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）是一种累及自身免疫性甲状腺疾病患者的严重进展性眼部病症，以眶周软组织炎症与肿胀为核心特征。脂肪组织可分泌一类被称为脂肪因子的细胞因子介质。本研究聚焦于GO患者血清中选定脂肪因子的水平与对照受试者的关联，并首次系统阐述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。本研究共纳入60例GO患者与34名对照受试者，采集其接受HDSC治疗前后的外周血样本，检测了脂联素（adiponectin）、AIF-1、A-FABP及FGF-21的血清浓度。三组研究对象的脂联素水平存在显著统计学差异（方差分析ANOVA，p=0.03）；AIF-1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、体质量指数（BMI）及促甲状腺激素（TSH）水平等临床混杂因素后，AIF-1水平与GO患病风险显著相关（比值比odds ratio=1.003，p<0.01）。鉴于AIF-1被认为是巨噬细胞活化的特异性标志物，该研究结果可为GO的治疗策略靶向巨噬细胞提供重要理论支撑。