甲状腺功能低下,细肠细菌过度生长和十二指肠微生物组变化之间的关系
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
概括
患有甲状腺功能低下的人患小肠细菌过度生长 (SIBO) 的风险增加. 利沃胺治疗似乎可以减轻这种风险,并且可能涉及肠道中的特定细菌变化.
科学领域:
- 胃肠病学
- 内分泌学
- 微生物组研究
背景情况:
- 甲状腺功能低下与细肠细菌过度生长 (SIBO) 相关,但潜在的机制需要进一步研究.
- 了解甲状腺功能与肠道微生物之间的联系对于管理相关的胃肠道疾病至关重要.
研究的目的:
- 在患有甲状腺功能低下或自身免疫性甲状腺炎的个体中评估SIBO发生率和风险因素.
- 分析与甲状腺状况和SIBO相关的小肠微生物种群的变化.
主要方法:
- 使用16S rRNA和元基因组测序分析了甲状腺功能低下和对照患者的十二指肠吸附物.
- 一项大型队列分析评估了使用TrinetX平台对照对象的甲状腺功能低下和自身免疫甲状腺炎患者的十年累积发病率和相对风险.
主要成果:
- 与对照组相比,甲状腺功能低下患者的SIBO患病率显著高 (32. 65%).
- 甲状腺功能低下症 (RR=2. 20) 和自身免疫性甲状腺炎 (RR=2. 40) 的十年累积发病率较高,但随着甲状腺素治疗而降低 (RR=0. 33和RR=0. 78).
- 在SIBO患者中,特定的细菌属,包括Neisseria和Klebsiella更为普遍,同时也增加了Gram阴性大肠杆菌.
结论:
- 甲状腺功能下降与发展SIBO的风险增加有关.
- 在甲状腺功能低下患者中,Levothyroxine治疗可能会降低SIBO的风险.
- 特定的格拉姆阴性大肠杆菌,如Klebsiella,可能在甲状腺功能低下的个体中起到SIBO的致病作用.
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