甲状腺機能低下症,小腸の細菌過剰増殖のリスク,および十二指管微生物群の変化との関連
Margaret Wei1, Sepideh Mehravar2, Gabriela Leite2
1Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Cedars-Sinai, Los Angeles, CA, USA.
The Journal of clinical endocrinology and metabolism
|September 5, 2025
まとめ
甲状腺機能低下症の人は小腸細菌過剰増殖 (SIBO) のリスクが高くなります. レボチロキシン治療は,このリスクを軽減し,腸内の特定の細菌の変化が関与している可能性があります.
科学分野:
- 胃腸内科
- 内分泌学
- 微生物群の研究
背景:
- 甲状腺機能低下は小腸の細菌過剰増殖 (SIBO) と関連しているが,その背後にあるメカニズムについてはさらなる調査が必要である.
- 甲状腺機能と腸内微生物群の関係を理解することは,関連する胃腸疾患の管理に不可欠です.
研究 の 目的:
- 甲状腺機能低下症または自己免疫性甲状腺炎を有する個体において,SIBOの発症の発生率と危険因子を評価する.
- 甲状腺の状態とSIBOに関連した小腸微生物群の変化を分析する.
主な方法:
- 16S rRNAとメタゲノムシーケンスを用いて,甲状腺下位症と対照被験者の十二指管アスピレーションを分析した.
- 大規模なコホート分析では,TrinetXプラットフォームを使用した対照群と比較して,甲状腺機能低下症と自己免疫性甲状腺炎の患者におけるSIBOの累積的な発生率と相対的なリスクを評価した.
主要な成果:
- SIBOの罹患率は,対照群と比較して,甲状腺機能低下患者 (32. 65%) で著しく高かった (15. 17%).
- SIBOの10年累積発生率は,甲状腺機能低下症 (RR=2. 20) と自己免疫性甲状腺炎 (RR=2. 40) で増加したが,レボチロキシン治療によって減少した (RR=0. 33およびRR=0. 78).
- ネイセリアとクレブシエラを含む特定のバクテリアの属は,SIBOを有する個体において,グラム陰性大腸菌の増加とともに,より一般的であった.
結論:
- 甲状腺機能低下は,SIBOを発症するリスクの増加と関連しています.
- レボチロキシン治療は,甲状腺機能低下患者のSIBOのリスクを減らすことができます.
- クレブシエラなどの特定のグラム陰性大腸菌は,甲状腺機能低下患者のSIBOの病原化に役割を果たす可能性があります.
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