2型糖尿病周围神经病变病人甲状腺激素及抗体表达水平变化的研究

目的 探讨2型糖尿病周围神经性病变(DPN)病人甲状腺激素及抗体水平的变化及临床意义.方法 选取2018年12月至2019年12月于上海健康医学院附属嘉定区中心医院住院2型糖尿病病人共260例,其中观察组为2型糖尿病周围神经性病变病人(n=128),对照组为单纯2型糖尿病病人(n=132).收集两组病人的性别、年龄、糖...     

Hepatitis C virus infection is frequently associated with high titers of anti-thyroid antibodies

Objective: To assess the implication of hepatitis C virus (HCV) infection in the development of autoimmune thyroid response, thyroid autoantibodies were studied in serum of HCV positive patients. Methods: Anti-microsomal, anti-thyroperoxidase (anti-TPO) and anti-thyroglobulin antibodies were evaluated in the sera of 100 patients with chronic hepatitis C (53 women and 47 men; mean age = 55±5 years). In parallel, thyroid autoantibodies were investigated in blood samples obtained from two separated control groups: age-matched HCV negative-HBV positive patients (25 women, 25 men; mean age= 47±6 years) and healthy blood donors (29 women and 21 men; mean age= 54±8 years). Results: Anti-thyroid antibodies were found more frequently in HCV positive women when compared to the men (8/53= 15.1% vs 0/47= 0%,.p<0.01).The prevalence of these autoantibodies was not statistically different between HCV positive and healthy female blood donors. However the investigation of thyroid autoantibody titers showed significantly higher levels of anti-TPO and anti-microsomal antibodies in HCV positive women in comparison with healthy women controls (respectively 1: 83200 vs 1: 1900 and 834 vs 23, p<0,01). Conclusions: This strong association between HCV infection and high levels of anti-thyroid autoantibodies in women outlines the interest of systematic detection of anti-microsomal and/or anti-TPO antibodies in this population.     

Prevalence of HCV antibodies in autoimmune thyroid disease

BACKGROUND AND OBJECTIVES: Auto-immune thyroid disease (AITD) has often been reported during interferon-alpha therapy for chronic viral C hepatitis (HCV) or other diseases. Recently, a high AITD prevalence has been reported in HCV independently on alpha-interferon therapy. The aim of our study is to investigate the possible relationship between AITD and HCV and HBV virus infections, and their influence on the thyroid function. MATERIAL AND METHODS: We prospectively studied 112 patients with AITD (94 women and 18 men; mean age: 49.8 +/- 14.9 yrs) and 88 patients with non-toxic goitre (NTG) (73 women and 15 men; mean age: 50.2 +/- 13.5 yrs) as controls. In all patients HCV antibodies, HBsAg and anti-HBs antibodies, TSH, FT3 and FT4 serum levels, circulating anti-thyroid-peroxidase antibodies (TPO-Ab) and anti-thyroglobulin antibodies (TG-Ab) were measured. RESULTS: HCV antibodies were positive in 11.6% of AITD patients (13/112) and in 2.3% of controls (2/88) (P < 0.05), the prevalence of HCV in the controls being similar to the expected value in the general population (about 2%). HBsAg and anti-HBs were found only in 2.6% of AITD patients (3/112) and 1.1% of controls (1/88) (P = NS), according to the expected value in the general population (about 2.5%). No difference in thyroid function was observed between positive and negative HCV subgroups. CONCLUSION: A significant association between HCV infection and AITD was found. This finding confirms that HCV, but not HBV, could be one of the environmental factors responsible for the breakdown of immunological tolerance. Therefore detection of TPO-Ab and TG-Ab in all HCV patients, independently of IFN therapy, is suggested and the utility of a screening for HCV in all AITD patients is stressed.     

Hypothyroidism in the pregnant woman

Around 1-2% of pregnant women receive levothyroxine treatment for overt hypothyroidism. This condition, which commonly has an autoimmune cause, is defined as a low plasma free thyroxine (T4) concentration and a raised plasma thyroid-stimulating hormone (TSH) concentration. Around another 2.5% of pregnant women have subclinical ('compensated') hypothyroidism, which is defined as a raised plasma TSH concentration with a normal free T4 concentration. Here we review the evidence on whether such problems affect pregnancy outcome or the offspring and update our previous advice on the management of hypothyroidism in pregnancy; we do not cover postpartum thyroid disorders.     

Mental improvement after replacement therapy with thyroxine plus triiodothyronine: relationship to cause of hypothyroidism

We treated 26 hypothyroid women - 11 with autoimmune thyroiditis and 15 who had been treated for thyroid cancer - with their usual dose of thyroxine (T4) or with a regimen in which 50 &mgr;g of T4 had been replaced by 12.5 &mgr;g of triiodothyronine (T3). Patients were first randomly assigned to one regimen for 5 wk and then to a second regimen for an additional 5 wk. The substitution of T3 for a portion of T4 caused expected changes in concentrations of thyroid hormones and thyroid-stimulating hormone (TSH). After combined hormone treatment there were clear improvements in both cognition and mood, the latter changes being greater. The patients who had been treated for thyroid cancer showed more mental improvement than the women with autoimmune thyroiditis, perhaps because they were more dependent on exogenous hormone. Some mood improvements correlated positively with changes in TSH while others correlated negatively with changes in free T4.     

抗甲状腺过氧化酶抗体与早期自然流产相关性分析

目的：分析抗甲状腺过氧化酶抗体与早期自然流产的相关性。方法：选取2013年9月～2014年12月到我院就诊的122例早期自然流产患者为病例组,以同期来我院行健康体检的60例健康女性为参照组。采用电化学发光法监测所有对象的血清甲状腺功能,包括抗甲状腺过氧化酶抗体（TPO-Ab）和抗甲状腺球蛋白抗体（TG-Ab）,分析比较两组研究对象的监测结果。结果：①病例组的TG-Ab、TPO-Ab水平均明显高于参照组（P＜0.05）;②病例组的TG-Ab阳性率（75.41％）、TPO-Ab阳性率（52.46％）、TA阳性率（50.00％）均显著高于参照组（分别为1.67％、0和1.67％）（P＜0.05）;③多元回归分析结果显示,早期自然流产与抗甲状腺过氧化酶抗体（TPO-Ab）阳性存在相关性。结论：抗甲状腺过氧化酶抗体（TPO-Ab）阳性与早期自然流产存在相关性,需做好甲状腺自身抗体检测和其他措施,降低早期自然流产的发生率。     

不孕症病人血清白细胞介素-6和甲状腺功能的相关性研究

目的 了解不孕症病人血清白细胞介素-6(IL-6)的水平及其与甲状腺功能的相关性.方法 选取66例不孕症女性为不孕组,根据其血清甲状腺激素水平将其分为不孕合并甲状腺功能减退组(32例)和不孕未合并甲状腺功能减退组(34例),另外选取健康孕龄期妇女29例为对照组,分别测定三组血清中IL-6、甲状腺激素及甲状腺自身抗体的水平.结果 (1)与对照组相比,不孕组病人血清IL-6水平升高(P<0.01);(2)在不孕症病人中,不孕合并甲减病人较不孕未合并甲减病人血清IL-6水平升高(P<0.01);(3)不孕症女性中,血清抗甲状腺球蛋白抗体(ATG)、抗甲状腺过氧化物酶抗体(TPO-Ab)阳性病人较阴性病人血清IL-6水平升高(P<0.01);(4)不孕症病人血清IL-6水平与游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、ATG、TPO-Ab均呈线性相关(P<0.01).多元线性回归分析调整混杂因素后,IL-6与FT3、FT4的相关性更为显著(P<0.05).结论 不孕症病人血清IL-6水平升高,尤其在合并甲减时更为明显,提示IL-6与甲状腺激素水平有一定的相关性.同时,甲状腺自身抗体阳性的不孕症病人也可通过影响IL-6的水平参与不孕症的发生发展.     

甲状腺过氧化物酶抗体的临床应用

甲状腺疾病是一组比较复杂的内分泌疾病,用于该疾病检测的实验室项目也日益增多,今天我们主要讨论甲状腺过氧化物酶抗体在我院临床诊断甲状腺类疾病的应用。甲状腺过氧化物酶（TPO）是位于甲状腺上皮细胞的顶端细胞膜上,直接参与甲状腺细胞中的氧化酪氨酸的碘化及碘化酪氨酸的偶联等。它是甲状腺激素合成过程中的关键酶。TPO 也是自身免疫性甲状腺疾病的(AITD)一种重要的自身抗原,可以刺激机体免疫系统产生TPO抗体（TPO-Ab）。TPO-Ab作为AITD一种主要的自身抗体,可通过激活补体,抗体依赖细胞介导的细胞毒作用和致敏的T杀伤细胞直接杀伤等作用机制,引起甲状腺滤胞损伤,间接的抑制甲状腺的合成,导致甲状腺功能减退的主要机制。所以TPO-Ab水平的检测是诊断AITD的一项不可缺少的实验室指标。     

Do thyroid abnormalities detected in patients treated for HCV-related chronic hepatitis persist?

One hundred and twenty-one patients with HCV-related chronic hepatitis and normal baseline thyroid function were studied. Forty-six patients received IFN alpha-2b, while 75 patients had Peg-IFN alpha-2b with ribavirin more recently. Thirty patients (ten belonging to the standard IFN group) were re-treated. The pre-treatment prevalence of thyroid antibodies was 3.3%. At the end of the first antiviral treatment, the prevalence of laboratory alterations (presence of antibodies and abnormal hormonal levels) of thyroid was assessed to be 20.7% (25 patients), being quite similar for standard-interferon- and pegylated-interferon-treated patients (P = 0.63). TSH level alteration was seen in eleven patients (9.1% of the overall population and 44% of the antibodies positive patients), of whom ten were females. The anti-microsomal, anti-thyroperoxidase and anti-thyroglobulin antibodies, in combined or isolated presence, were detected in all 25 patients. During the re-treatment we noticed worsening only of previous thyroid abnormalities. No patient changed the antiviral schedule after the emerging of thyroid alterations. All eleven patients remained thyroid dysfunctional at the end of the follow-up (ten with Hashimoto's thyroiditis and one with Graves disease), meanwhile the near totality of patients with presence of antibodies remained positive. Interestingly, eight out the 14 patients who showed mood disorders after antiviral therapy, belonged to the aforementioned cohort.     

Acute-phase reactans in Hashimoto thyroiditis

Hashimoto thyroiditis (HT) is one of the autoimmune diseases of the thyroid gland. It is characterized by diffuse lymphocytic infiltration of the thyroid gland and the elevated levels of the serum anti-thyroid antibodies. Recently Hashimoto thyroiditis has been proposed as a systemic disorder. Acute-phase reactans have been implicated for their involvement as pro-inflammatory molecules in various inflammatory diseases. The aim of the present study was to examine the blood concentrations of acute-phase proteins, namely C-reactive protein (CRP), serum amyloid A (SAA) and fibrinogen in the patients with Hashimoto thyroiditis. Two groups were enrolled: study group consisting from euthyroid patients with HT (n=30), and healthy control subjects (n=30). Blood samples were obtained from all the patients and control subjects and were analyzed for serum CRP, SAA, fibrinogen, and ESR. Mean ESR was found to be higher in HT patients than control group (p=0.024). The mean fibrinogen and SAA values in HT were also significantly higher than that of the control group (p=0.03, p=0.002). We therefore suggest that a low-grade systemic inflammation may exist in HT patients even if they were euthyroid.     

Thyroid status and the levels of thyroid auto-antibodies in the sera of hyperthyroid and goitrous subjects

OBJECTIVES: To determine the prevalence of thyroid auto-antibodies in specimens sent to Parirenyatwa hospital laboratory for thyroid function testing and to compare the thyroid status of these patients with that of apparently healthy subjects. DESIGN: Cross sectional study. SETTING: Immunology and radio-immunoassay laboratories, Parirenyatwa hospital, Department of Chemical Pathology, and Blood Transfusion Services, Harare. SUBJECTS: 212 blood samples submitted for thyroid function testing and 230 blood samples from apparently healthy blood donors. MAIN OUTCOME MEASURES: Serum concentrations of free triiodothyronine (FT3), thyroxine (FT4), thyrotropin (TSH), and thyroid auto-antibodies; anti microsomal (M Ab) and antithyroglobulin (Ag Ab) antibodies. RESULTS: The hyperthyroid subjects had median serum TSH level of 0.027 mIU/L (Q1 = 0.006, Q3 = 0.052), median serum FT3 level of 15.895 pmol/L (Q1 = 10.563; Q3 = 30.111), and a median serum FT4 level of 45.513 pmol/L (Q1 = 30.256; Q3 = 63.910). The goitrous subjects had median serum TSH level of 0.390 mIU/L (Q1 = 0.157; Q3 = 0.745). The blood donor group had median TSH value of 0.724 mIU/L (Q1 = 0.471; Q3 = 1.170). (Normal ranges: TSH = 0.167 to 2.80) Amerlite TSH-30 diagnostic kit; FT3 = 3.4 to 7.2 pmol/L; FT4 = 11 to 24 pmol/L) Amelex-MAB diagnostic kits) Thirty nine percent of the hyperthyroid subjects had either positive M Ab or Tg Ab or both. None of the goitrous subjects and the blood donors tested positive for neither M Ab, nor Tg Ab. No significant difference was found between the blood donors and the goitrous subjects for serum FT4 (P = 0.51). However, significant differences were found between the goitrous, the blood donor and the hyperthyroid groups with regards to serum TSH, serum FT4, and serum FT3 levels (p = 0.001). CONCLUSION: Our findings indicate that the occurrence of thyroid auto-antibodies among the blood donors and the goitrous population was uncommon, but high in the hyperthyroid subjects. The increase of iodine intake through iodine prophylaxis could have had the side effects of iodine induced hyperthyroidism.     

雷公藤皂苷和白介素-10抑制树突状细胞诱导实验性自身免疫性甲状腺炎(英文)

目的:研究雷公藤皂苷和白介素-10(IL-10)在树突状细胞(DC)诱导实验性自身免疫性甲状腺炎(EAT)中的作用.方法:ELISA法检测甲状腺球蛋白抗体水平,TNF_β和NO分别采用生物学方法及Griess法测定,淋巴细胞增殖试验采用MTT掺入法.结果:DC能诱导EAT的发生,表现为甲状腺内出现淋巴细胞浸润并伴有血清中TgAb明显升高;但经雷公藤皂苷和IL-10处理后,DC不能诱导EAT的发生,表现为甲状腺无病理改变,血清中TgAb明显低下.同时,雷公藤皂苷组和IL-10组小鼠TNF_β活性、NO浓度和淋巴细胞增殖能力显著低于树突状细胞组(P<0.05).结论:雷公藤皂苷和IL-10能显著抑制DC诱导EAT的发生.     

甲状腺激素与甲状腺结节良恶性的关系

【摘要】目的 观察甲状腺结节（TN）患者血清甲状腺激素的水平并探讨其与TN良恶性的关系。方法随机抽取TN患者245例,根据甲状腺相关抗体水平及术后病理结果分为结节性甲状腺肿组（NG组）、甲状腺腺瘤组（TA 组）和甲状腺癌组（TC组）,TC组进一步分为甲状腺相关抗体升高组（TC-Ab +组）和甲状腺相关抗体正常组(TC-Ab - 组)。检测患者术前血清游离T3（FT3）、游离T4（FT4）和促甲状腺激素（TSH）。分析各组患者甲状腺激素水平的差异。结果以NG组、TA组和TC组3组比较时,TC组血清TSH水平高于其他2组（P＜0.05）。TC-Ab +组血清FT3水平低于NG组和TC-Ab -组,FT4水平低于NG组,TSH水平明显高于其他各组（P＜0.05）。结论部分TC患者出现血清TSH水平升高,其原因可能是由于伴有自身免疫性甲状腺炎并继发了甲状腺功能减退。血清TSH水平升高未必是TC的固有特征。     

脑卒中急性期情感障碍患者甲状腺功能变化的临床研究

目的探讨脑卒中急性期情感障碍患者甲状腺功能的变化。方法对109例急性脑卒中患者进行分组(卒中后无情感障碍组55例和卒中后情感障碍组54例)。收集两组发病第2天及第14天两次空腹血清,采用化学发光法进行甲状腺功能测定,并与40名正常对照组比较分析。结果第2天甲状腺功能变化情况:两观察组比对照组血清游离三碘甲状腺原氨酸(FT3)水平明显下降,而血清游离甲状腺素(FT4)水平显著增高,脑卒中后情感障碍组比无情感障碍组的变化程度更显著;卒中后无情感障碍组血清促甲状腺素(TSH)水平比对照组显著增高,但脑卒中后情感障碍组TSH水平升高不明显。第14天甲状腺功能变化情况:卒中后无情感障碍组FT3、FT4、TSH均恢复接近正常,与对照组比较差异无统计学意义;卒中后情感障碍组FT3、FT4虽有恢复但不明显,与对照组比较差异有统计学意义;3组的TSH水平比较差异均无统计学意义。结论卒中患者甲状腺功能都发生变化,而卒中后情感障碍患者比无情感障碍患者FT3、FT4变化更明显,且恢复慢。     

硒酵母联合维生素D对实验性自身免疫甲状腺炎大鼠甲状腺相关激素及抗体的影响 #br#

目的观察硒酵母联合维生素D对实验性自身免疫性甲状腺炎（EAT）大鼠甲状腺相关激素及抗体的作 用。 方法55只雌性SD大鼠,其中45只采用猪甲状腺球蛋白（pTG）致敏+饮用高碘水建立EAT大鼠模型,建模成功 大鼠（40只）采用随机数字表法分为模型组、硒酵母组、维生素D组、联合组,每组10只;其余10只为对照组。加强免 疫4周后,硒酵母组予硒酵母溶液灌胃+腹腔注射生理盐水,维生素D组予生理盐水灌胃+腹腔注射维生素D3注射液, 联合组予硒酵母溶液灌胃+腹腔注射维生素D3注射液,对照组和模型组予生理盐水灌胃+腹腔注射生理盐水。6周 后,比较各组血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、甲状腺球蛋白抗体 （TGAb）、甲状腺过氧化物酶抗体（TPOAb）、干扰素-γ（IFN-γ）、白介素（IL）-4、IFN-γ/IL-4;HE染色比较各组甲状腺 组织病理学形态;比较各组甲状腺组织 p38MAPK、环氧合酶-2（COX-2）mRNA 相对表达量及 p38MAPK、pp38MAPK、COX-2蛋白相对表达量。 结果HE染色结果显示,对照组甲状腺滤泡形态正常;模型组甲状腺滤泡结构 破坏,淋巴细胞浸润,间质纤维化;硒酵母组、维生素D组及联合组较模型组均有一定改善,其中联合组改善最为明 显。与模型组比较,硒酵母组、维生素D组、联合组血清FT3、FT4、TSH、TGAb、TPOAb、IFN-γ、IFN-γ/IL-4水平,甲状 腺组织COX-2 mRNA 相对表达量及p-p38MAPK、COX-2蛋白相对表达量均降低（P＜0.05）,血清IL-4水平均升高 （P＜0.05）;与硒酵母组和维生素D组比较,联合组血清FT3、FT4、TSH、TGAb、TPOAb、IFN-γ、IFN-γ/IL-4水平降低 （P＜0.05）,甲状腺组织COX-2 mRNA相对表达量及p-p38MAPK、COX-2蛋白相对表达量均降低,血清IL-4水平升 高（P＜0.05）。 结论硒酵母联合维生素D可有效抑制EAT大鼠甲状腺组织损伤,保护甲状腺组织,其机制可能是通 过抑制MAPK信号通路发挥调控作用。     

Can levothyroxine treatment reduce urinary albumin excretion rate in patients with early type 2 diabetic nephropathy and subclinical hypothyroidism? A randomized double-blind and placebo-controlled study

Objective:

To investigate the effect of levothyroxine (LT₄) therapy on urinary albumin excretion rate (UAER) in early type 2 diabetic nephropathy (DN) and subclinical hypothyroidism (SCH) patients with mildly increased thyroid stimulating hormone (TSH) levels and serum thyroid peroxidase antibody (TPO-Ab) positivity.

Methods:

Application of randomized double-blind and placebo-controlled methods. A total of 136 normotensive patients with early type 2 DN and SCH (TSH 4.0–7.0 mIU/L and TPO-Ab positive) were selected, and were randomly divided into two groups for LT₄ or placebo treatments, respectively. Changes in UAER, serum creatinine, glomerular filtration rate (GFR), blood pressure, serum uric acid and lipids in patients before and after 48 weeks of treatment were examined and compared between groups.

Results:

There were no statistically significant differences in the baseline characteristics of study participants between two treatment groups (p?>?0.05 for all). After 48 weeks of treatment, compared to the placebo treatment, the LT₄ treatment was more effective in reducing total cholesterol (p?4 treatment was better in reducing UAER, low-density lipoprotein cholesterol and uric acid than the placebo group (p?Conclusion:

The LT₄ treatment may decrease UAER and exert kidney protection effects in early type 2 DN and SCH patients with mildly increased TSH levels and serum TPO-Ab positivity. However, due to the short duration of follow-up and small number of cases, the results of this study need future trials with larger numbers of patients and longer follow-up periods to verify whether such a strategy can provide durable benefits.     

体内应用编码人白介素-10质粒DNA对实验性自身免疫性甲状腺炎小鼠的基因治疗(英文)

目的:研究白介素-10(IL-10)对实验性自身免疫性甲状腺炎小鼠的基因治疗作用。方法:将IL-10质粒DNA注射入由猪甲状腺球蛋白(pTg)诱发的自身免疫性甲状腺炎小鼠甲状腺内,pTg免疫后28天,进行甲状腺IL-10 mRNA表达和组织学等检查。结果:IL-10质粒DNA注射后1周或2周甲状腺均有IL-10 mRNA表达;转染IL-10质粒DNA的COS-7细胞48小时有显著IL-10 mRNA表达,同时转染后48、72小时细胞培养液中IL-10浓度显著增高;治疗组小鼠甲状腺淋巴细胞浸润指数(1.1±0.4)明显低于对照组(2.2±0.5)(P<0.01);治疗组小鼠血清IFN-Υ水平明显低于对照组(P<0.01)。结论:甲状腺直接注射编码IL-10质粒DNA能显著抑制自身免疫性甲状腺炎淋巴细胞对甲状腺的浸润,缓解病情的发展。     

超声评价甲状腺激素水平与甲状腺动脉内径和血流速度的关系

目的：观察甲状腺激素对甲状腺的动脉宽度和血流参数的影响。方法：用彩色多普勒血流显像（CDFI）观察50例Graves＇病（GD组），35例摄^131I低性甲状腺功能亢进（非GD甲亢组），16例甲状腺功能减退（甲减组）及25例正常对照（对照组）的甲状腺上动脉（STA）、舒张期内径（D）、收缩期最高血流速度（Vmax）、舒张末期血流速度（Vmin）和阻力指数（Pa）。结果：（1）甲减组及GD组的D、Vmax和Vmin显著高于非GD甲亢组与正常组，而前2组和后2组之间比较，除D外差异无统计学意义（P〉0．05）。（2）在甲减组和非GD甲亢组中，促甲状激素（TSH）与D、Vmax、Vmin呈显著正相关。结论：决定舒张期内径和血流速度的不是甲状腺激素，而是促甲状腺激素。     

甲状腺疾病与乳腺癌关系的研究进展

甲状腺与乳腺疾病之间的关系早在 1896年就引起了人们的关注。考虑到两种疾病发病均以女性为主,且两者皆受下丘脑 -垂体 -腺体轴调控,研究两者的关系对于进一步了解肿瘤的生物学行为有着重要的意义,也有助于两种疾病的诊断和临床管理。该研究总结了甲状腺功能亢进、甲状腺功能减退、自身免疫性甲状腺炎和甲状腺癌等甲状腺疾病在乳腺癌发病中的作用以及相关机制的研究进展。认为甲亢与乳腺癌的风险增加相关,而甲减可以降低乳腺癌的风险,自身免疫性甲状腺炎通过免疫系统参与乳腺癌的发生发展,甲状腺癌与乳腺癌之间存在双向联系。     

Hepatitis B vaccine and risk of autoimmune thyroid disease: a Vaccine Safety Datalink study

PURPOSE: Hepatitis B vaccine has been postulated as a possible cause of autoimmune disorders, including autoimmune thyroid diseases (ATD). Cases of Graves' disease and Hashimoto's thyroiditis, following hepatitis B vaccine have been reported to the Vaccine Adverse Events Reporting System (VAERS). To test the hypothesis that hepatitis B vaccine increases the risk of ATD, we conducted a case-control study, within the Vaccine Safety Datalink project. METHODS: We identified potential cases of Graves' disease and Hashimoto's thyroiditis, among persons aged 18-69 years from administrative data recorded by three health maintenance organizations (HMOs) and verified cases by medical record review. Controls were frequency-matched to cases by birth year, sex, and study site. Vaccine information was collected from administrative records, chart review, and telephone interviews with study subjects. We enrolled 355 Graves' disease cases, 418 Hashimoto's thyroiditis cases, and 1102 controls. We assessed the association between ever-receipt of hepatitis B vaccine, as well as receipt of hepatitis B vaccine less than 1 year, 1-5 years and at least 5 years prior to the index date, and the risk of ATD. RESULTS: Ever-receipt of hepatitis B vaccine was not associated with risk of Graves' disease (odds ratio (OR), 0.90; 95% confidence interval (CI), 0.62-1.32) or Hashimoto's thyroiditis (OR, 1.23; 95%CI, 0.87-1.73). There was also no association between the time interval since receipt of hepatitis B vaccination and either outcome. CONCLUSIONS: We did not observe an increased risk of Graves' disease or Hashimoto's thyroiditis, following receipt of hepatitis B vaccine.