Expression Levels Of Serum Cytokines And Blood Lipids In Patients With Thyroid Associated Ophthalmopathy And Their Clinical Significance

Purposes:Thyroid Associated Ophthalmopathy(TAO)is a complex autoimmune disease,in which cytokines play an important role in the immune process.As a newly discovered risk factor,blood lipids may affect the occurrence and development of TAO through inflammatory cytokines.This study aims to detect the levels of 12 inflammatory cytokines in patients’ peripheral blood,Explore the types of inflammatory factors related to the onset of TAO;To understand the blood lipid levels of TAO patients through serum lipid testing and explore the correlation between blood lipids and TAO;And explore the correlation between serum inflammatory cytokines,blood lipids,and TAO,providing new evidence and clues for the pathogenesis,prevention,and treatment of thyroid associated ophthalmopathy.Methods:The study selected 24 patients(15 males and 9 females)who were first diagnosed with TAO in the ophthalmology department of the Second Affiliated Hospital of Nanchang University from January 2022 to December 2022,with an average course of 10 months and an age of 50.50±13.48 years;Among them,there were 14 cases in the active phase and 10 cases in the inactive phase.14 patients with Idiopathic Orbital Inflammatory Pseudotumor(IOIP)admitted to our department during the same period were selected as controls,including 7 males and 7 females,with an average course of 12 months and an age of 57.79±11.29 years.And 24 patients with intradermal nevi,eyelid skin laxity,and congenital ptosis were selected as controls.All patients in the three groups used automatic biochemical analyzer to detect blood lipids,flow cytometry to detect 12 cytokines and TB/NK cells in serum,and chemiluminescence analyzer to detect serum free thyroxine(FT4),free triiodothyronine(FT3),thyroid hormone(TSH),and thyroid hormone receptor antibody(TRAb).SPSS26 was used for statistical analysis of all data,and P<0.05 indicates a statistically significant difference.Results:1.Among the 12 serum cytokines of 24 TAO and 14 IOIP patients,only some patients were observed to have IL-5,IL-1β,IL-6,IL-8,IL-17,and IFN-y factor expression levels exceeding the normal reference range;2.The expression levels of IL-5,IL-2,IL-6,IL-17,and TNF-α in the serum of the TAO group were higher than those of the control group,with a statistically significant difference(P<0.05).There was no statistically significant difference in serum IL-1β and IL-8 between the TAO group and the control group(P>0.05);3.The expression levels of serum IL-5,IL-2,and IL-6 in the IOIP group were higher than those in the control group,with a statistically significant difference(P<0.05).There was no statistically significant difference in serum IFN-γ between the IOIP group and the control group(P>0.05);4.There was no statistical difference in the levels of various cell factors between the TAO group and the IOIP group(P>0.05);5.TB/NK cell count tests,CD16+CD56+%in the TAO group was 13.97±5.86%,24.29±13.26%in IOIP group,in the control group was 14.04±4.67%,IOIP group is higher than TAO group and the control group,the difference was statistically significant(P<0.05);CD 19+%in the TAO group was 15.53±4.78%in IOIP group was 11.00±4.52%,12.48±3.29%in the control group,TAO above IOIP group and control group,the difference was statistically significant(P<0.05);TH/S was 1.93±0.90 in TAO group,2.16±0.86 in IOIP group and 1.51±0.29 in control group,and the IOIP group was higher than control group,the difference was statistically signi fi cant(P<0.05);6.In the TAO group,66.67%(16/24)patients had abnormal lipid levels,among which 68.75%(11/16)patients were active TAO patients and 31.25%(5/16)patients were inactive TAO patients;7.In the TAO group,37.50%(9/24)of patients had elevated total cholesterol(CHOL),37.50%(9/24)of patients had elevated triglycerides(TG),and 41.67%(10/24)of patients had high density lipoprotein(HDL)below the normal reference range.In the active TAO group,CHOL was elevated in 35.71%(5/14),TG was elevated in 42.86%(6/14),and HDL was lower than the normal reference range in 42.86%(6/14).In the non-active TAO group,40.00%(4/10)of patients had elevated CHOL,30.00%(3/10)of patients had elevated TG,and 40.00%(4/10)of patients had HDL below the normal reference range;8.The TRAb content of TAO formation was 2.22(0.46,6.28)IU/L,The TRAb levels in TAO patients were 3.19(1.63,14.08)IU/L during the active phase and 0.68(0.15,4.28)IU/L during the inactive phase,with a statistically significant difference(P<0.05);TRAb is positively correlated with CAS score(r=-0.490,P=0.015).TRAb has clinical significance in the evaluation of TAO activity(P<0.05),with a maximum curve area of 0.761(95%CI:0.553-0.968),sensitivity of 85.70%,specificity of 70.00%,and optimal diagnostic cutoff point of 1.18IU/L;9.There was no statistical difference in the expression of serum cytokines and blood lipids between active and inactive TAO patients.(P>0.05);10.In the TAO group,CHOL was positively correlated with IFN-α(r=0.442,P<0.05),HDL was positively correlated with TNF-α(r=0.416,P<0.05),low density lipoprotein(LDL)was positively correlated with IL-5,IL-12P70(r=0.482,0.434,P<0.05),apolipoprotein A(ApoA)was positively correlated with IFN-γ(r=0.637,P<0.01),and apolipoprotein B(ApoB)was positively correlated with IL-5(r=0.483,P<0.05),ApoE was positively correlated with IFN-γ(r=0.443,P<0.05),while homocysteine was negatively correlated with IFN-γ(r=-0.444,P<0.05).Conclusions:1.Serum cytokines IL-5,IL-2,IL-6,IL-17,and TNF-α may participate in the immune response of TAO.2.TAO CHOL and cytokines in patients with IFN-α,and TNF-α,LDL and HDL cholesterol IL-5,IL-12 p70 were positively correlated,but not as a judge TAO was active.3.TRAb may be used as one of the indicators to evaluate TAO disease activity.