细胞活化的标志物，该发现可为格雷夫斯眼病的靶向巨噬细胞治疗策略提供理论依据。