| Abstract | Ciljevi istraživanja: Detaljno opisati ispitivanu skupinu ljudi oboljelih od HT-a s obzirom na prikupljene fenotipove. Utvrditi postoje li razlike u medijanima fenotipova karakterističnih za HT između ispitanika koji primaju terapiju levotiroksinom i onih koji ne primaju terapiju. Utvrditi postojanje korelacija između fenotipova karakterističnih za HT i ostalih značajnih fenotipova te međusobnih korelacija između fenotipova karakterističnih za HT. Ustroj istraživanja: Presječno istraživanje Mjesto istraživanja: Katedra za Medicinsku biologiju, Medicinski fakultet Sveučilišta u Splitu Materijali i metode: Za izradu ovog diplomskog rada su korišteni podatci koji su dobiveni u okviru HRZZ Uspostavne potpore „Cjelogenomska analiza povezanosti Hashimotovog tiroiditisa“. Formirana je baza podataka o ispitanicima oboljelim od HT-a, koji su prikupljeni u KBC-U Split na Kliničkom zavodu za nuklearnu medicinu. Korišteni su podatci o medicinskom statusu ispitanika, kliničkoj klasifikaciji guše, ultrazvuku štitnjače, terapiji te razinama hormona i protutijela štitnjače (TSH, T3, T4, fT4, TgAt, TPOAt). Razine hormona štitnjače (TSH, T3, T4, fT4) i razine protutijela (TgAt, TPOAt) u plazmi sudionika određene su radioimunoesej kvantitativnom metodom. Svi kvantitativni fenotipovi opisani su pomoću medijana i raspona, dok je za kategorijske fenotipove prikazan broj ispitanika i udio (tj. postotak) ispitanika koji pripadaju određenoj kategoriji. Razlike u medijanima testirane su korištenjem neparametrijskog, Mann- Whitney testa. Za testiranje povezanosti promatranih varijabli korišten je Spearmanov test korelacije. Rezultati: Okarakterizirali smo 405 ispitanika u ovom istraživanju, uzimajući u obzir razine hormona i protutijela štitnjače, antropometrijske karakteristike i pušačke navike. Kao najčešći simptom hipotireoze se javlja slabost (64,7%), a najčešći komorbiditet astma ili alergija (15,5%). Većina ispitanika (85,8%) ima difuznu bolest štitnjače, a 57,7% ispitanika se nalazi u kategoriji 1a koja predstavlja pacijente s palpabilnom štitnjačom koja se ne vidi pri istezanju vrata. Uočili smo i značajne razlike u laboratorijskim vrijednostima razine hormona i protutijela među ispitanicima na terapiji i ispitanicima koji ne primaju terapiju. Kao najznačajniju novu korelaciju koju smo pronašli, izdvajamo pozitivnu korelaciju između TgAt i broja simptoma. Ostali dobiveni rezultati su u skladu s literaturom. Zaključak: Ovim radom smo, uz detaljnu karakterizaciju ispitivane skupine, dodatno potvrdili dobivene rezultate o HT-u iz prethodnih istraživanja. Prvi smo ukazali na povezanost TgAt i broja simptoma. Našim radom smo pridonijeli osvjetljavanju kliničke slike HT-a i ukazali na prognostičku ulogu protutijela na tijek bolesti. |
| Abstract (english) | Objectives: The main aim of our research was to describe in detail the group of individuals with HT regarding collected/measured phenotypes. The next objective was to determine whether there are differences in medians of HT-specific phenotypes among individuals receiving levothyroxine therapy and those who do not receive therapy. Finally, we aim to determine the correlation between phenotypes characteristic for HT and other significant phenotypes and, also, a correlation between HT-characteristic phenotypes. Design: Cross-section study Settings: Department of Medical Biology, University of Split School of Medicine Materials and methods: For the purposes of this graduate thesis we obtained the data from the HRZZ under the HRZZ Installation Grant "Genome-wide association analysis of Hashimoto's thyroiditis". HT patients were recruited after examination in Outpatient clinic for thyroid disorders at Department of Nuclear Medicine, University Hospital Split. The information on medical status of subjects, clinical classification of goitre, thyroid ultrasound, therapy, and levels of hormones and thyroid antibodies (TSH, T3, T4, fT4, TgAt, TPOAt) were used. Thyroid hormones (TSH, T3, T4, fT4) and antibody levels (TgAt, TPOAt) in plasma of participants were determined by radioimmunoassay method. All quantitative phenotypes are described by median and span, while for categorical phenotypes the number of subjects and the percentage of subjects from particular category are shown. Differences in medians were tested using non-parametric, Mann-Whitney test. Spearman's correlation test was used to test the correlation of observed variables. Results: We have characterized 405 subjects in this study, focusing on hormone levels, thyroid antibodies, anthropometric characteristics and smoking habits. The most common symptom of hypothyroidism in our study is nausea (64,7%), and the most common comorbidity is allergy or asthma (15,5%). Most of the subjects (85.8%) have a diffuse thyroid disease, while 57.7% of respondents belong in category 1a, which corresponds to palpable thyroid that is not visible at the stretching of the neck. We also noted significant differences in laboratory values of hormone levels and antibodies between respondents on therapy and non-therapeutic subjects. As the most significant finding in our study, we highlight the positive correlation between TgAt and the number of symptoms. Other results obtained are consistent with the literature. Conclusion: We performed a detailed characterization of the group of patients with HT, resulting with additional evidence and confirmations of findings from previous studies. We are the first to point to the newly discovered correlation between TgAt and the number of symptoms. Through our work we have contributed to better understanding of HT's clinical image and pointed out the prognostic value of antibodies with respect to disease severity. |
