Study On The Correlation Between Vitiligo And Thyroid Hormone, Its Antibody And Anxiety

Objective: This study would use the consensus of diagnosis and treatment of vitiligo in 2014 to diagnose patients with vitiligo.Chemiluminescence method would be used to detect the thyroid function of patients' peripheral blood.To observe self-rating anxiety scale and related clinical data of qualified patients with vitiligo,and then clinical data of healthy people were collected.A database will be established and divided into vitiligo group and control group.The clinical characteristics of vitiligo were analyzed.anti-thyroid peroxidase antibodies and anti-thyroglobulin antibodies were compared.To explore the pathogenesis of vitiligo vulgaris and analyze the correlation between vitiligo and thyroid hormones and their antibodies,so as to provide theoretical basis for routine thyroid function examination in patients with vitiligo.To understand and analyze the anxiety level of patients with vitiligo,which could provide theoretical basis for treatment.Methods: 1.157 patients with generalized vitiligo diagnosed in dermatology department of our hospital from October 2016 to October 2018,which were selected as the study subjects,and general data such as gender,age,stage of illness and area of leukoplakia were recorded.At the same time,100 healthy people in the physical examination center were collected as control group.Serum of vitiligo group(n=157)and control group(n=100)were detected thyroid function examination,including free triiodothyronine(FT3),free thyroxine(FT4),thyrotropin(TSH),thyroglobulin antibody(TG-Ab),thyroid peroxidase antibody(TPO-Ab).In addition,dividing intosex,age and disease stages of vitiligo group,thyroid function was compared.2.Eighty-five patients with vitiligo were tested with self-rating anxiety scale(SAS)and grouped according to the stages of the disease.The measured data were compared with the values of the Chinese norm.Indicators included in the comparison included general clinical data,laboratory test results,SAS standard score mean and so on.All data were processed and analyzed by SPSS20.0 software.T test and chi-square test were used to compare the data.The P value < 0.05 had statistical significance.Results: 1.General data:(1)A total of 157 patients with generalized vitiligo were included in the study.There were 82 males and 75 females,47.77% females,52.23% males and 1.09:1 females.(2)The average age was(46±30)years,and the average age of onset was(37±35).(3)The exposed areas(head,face,neck and hands)were the most susceptible sites for initial white spot.(63.69%);(4)Sporadic type was the most common(65.61%).(5)The average course of disease was(1±4.76)years,82 cases(52.22%)had a course of disease <= 1 year.(6)The area of mild skin lesion was 82 cases(52.22%).(7)The area of white spot was 12 cases(7.64%)and 5 cases(3.18%)had peer reaction.(8)18 cases(0.64%)had family history.The positive rate of family history was 11.46%.(9)There were 99 patients in advanced stage and 58 patients in stable stage.2.Laboratory tests:(1)There were 35 thyroid autoantibodies positive,112 negative,21 TGAb positive and 26 TPOAb positive.(2)The average concentration of FT3,FT4 and TSH were respectively(3.07±1.20)pmol/L,(4.30±5.54)pmol/L and(5.54±33.66)uIU/mL.3.There were statistical significant differences in TGAb positive rate,TPOAb positive rate and FT4 average concentration between vitiligo group and control group,but no statistical significant differences in TSH and FT3 average concentration.3.Vitiligo group:(1)There were statistical differences in the positive rates of TGAb,TPOAb in female and male serum(P < 0.05).(2)There were no statistical differencesin the positive rates of progressive TGAb,TPOAb and stable TGAb,TPOAb.(3)There were no statistical differences in the positive rates of TGAb and TPOAb in exposed sites(head,neck,hands and feet)and non-exposed sites(P > 0.05).(4)There was no significant difference in the positive rates of TGAb and TPOAb between the areas of degree white spot and those of other degree white spot(P > 0.05).(5)There was no significant difference in the positive rates of sporadic type and facial-extremity type of TGAb and TPOAb(P > 0.05).(6)There was no significant difference in the positive rates of TGAb and TPOAb between those with accompanying symptoms and those without accompanying symptoms(P > 0.05).(7)The positive rates of TGAb and TPOAb with family history were lower than those without accompanying symptoms(P > 0.05).There was no significant difference in the positive rates of TGAb and TPOAb in family history(P > 0.05).4.SAS group:(1)85 patients aged 18 years and over in vitiligo group completed SAS test,14 patients with anxiety and 71 patients without anxiety.(2)The average SAS scores of progressive and stable vitiligo patients were(39.54±7.87)and(42.08±10.96),respectively.Compared with the Chinese norm group(29.78 ± 0.46),the average SAS scores of vitiligo patients were higher than that of the norm group(P < 0.05).(3)There was no significant difference in the average SAS scores of progressive patients compared with stable patients(P > 0.05).(4)The positive rates of serum TGAb and TPOAb in patients with anxiety were higher than those in patients without anxiety(P > 0.05).Conclusion: 1.The positive rates of TGAb and TPOAb in patients with vitiligo were statistical significantly different,indicating that there was a correlation between vitiligo and thyroid autoantibodies.2.Women are more likely than men to have thyroid autoantibody abnormalities in patients with vitiligo.For vitiligo patients,thyroid function should be tested routinely,especially for female patients.3.The standard score of SAS test group was higher than that of Chinese norm group,suggesting that patients with vitiligo have anxiety and need psychological intervention and prevention in the course of treatment.