山东沿海地区碘营养状况和HLA等位基因DQA1*0501、DQA1*0201对AITDs发病的影响

目的探讨山东沿海地区自身免疫性甲状腺病（AITDs）与HLA等位基因DQA1＊0501、DQA1＊0201及碘营养状况对AITDs发病的影响。方法HLA等位基因测定采用PCR-SSP技术，尿碘浓度测定采用砷铈催化分光光度法。结果①DQA1＊0501等位基因为AITDs易感基因（GD和HT的OR值=2．14、2．5）；而DQA1＊0201为女性AITDs保护基因（GD和HT的OR值=0．33、0．27）。②AITDs组尿碘浓度高于300μg／L患者分布频率均显著高于对照组（P〈0．05），且DQA1＊0501（＋）发生AITDs的OR值为2．7，DQA1＊0201（＋）的OR值为0．42；AITDs组碘正常组DQA1＊0501（＋）OR值为5．12，DQA1＊0201（＋）的OR值为0．21。③logistic回归分析发现尿碘浓度对数、DQA1＊0501为AITDs的易感因素，DQA1＊0201为保护因素。结论HLA-DQA1＊0501等位基因与该地区AITDs的发病易感性相关，而DQA1＊0201与女性患者的保护性相关。碘和HLA等位基因DQA1＊0501、DQA1＊0201共同影响GD、HT的发病。

Influences of the iodine nutrition status and the HLA- DQA1 * 0501 and -DQA1 * 0201 alleles on the pathogenesis of AITDs in coastal area of Shandong province

Objective To investigate the association of HLA-DQA1*0501 and-DQA1*0201 alleles with autoimmune thyroid disea-(ses(AITDs)) patients in Shandong seashore areas,and evaluate the effects of iodine nutrition status on AITDs.Methods AITDs were divided into graves disease(GD) group and hashimoto thyroiditis(HT) group.The HLADQA1*0501 and DQA1*0201 alleles were detected by polymerase chain reaction with sequence-specific primers(PCR-SSP).The urine iodine concentration was determined by China national standard method.Results The frequency of the HLA-DQA1*0501 allele was significantly higher in GD and HT female groups than in control(GD: P < 0.05,OR = 0.33;HT: P < 0.01,OR = 0.27).The frequency of the HLA-DQA1*0201 allele was significantly lower in GD and HT groups than in control(GD P < 0.01,OR = 0.4;HT P < 0.05,OR = 0.42).The median values of urinary iodine of GD and HT patients were significantly higher than that of control group in Shandong seashore areas(P < 0.05).In the subjects of DQA1*0501 allele(-),the median values of urinary iodine in GD and HT patients with hyperthyroidism were significantly higher than that in control group(P < 0.05).In the subjects of DQA1*0201(+),the median values of urinary iodine in GD and HT patients was significantly higher than that in control group(P < 0.05).The logarithm of urinary iodine and the DQA1*0501 were positive correlated with GD and HT by multiple logistic regression analysis;DQA1*0201 was negative correlated with GD and HT.Conclusion The HLA-DQA1*0501 allele is positively associated with mosbidity of GD and HT in Shandong coastal districts,whereas HLA-DQA1*0201 allele is associated with protection of GD and HT,especially for female patients.Iodine,HLA-DQA1*0501,and HLA-DQA1*0201 alleles have cooperative effect on the pathogenesis of GD and HT.