ﻪﻠﺠﻣ مﻮﻠﻋ يزار ﻲﻜﺷﺰﭘ هرود
19
، هرﺎﻤﺷ 95
، ﺖﺸﻬﺒﻳدرا ﻲﺸﻫوﮋﭘ ﻪﻟﺎﻘﻣ 1391
ﻪﻣﺪﻘﻣ
هﺪﻏ ﺗ ﻴ ﺋوﺮ ﻴ ﺪ ﻪﺑ ناﻮﻨﻋ ﻳ ﻜ ﻲ زا ﻢﻬﻣ ﺮﺗ ﻳ ﻦ دﺪﻏ نورد
ر ﻳ ﺰ ﺎﺑ ﺢﺷﺮﺗ نﻮﻣرﻮﻫ ﺎﻫ ي ﺗ ﻴ ﺴﻛوﺮ ﻴ ﻦ ) T4 ( و
′3 - 3 -
5 ﺮﺗ ي ﻳ ﺮﺗوﺪ ﻳ ﻧﻮ ﻴ ﻦ ) T3 ( رد لﺮﺘﻨﻛ و ﻈﻨﺗ ﻴ ﻢ
،ﺪـﺷر
ﺎــﻤﺗ ﻳ
،ﺰ ﻟﻮﺑﺎﺘﻣ ﻴ ﻢــﺴ و لﺎــﻤﻋا ﻓ ﻴ ﺰ ﻳ ژﻮﻟﻮ ــﻳ ﻚ ﺐــﻠﻏا
ﺖــﻓﺎﺑ ﺎــﻫ ي نﺪــﺑ ﺶــﻘﻧ ــﻤﻬﻣ ﻲ دراد ) 1 .( زا ﻣ ــﻴ نﺎ
تﻻﻼﺘﺧا ﻪﺘﺧﺎﻨﺷ
هﺪﺷ هﺪﻏ ﺗ ﻴ ﺋوﺮ ﻴ ﺪ ﻣ ﻲ ناﻮﺗ ﻪﺑ ﺮﭘ رﺎﻛ
ي نآ هرﺎﺷا دﻮﻤﻧ ﻪﻛ رد ﺐﻠﻏا دراﻮﻣ ﺎـﺑ اﺰـﻓا ﻳ ﺶ
ﻣ ــﻴ ناﺰ نﻮــﻣرﻮﻫ ﺎــﻫ
ي T3 و T4 هاﺮــﻤﻫ ﺖــﺳا و
ﺑﻴ رﺎــﻤ ي ﺮﮔ ــﻳ زﻮ Graves) ( ﻣز ﻴ ﻪــﻨ زﺎــﺳ زوﺮــﺑ ا ــﻳ ﻦ
لﻼﺘﺧا بﻮﺴﺤﻣ ﻣ
ﻲ دﻮـﺷ . لﻼﺘـﺧا ﺎـﺷ
ﻳ ﻊ د ﻳ
،ﺮـﮕ
ﻢﻛ رﺎﻛ ي ﺗ ﻴ ﺋوﺮ ﻴ ﺪ ﺖﺳا ﻪﻛ ﻻﻮﻤﻌﻣ ﺎﺑ ﺶﻫﺎﻛ ﻟﻮﺗ ﻴ ﺪ و
ﺢــﺷﺮﺗ نﻮــﻣرﻮﻫ ﺎــﻫ
ي نآ هﺪــﻏ هاﺮــﻤﻫ هدﻮــﺑ و
رﺎــﺠﻨﻫﺎﻧ ي ﺎــﻫ ي ردﺎــﻣ داز ي ﺗ ﻴ ﺋوﺮ ــﻴ ﺪ ــﻳ ﺎ تﻻﻼﺘــﺧا
مﺎﻓ ﺎﺘﻴﺑ : ﻲﺘﺸﻬﺑ ﺪﻴﻬﺷ ﻢﺴﻴﻟﻮﺑﺎﺘﻣ و ﺰﻳر نورد دﺪﻏ هﺪﻜﺸﻫوﮋﭘ ﻲﻗﺎﭼ نﺎﻣرد و يﺮﻴﮕﺸﻴﭘ تﺎﻘﻴﻘﺤﺗ ﺰﻛﺮﻣ ،ﻲﻤﻴﺷﻮﻴﺑ ﺪﺷرا سﺎﻨﺷرﺎﻛ
، ﺪﻴﻬﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﺘﺸﻬﺑ
، ناﺮﻬﺗ
، ناﺮﻳا .
[email protected] رﻮﭙﺸﻧاد تادﺎﺴﻟا ﻢﻳﺮﻣﺮﺘﻛد :
،ﻚﻴﺘﻧژ ياﺮﺘﻛد نﺎﻣردو يﺮﻴﮕﺸﻴﭘ تﺎﻘﻴﻘﺤﺗﺰﻛﺮﻣ
،ﻲﻗﺎﭼ ر نورد دﺪﻏ هﺪﻜﺸﻫوﮋﭘ ﺰﻳ
ﻟﻮﺑﺎﺘﻣ و ﻢﺴﻴ ﻬﺷ ﺪﻴ ﺘﺸﻬﺑ ﻲ ﺪﻴﻬﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﺘﺸﻬﺑ
، ناﺮﻬﺗ
،
ناﺮﻳا [email protected] .
ﻲﺤﻟﺎﺻ ﻪﻴﺿﺮﻣ :
ﺪﺷرا سﺎﻨﺷرﺎﻛ
،ﻚﻴﺘﻧژ
،ﻲﻗﺎﭼ نﺎﻣردو يﺮﻴﮕﺸﻴﭘ تﺎﻘﻴﻘﺤﺗﺰﻛﺮﻣ ر نورد دﺪﻏ هﺪﻜﺸﻫوﮋﭘ
ﺰﻳ ﻟﻮﺑﺎﺘﻣ و ﻢﺴﻴ ﻬﺷ ﺪﻴ ﺘﺸﻬﺑ ﻲ
، ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﺪﻴﻬﺷ
ﻲﺘﺸﻬﺑ
، ناﺮﻬﺗ
، ناﺮﻳا .
* ﻲﺘﻳاﺪﻫ يﺪﻬﻣﺮﺘﻛد
،ﻲﻤﻴﺷﻮﻴﺑ ياﺮﺘﻛد و رﺎﻳدﺎﺘﺳا: ﻲﺘﺸﻬﺑ ﺪﻴﻬﺷ ﻢﺴﻴﻟﻮﺑﺎﺘﻣ و ﺰﻳر نورد دﺪﻏ هﺪﻜﺸﻫوﮋﭘ ،ﻲﻗﺎﭼ نﺎﻣرد و يﺮﻴﮕﺸﻴﭘ تﺎﻘﻴﻘﺤﺗ ﺰﻛﺮﻣ
ﺪﻴﻬﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﺘﺸﻬﺑ
،
ناﺮﻬﺗ
، ناﺮﻳا ).
* ﺴﻣ هﺪﻨﺴﻳﻮﻧ ﺌ (لﻮ [email protected].
يﺰﻳﺰﻋ نوﺪﻳﺮﻓ ﺮﺘﻛد ﻲﺘﺸﻬﺑ ﺪﻴﻬﺷ ﻢﺴﻴﻟﻮﺑﺎﺘﻣ و ﺰﻳر نورد دﺪﻏ مﻮﻠﻋ هﺪﻜﺸﻫوﮋﭘ ،ﺰﻳر نورد دﺪﻏ تﺎﻘﻴﻘﺤﺗ ﺰﻛﺮﻣ ،ﻢﺴﻴﻟﻮﺑﺎﺘﻣ و ﺰﻳر نورد دﺪﻏ ﺺﺼﺨﺗ قﻮﻓ و دﺎﺘﺳا:
، مﻮﻠﻋ هﺎﮕﺸﻧاد
ﺪﻴﻬﺷ ﻲﻜﺷﺰﭘ ﻲﺘﺸﻬﺑ
، ناﺮﻬﺗ
، ناﺮﻳا [email protected] .
ﻲﻠﻜﺷ ﺪﻨﭼ يﺎﻫ
زاﺪﻴﺴﻛاﺮﭘ نژ نآﺪﺿ يدﺎﺑ ﻲﺘﻧآ ناﺰﻴﻣ و ﺪﻴﻳوﺮﻴﺗ
ﺖﻴﻌﻤﺟ رد
ﻲﻧاﺮﻬﺗ نﻻﺎﺴﮔرﺰﺑ
هﺪﻴﻜﭼ فﺪﻫ و ﻪﻨﻴﻣز :
رد ﻲﻜﻴﺘﻧژ تاﺮﻴﻴﻐﺗ نژ
يﺪﻴﻳوﺮﻴﺗ زاﺪﻴﺴﻛاﺮﭘ (TPO)
ﻲﻜﻳ زا هﺪﻏ ﻲﻨﻤﻳادﻮﺧ يرﺎﻤﻴﺑ ﻲﻠﺻا ﻞﻠﻋ ﺪﻴﻳوﺮﻴﺗ
.ﺖﺳا فﺪﻫ
،ﺶﻫوﮋﭘ ﻦﻳا ﻲـﺳرﺮﺑ
طﺎﺒﺗرا يﺎﻫ ﻲﻠﻜﺷﺪﻨﭼ 1936C
،T 2229C وT 2257C نژA ناﺰﻴﻣ ﺎﺑTPO ﺪـﺿ يدﺎﺑ ﻲﺘﻧآ
يﺪـﻴﻳوﺮﻴﺗ زاﺪﻴـﺴﻛاﺮﭘ (Anti –TPO)
نﻻﺎـﺴﮔرﺰﺑ ﺖـﻴﻌﻤﺟ رد
ناﺮﻬﺗ ﺪﻴﭙﻴﻟ و ﺪﻨﻗ ﻪﻌﻟﺎﻄﻣ (TLGS=Tehran Lipid and Glucose Study)
دﻮﺑ .
شور رﺎﻛ : ﻪﻌﻟﺎﻄﻣرد درﻮﻣ - ﺪﻫﺎﺷ ﺮﺿﺎﺣ ي ، 188 ﺮﻔﻧ ) 86 ودﺮﻣ 102 نز ( ﻲﻨﺳ ﻪﻠﺻﺎﻓ ﺎﺑ 20
ﺎﺗ 80 ﻲﻓدﺎﺼﺗ ترﻮﺻ ﻪﺑ ،لﺎﺳ هﺪﻨﻨﻛ ﺖﻛﺮﺷ داﺮﻓا زا
رد و ﺪـﻨﻗ ﻪـﻌﻟﺎﻄﻣ
ﺪﻴﭙﻴﻟ ناﺮﻬﺗ ﺪﻧﺪﺷ بﺎﺨﺘﻧا .
ناﺰﻴﻣ Anti-TPO ﻢﻳﺰـﻧآ ﻪـﺑ ﻞـﺼﺘﻣ ﻲـﻨﻤﻳا بﺬـﺟ ﺶﺠﻨﺳ شور ﻪﺑ
(ELISA= Enzyme Linked Immunosorbent
Assay) ﺪﺷ يﺮﻴﮔ هزاﺪﻧا .
ﻲﻠﻜﺷ ﺪﻨﭼ C يﺎﻫ
A2257 Cو T2229 ﻪﺑ RFLP(Restriction Fragment Length Polymorphism)شور و
ﺎﺑ هدﺎﻔﺘﺳا
زا ﻢﻳﺰﻧآ يﺎﻫ دوﺪﺤﻣ هﺪﻨﻨﻛ وBsrI Eco57I ﺪﻧﺪﺷ ﻲﻳﺎﺳﺎﻨﺷ .
ﻲﻠﻜـﺷ ﺪـﻨﭼ 1936C
ﺎـﺑT ARMS- PCR amplification refractory mutation شور
system – polymerase chain reaction ﺺﺨﺸﻣ
ﺪﻳدﺮﮔ .
ﺎﻫ ﻪﺘﻓﺎﻳ : يدرﺎﻫ لدﺎﻌﺗ زا ﻲﺑﺎﺨﺘﻧا يﺎﻫ ﻢﺴﻴﻓرﻮﻣ ﻲﻠﭘ يﺎﻫ ﭗﻴﺗﻮﻧژ و ﺎﻫ ﻞﻟا ﻲﻧاواﺮﻓ -
ﻲﻣ ﺖﻴﻌﺒﺗ گﺮﺒﻨﻳاو دﺮﻛ
. رﻮﻀﺣ ا Cﻞﻟ ﻢﺴﻴﻓرﻮﻣ ﻲﻠﭘ 1936C
ﺎﺑT Anti-
داد نﺎﺸﻧ ﻲﺸﻳاﺰﻓا طﺎﺒﺗراTPO )
002 / p=0 IU/L؛ 3 /
±11 1 / TT: 74 ﻞﺑﺎﻘﻣ رد 9 /
±15 7 / CT:47
، 3 /
±43 CC: 238 ( ﻪﻛ ﻦﻳا طﺎﺒﺗرا زا ﺲـﭘ
ﺮـﺛا ﻞﻳﺪـﻌﺗ ﺲﻨﺟ
ﻦـﺳو
دﻮـﺒﻧ راد ﻲـﻨﻌﻣ 059 )
/ (p=0 .
ﻲﻠﻜـﺷ ﺪـﻨﭼ 2229C
ناﺰـﻴﻣ ﺎـﺑ يراد ﻲـﻨﻌﻣ طﺎـﺒﺗراT Anti-TPO
ﺖـﺷاﺪﻧ ) 196 / p=0 IU/L؛ 8 /
±13 5 / TT: 126
ﻞﺑﺎﻘﻣرد 6 /
±12 5 / CT:43
، 5 /
±24 CC:129 .(
طﺎﺒﺗرا 2257C ﻲﻣﺮـﺳ ﺢﻄﺳ ﺎﺑA Anti-TPO
دﻮـﺑ راد ﻲـﻨﻌﻣ ﺮـﮔ ﻪـﻠﺧاﺪﻣ ﻞـﻣاﻮﻋ ﻞﻳﺪـﻌﺗ زا ﺲـﭘ اﺮـﺼﺤﻨﻣ ،
) 007 / p=0 .( يﺎﻫ ﭗﻴﺗﻮﻠﭘﺎﻫ وCTT
ناﺰﻴﻣ ﺎﺑATC Anti-TPO ﺪﻨﺘﺷاد طﺎﺒﺗرا
) 021 / 0 و 023 / p=0 ( ﭗﻴﺗﻮﻠﭘﺎﻫ طﺎﺒﺗرا ، ﺎﺑCTT
Anti-TPO ﻞﻳﺪﻌﺗ زا ﺲﭘ
راد ﻲﻨﻌﻣ نﺎﻨﭽﻤﻫ ﺲﻨﺟ ﺮﺛا دﻮﺑ
) 014 / p=0 .(
يﺮﻴﮔ ﻪﺠﻴﺘﻧ :
نژ يﺎـﻫ ﻢـﺴﻴﻓرﻮﻣ ﻲـﻠﭘ طﺎﺒﺗرا ﺮﺑ ﺮﺛﻮﻣ ﻞﻣاﻮﻋ زا ﺲﻨﺟ و ﻦﺳ ،ﺶﻫوﮋﭘ ﻦﻳا يﺎﻫ ﻪﺘﻓﺎﻳ سﺎﺳا ﺮﺑ TPO
ناﺰـﻴﻣ ﺎـﺑ Anti – TPO بﻮـﺴﺤﻣ
ﻲﻣ ﺪﻧﻮﺷ .
هژاوﺪﻴﻠﻛ ﺎﻫ
،يﺪﻴﻳوﺮﻴﺗ زاﺪﻴﺴﻛاﺮﭘ ﻢﻳﺰﻧآ:
،ﻲﻠﻜﺷ ﺪﻨﭼ ناﺮﻬﺗ ﺪﻴﭙﻴﻟ و ﺪﻨﻗ ﻪﻌﻟﺎﻄﻣ ،يﺪﻴﻳوﺮﻴﺗ زاﺪﻴﺴﻛاﺮﭘ ﺪﺿ يدﺎﺑ ﻲﺘﻧآ .
ﺖﻓﺎﻳرد ﺦﻳرﺎﺗ :
27 / 6 / 90 شﺮﻳﺬﭘ ﺦﻳرﺎﺗ :
22 / 12 / 90
ﻲﻠﻜﺷ ﺪﻨﭼ
يﺎﻫ Poly morphisms) (
ﺪﻴﻳوﺮﻴﺗ زاﺪﻴﺴﻛاﺮﭘ نژ ...
11
ادﻮــــﺧ ﻳ ﻨﻤ ﻲ ﺪــــﻨﻧﺎﻣ ﺗ
ﻴ ﺋوﺮ ــــﻴ ﺪ ﻳ ﺖ ــــﺷﺎﻫ ﻴ ﻮﺗﺎﻤ
(Hashimoto) ﻪــﻛ
ــﻣ ﻲ ﺪــﻧاﻮﺗ ﺮــﺠﻨﻣ ﻪــﺑ لﻼﺘــﺧا
هدﺮﺒﻣﺎــﻧ دﻮــﺷ
. رد ﺑﻴ رﺎــﻤ ي ﺎــﻫ ي ادﻮــﺧ ﻳ ﻨﻤ ﻲ هﺪــﻏ
ﺗ ﻴ ﺋوﺮ ﻴ ﺪ
، ﺳ ﻴ ﻢﺘﺴ اﻳ ﻨﻤ ﻲ نﺪﺑ ﻠﻋ ﻴ ﻪ ﺖـﻓﺎﺑ ﻟﻮﻓ ﻴ ﻟﻮـﻜ ﻲ
هﺪﻏ و ﻳﺎ ﺰﻧآ ﻳ ﻢ ﺎﻫ ي نآ ﺘﻧآ ﻲ دﺎﺑ ي ﺢـﺷﺮﺗ ـﻣ ﻲ ﺪـﻨﻛ .
ﺶﻫوﮋﭘ ﺎﻫ ﺑﻴ ﺮﮕﻧﺎ ﺷ ﻴ عﻮ ﺑﻴ ﺮﺘﺸ تﻻﻼﺘﺧا ادﻮﺧ
ﻳ ﻨﻤ ﻲ
ﺗ ﻴ ﺋوﺮ ﻴ ﺪ رد نﺎﻧز ﺖﺒﺴﻧ ﻪـﺑ نادﺮـﻣ ـﻣ ﻲ ﺪـﺷﺎﺑ . ﺮـﺑ
سﺎﺳا تﺎﻌﻟﺎﻄﻣ مﺎﺠﻧا
،هﺪﺷ ﻞﻣاﻮﻋ ﺘﻧژ ﻴ ﻜ ﻲ رد زوﺮـﺑ
ﺑﻴ رﺎﻤ ي ﺷﺎﻫ ﻴ ﻮﺗﺎﻤ ﻪﻛ ﺐﻠﻏا رد ﻌﻤﺟ ﻴ ﺖ نﺎﻧز 30 ﺎـﺗ
50 لﺎﺳ د ﻳ هﺪ ﻣ ﻲ
،دﻮﺷ ﺶﻘﻧ ﻤﻬﻣ ﻲ ﺪﻧراد و ﻮﮕﻟا ي
ثراﻮﺗ اﻳ ﻦ ﺑﻴ رﺎﻤ ي رد هداﻮﻧﺎﺧ ﺎﻫ ﻲﻳ ﻪﻛ اراد ي داﺮـﻓا
ﻼﺘﺒﻣ
،ﺪﻨﺘﺴﻫ ﺺﺨﺸﻣ هﺪﺷ
ﺖﺳا . ﺰﻧآ ﻳ ﻢ ﺴﻛاﺮﭘ ﻴ زاﺪ
ﺗ ﻴ ﺋوﺮ ﻴ ﺪ (TPO)ي
، ﻪﺑ ناﻮﻨﻋ ﺰﻧآ ﻳ ﻢ ﻠﻛ ﻴ ﺪ ي رد ﻛﺮﺗ ﻴ ﺐ
نﻮﻣرﻮﻫ ﺎﻫ
ي ﺗ ﻴ ﺋوﺮ ﻴ ﺪ ي
، ﺶﻨﻛاو ﺎـﻫ ي ﻠـﺻا ﻲ ـﻳ ﺪ
ندﺮﻛراد ﻗﺎﺑ
ﻴ هﺪﻧﺎﻤ ﺎﻫ ي ﺗ ﻴ زوﺮ ﻳ ﻞ رد ﻠﮔ ﻴ ﻮﻜ ﺌﺗوﺮـﭘ ﻴ ﻦ
ﺗ ﻴ ﺑﻮﻠﮔوﺮ ﻴ ﻦ و ﺖﻔﺟ نﺪﺷ ﻮﻨﻣ ـﻳ وﺪ ﺗ ـﻴ ﻧوﺮ ﻴ ﻦ و د ي
ــﻳ وﺪ ﺮﺗ ــﻳ ﻧﻮ ﻴ ﻦ ار ﺖــﻬﺟ ﻟﻮﺗ ــﻴ ﺪ نﻮــﻣرﻮﻫ ﺎــﻫ
ي
ﺗ ﻴ ﺋوﺮ ﻴ ﺪ ي ﻟﺎﺗﺎﻛ ﻴ ﺰ catalyze) (
ﻣ ﻲ ﺪﻨﻛ ) 2 و 3 (.
. ﺰﻧآ ﻳ ﻢ
ﺎﺑTPO 933 ﺳا ﻴ ﺪ ﻣآ ﻴ
،ﻪﻨ ﻠﮔ ﻴ ﻮﻜ ﺌﺗوﺮﭘ ﻴ ﻨ ﻲ ﺎـﺑ نزو
ﻟﻮﻜﻟﻮﻣ ﻲ 110 ﻛ ﻴ ﻮﻠ نﻮـﺘﻟاد ﺖـﺳا ﻪـﻛ زا ﻦـﻫآ ﻪـﺑ
ناﻮﻨﻋ لﺎﻌﻓ هﺪﻨﻨﻛ هدﺎﻔﺘﺳا ﻣ ﻲ ﺪﻨﻛ ) 4 و 5 .(
نژ ﺪﻛ
هﺪــﻨﻨﻛ ﺎــﺑTPO
17 نوﺰــﮔا ﺪــﻛ هﺪﻧﻮــﺷ دوﺪــﺣ
150 ﻛ ﻴ لﻮﻃرﺎﺑﻮﻠ دراد
و ور ي وزﺎﺑ ي هﺎﺗﻮﻛ موزﻮﻣوﺮﻛ
ود رد ﻌﻗﻮﻣ ﻴ ﺖ p25 2 ﻊﻗاو هﺪﺷ ﺖـﺳا ) 6 و 7 .(
ﺮـﺑ
سﺎﺳا ﻳ ﻪﺘﻓﺎ ﺎﻫ ي ﺶﻫوﮋﭘ ﺎـﻫ ي ﻟﻮـﻜﻟﻮﻣ ﻲ
، ﻐﺗ ـﻴﻴ تاﺮ
ﺘﻧژ ﻴ ﻜ TPOﻲ ﺖﺛاروﺎﺑ ﻣوزﻮﺗا ﻲ
،بﻮﻠﻐﻣ ﻳ ﻜ ﻲ ﺎـﺷزا ﻳ ﻊ
ﺮﺗ ﻳ ﻦ ﺖﻠﻋ ﺎﻫ ي ﺑزوﺮﺑ ﻴ رﺎﻤ ي ﺎﻫ ي دﻮﺧ اﻳ ـﻨﻤ ﻲ هﺪـﻏ
ﺗ ﻴ ﺋوﺮ ﻴ ﺪ ﺎﺑ ﻧﺎﻜﻣ ﻴ ﻢـﺴ ﺎـﻫ ي نﻮﮔﺎـﻧﻮﮔ ﺪـﻨﻧﺎﻣ
ﻧاﻮﺗﺎـﻧ ﻲ
ﺰﻧآ ﻳ TPOﻢ
، ﺶﻫﺎﻛ ﺎـﻧاﻮﺗ ﻲﻳ نآ ﺖـﻬﺟ لﺎـﺼﺗا ﻪـﺑ
لﺎــﻌﻓ هﺪــﻨﻨﻛ و
ﻣ ــﻴ نﺎ ﺶﻨــﻛ ﺎــﺑ ﺗ ﻴ ﺑﻮــﻠﮔوﺮ ﻴ ﻦ و
ﺎﺟ ﻳ ﮕ ﻴ ﺮ ي ﺐﺳﺎﻨﻣﺎﻧ رد
هﺪـﻏ ﺗ ﻴ ﺋوﺮ ـﻴ ﺪ )ﺖـﺳا 2
، 8 -
(10 . ﺎﺑ ﻪـﺟﻮﺗ ﻪـﺑ ﻤﻫا ـﻴ ﺖ طﺎـﺒﺗرا ـﺑ ﻴ ﻦ ﻐﺗ ـﻴﻴ تاﺮ
ﺘﻧژ ﻴ ــﻜ ﻲ نژ ــﺴﻛاﺮﭘ ﻴ زاﺪ ﺗ ﻴ ﺋوﺮ ــﻴ ﺪ ي ﺎــﺑ تﻻﻼﺘــﺧا
ادﻮﺧ ﻳ ﻨﻤ ﻲ هﺪﻏ ﺗ ﻴ ﺋوﺮ ـﻴ ﺪ
، فﺪـﻫ ﺶﻫوﮋـﭘ ﻧﻮـﻨﻛ
ﻲ
ﺳرﺮﺑ ﻲ طﺎﺒﺗرا ـﻠﭘ ﻲ ﻓرﻮﻣ ﻴ ﻢـﺴ ﺎـﻫ Gي A1936 رد
نوﺰﮔا 11 C، T2229 Cو A2257 رد نوﺰـﮔا 12 نژ
ﺎــﺑTPO ﻣ ــﻴ ناﺰ ــﺘﻧآ ﻲ دﺎــﺑ ي ﺪــﺿ ــﺴﻛاﺮﭘ ﻴ زاﺪ
ﺗ ﻴ ﺋوﺮ ﻴ ﺪ ي و ﺳرﺮﺑ ﻲ ﺮﺛا ﻦﺳ و ﺲﻨـﺟ ﺮـﺑ ور ي ا ـﻳ ﻦ
طﺎﺒﺗرا رد ﻌﻤﺟ ﻴ ﺖ درﻮﻣ ﻪﻌﻟﺎﻄﻣ ﺪﻨﻗ و ﻟﻴ ﭙ ﻴ ﺪ ناﺮﻬﺗ
(TLGS) دﻮﺑ
. ﻲﺳرﺮﺑ شور
درﻮــﻣ ﺶﻫوﮋــﭘ يﺪﻫﺎــﺷ–
داﺮــﻓا يور ﺮــﺑ ﻲﻧﻮــﻨﻛ
ناﺮﻬﺗ ﺪﻴﭙﻴﻟ و ﺪﻨﻗ ﻪﻌﻟﺎﻄﻣ رد هﺪﻨﻨﻛ ﺖﻛﺮﺷ لﺎﺴﮔرﺰﺑ ﺪﺷ مﺎﺠﻧا TLGS.
ﻪﺑ ، ﻦﻴﻴﻌﺗ رﻮﻈﻨﻣ ﻞـﻣاﻮﻋ
ﺮﻄﺧ زﺎـﺳ
يرﺎﻤﻴﺑ يﺎﻫ ﻪﻠﻤﺟزا ،ﺮﻴﮔاوﺮﻴﻏ ﺎـﺑ ﻚـﻴﻟﻮﺑﺎﺘﻣ مرﺪﻨـﺳ
ﻪـﺑ ور ﺪﻧور زا يﺮﻴﮕﺸﻴﭘ و ﻲﮔﺪﻧز هﻮﻴﺷ حﻼﺻا فﺪﻫ يرﺎﻤﻴﺑ ﺪﺷر يا ﻪـﻳﺬﻐﺗ تﻻﻼﺘﺧا ،ود عﻮﻧ ﺖﺑﺎﻳد يﺎﻫ
ﻲﻣﺮــﺳ يﺎــﻫ ﻲــﺑﺮﭼ و ﺖــﻴﻌﻤﺟرد
15005 زا يﺮــﻔﻧ
ﻪــﻘﻄﻨﻣ ﻦﻴﻨﻛﺎــﺳ 13
ﺮﻬــﺷ ناﺮــﻬﺗ و هﺪــﺷ ﻲــﺣاﺮﻃ
ﺳاﺮﺟا لﺎﺣ رد نﺎﻨﭽﻤﻫ ﺖ
) 11 و 12 ( . ،ﻪـﻌﻟﺎﻄﻣ ﻦﻳا رد
188 ﺮﻔﻧ ) 86 و دﺮـﻣ 102 نز ( ﻲﻨـﺳ ﻪﻠـﺻﺎﻓ ﺎـﺑ 20
ﺎﺗ 80 ﺪﻨﻗ ﻪﻌﻟﺎﻄﻣ رد هﺪﻨﻨﻛ ﺖﻛﺮﺷ داﺮﻓا نﺎﻴﻣ زا لﺎﺳ
ﺪﻧﺪـﺷ بﺎـﺨﺘﻧا ﻲﻓدﺎﺼﺗ رﻮﻃ ﻪﺑ ناﺮﻬﺗ ﺪﻴﭙﻴﻟ و .
داﺮـﻓا
ﺖﻛﺮﺷ ﻪـﻣﺎﻧ ﺖﻳﺎـﺿر مﺮـﻓ ،ﺶﻫوﮋـﭘ ﻦـﻳا رد هﺪـﻨﻨﻛ
ﻤﻛ ﻂـﺳﻮﺗ ﻖـﻴﻘﺤﺗ ﻦﻳا و ﺪﻧدﻮﻤﻧ ﺎﻀﻣا ار ﻪﻧﺎﻫﺎﮔآ ﻪـﺘﻴ
و ﺰـﻳر نورد دﺪـﻏ مﻮـﻠﻋ هﺪﻜﺸﻫوﮋﭘ ﻲﺸﻫوﮋﭘ قﻼﺧا ﻪـﺑ ﻲﺘـﺸﻬﺑ ﺪﻴﻬـﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻢﺴﻴﻟﻮﺑﺎﺘﻣ
ﺖــﺳا هﺪﻴــﺳر ﺐﻳﻮــﺼﺗ .
،ﻲﺠﻨــﺳ ﻦــﺗ تﺎــﻋﻼﻃا
ﻲـﺒﻠﻗ يﺎـﻫ يرﺎـﻤﻴﺑ ﻲﮔداﻮﻧﺎﺧ ﻪﻘﺑﺎﺳ ،ﻲﻳﺎﻴﻤﻴﺷﻮﻴﺑ -
و ود عﻮﻧ ﺖﺑﺎﻳد ،ﻲﻗوﺮﻋ ﺪﻴﺋوﺮﻴﺗ
ﻪﻘﺑﺎـﺳ ﻦﻴﻨﭽﻤﻫ ،ي
بﺎـﺨﺘﻧا داﺮـﻓا زا ﻚـﻳ ﺮـﻫ ياﺮﺑ رﺎﮕﻴﺳ و وراد فﺮﺼﻣ ﺖــﺳا هﺪــﺷ ﺖــﺒﺛ هﺪــﺷ .
ﺪــﺿ يدﺎــﺑ ﻲــﺘﻧآ ناﺰــﻴﻣ
زاﺪﻴﺴﻛاﺮﭘ ﺪﻴﺋوﺮﻴﺗ
(Anti-TPO)ي ﺶﺠﻨﺳ شور ﻪﺑ
ﻢﻳﺰﻧآ ﻪﺑ ﻞﺼﺘﻣ ﻲﻨﻤﻳا بﺬﺟ (ELISA)
يﺮـﻴﮔ هزاﺪﻧا
ﺪﺷ . ناﺰﻴﻣ سﺎﺳا ﺮﺑ داﺮﻓا Anti-TPO
ﺎـﺑ هوﺮـﮔ ود ﻪﺑ
Anti-TPO<100 Iu/ml ــﺑ
و ﺪﻫﺎــﺷ هوﺮــﮔ ناﻮــﻨﻋ ﻪ
Anti-TPO≥ 100 Iu/ml درﻮﻣ هوﺮﮔ ناﻮﻨﻋ ﻪﺑ
ﻢﻴﺴﻘﺗ
ﺪﻧﺪﺷ يﺪﻨﺑ .
ﻲﻠﻜـﺷ ﺪـﻨﭼ زا ﻚـﻳ ﺮـﻫ ﻲﺳرﺮﺑ يﺎـﻫ
نژ زا هﺪـﺷ بﺎﺨﺘﻧا يور ﺮـﺑ TPO
جاﺮﺨﺘـﺳاDNA
عﺎﺒــﺷا ﻚــﻤﻧ شور ﻪــﺑ داﺮــﻓا نﻮــﺧ ﻪــﻧﻮﻤﻧ زا هﺪــﺷ ﺗوﺮﭘ ﺌ زﺎﻨﻴ ﺖﻓﺮﮔ مﺎﺠﻧاK .
زاﺮـﻤﻴﻠﭘ يا هﺮﻴﺠﻧز ﺶﻨﻛاو
(PCR) ﻪـﻌﻄﻗ ﺮـﻴﺜﻜﺗ ياﺮﺑ
121bp ﻢـﺴﻴﻓرﻮﻣ ﻲـﻠﭘ
2257C ﻪﻌﻄﻗوA
177bp ﻢﺴﻴﻓرﻮﻣ ﻲﻠﭘ 2229C
T
TPO نژ يﺎﻫ ﺮﻤﻳاﺮﭘ يﺮﻴﮔرﺎﻛ ﻪﺑ ﺎﺑ (Primers)
ﻞـﻳذ
ﺪﺷ مﺎﺠﻧا ﺐﻴﺗﺮﺗ ﻪﺑ :
F: 5'CTGTCTCGGGTCATCTGTG3' R: 5'GTAACGTGGTGTGAGAGGAGAC3' F: 5'AAATAACCTTAATCATCAATTGG<T>3' R: 5'GGTTCTTAGCAGCAAGAGTC<C>3'
ﺮـﻈﻧ درﻮـﻣ يﺎـﻫ ﻢـﺴﻴﻓرﻮﻣ ﻲـﻠﭘ ﺺﻴﺨﺸﺗ ﺖﻬﺟ
مﺎﻓ ﺎﺘﻴﺑ
نارﺎﻜﻤﻫ و 12
لوﺪﺟ 1 : نژ يﺎﻫ ﻢﺴﻴﻓرﻮﻣ ﻲﻠﭘ يﺎﻫ ﻞﻟا و ﺎﻫ ﭗﻴﺗﻮﻧژ ﻲﻧاواﺮﻓ نادﺮﻣ و نﺎﻧز ﺖﻴﻌﻤﺟ رد ﻚﻴﻜﻔﺗ ﻪﺑTPO
نﺎﻧز
) داﺪﻌﺗ = 102 (
نادﺮﻣ ) داﺪﻌﺗ = 86 (
ﺖﻴﻌﻤﺟ ﻞﻛ ) داﺪﻌﺗ = 188 (
ﻮﻧژ ﻲﻧاواﺮﻓ ﺗ ﺎﻫ ﭗﻴ (%)
T2229C )
1 / 71 (
59 67(81/7) 129(76/3) CC
) 1 / 24 (
20 15(18/3) 36(21/3) CT
) 8 / 4 (
4 0 4(2/4) TT
T1936C )
5 / 76 ( 78
* 25(29/1) 103(53/9) CC
) 7 / 15 (
16 54(62/8) 73(38/2) CT
) 8 / 7 (
8 7(8/1) 15(8/2) TT
A2257C )
8 / 65 (
73 45(61/6) 118(64/1) CC
) 2 / 25 (
28 23(31/5) 51(27/7) CA
) 9 (
10 5(6/8) 15(8/2) AA
ﺎﻫ ﻞﻟا ﻲﻧاواﺮﻓ T2229C 83
/
0 0/91 0/87 Cﻞﻟا
17 /
0 0/09 0/13 Tﻞﻟا
T1936C 84
/
0 0/60 0/73 Cﻞﻟا
16 /
0 0/40 0/27 Tﻞﻟا
A2257C 78
/
0 0/77 0/78 Cﻞﻟا
22 /
0 0/23 0/22 A ﻞﻟا
* : 05 / p<0
تﻻﻮﺼﺤﻣ ﺖﻋﺎﺳ ود تﺪﻣ ﻪﺑPCR
رد يﺎﻣد 37 ﻪـﺟرد
سﻮﻴﺴﻠﺳ ،
هﺪﻨﻨﻛ دوﺪﺤﻣ يﺎﻫ ﻢﻳﺰﻧآ ﺮﻴﺛﺎﺗ ﺖﺤﺗ BsrI
Eco57Iو ﺪﻧﺪــﺷ ﻪــﺑﻮﻜﻧا
. تﺎــﻌﻄﻗ هﺪــﻣآ ﺖــﺳد ﻪــﺑ
ياﺮــﺑ 2257SNPC
وA 2229C ﺎــﺑ ﺐــﻴﺗﺮﺗ ﻪــﺑT
،زرﻮﻓوﺮﺘﻜﻟا شور زا هدﺎﻔﺘﺳا يور ﺮﺑ
لژ ﻲـﻠﭘ ﻞـﻳﺮﻛآ
ﺪــﻴﻣآ 12 % زورﺎــﮔآ و 3
% ﺪﻧﺪــﺷ ﻲــﺳرﺮﺑ .
ﻲــﻠﭘ رد
ﻢــﺴﻴﻓرﻮﻣ
،لوا ﭗــﻴﺗﻮﻧژ ﺎــﺑCC
ﻪــﻌﻄﻗ 121bp
ﻞــﺑﺎﻗ
دﻮﺑ ﻲﻳﺎﺳﺎﻨﺷ تﺎﻌﻄﻗ ،
121bp
، 68 و 62 ﭗﻴﺗﻮﻧژ فﺮﻌﻣ
وCA تﺎﻌﻄﻗ 68bp
و 62
ﭗـﻴﺗﻮﻧژ هﺪـﻨﻫد نﺎﺸﻧ AA
دﻮﺑ ﺪﻧ . ﻢـﺴﻴﻓرﻮﻣ ﻲﻠﭘ رد 2229C
ﭗـﻴﺗﻮﻧژ ،T ﺎـﺑCC
bpﻪﻌﻄﻗ 177 ﺪﻳدﺮﮔ ﺺﺨﺸﻣ .
تﺎـﻌﻄﻗ 177bp
، 95
و 82 ﭗﻴﺗﻮﻧژ ﺮﮕﻧﺎﻴﺑ تﺎﻌﻄﻗ وCT
95bp و 82 فﺮـﻌﻣ
ﭗﻴﺗﻮﻧژ ﺪﻧدﻮﺑTT
. ﻲﺑﺎـﺨﺘﻧا ﻢـﺴﻴﻓرﻮﻣ ﻲﻠﭘ 1936G
نوﺰﮔا ردA 11
TPO نژ شور ﻪﺑ ARMS-PCR
ﺎـﺑ
ﺖﻓﺮﮔ راﺮﻗ ﻲﺳرﺮﺑ درﻮﻣ ﻞﻳذ يﺎﻫ ﺮﻤﻳاﺮﭘ زا هدﺎﻔﺘﺳا .
F1: 5'CTAGAGTGAGATGGGCTGAAC3' R1: 5'CTCCCATTCTAAGTGCTACGTG3'
F2: 5'CAG ATGAAGGCTCTGCGGTAC3' R2: 5' GGATAGGAACGTACCAGTACC3'
ﻦــﻳا ﻪــﺑ طﻮــﺑﺮﻣ يﺎــﻫ ﭗــﻴﺗﻮﻧژ زا ﺲــﭘSNP
مﺎﺠﻧا زورﺎﮔآ لژ يور ﺮﺑPCR
2 % ﺪﻳدﺮﮔ ﻦﻴﻴﻌﺗ .
دﻮﺟو
تﺎﻌﻄﻗ 454bp
و 252 ﭗـﻴﺗﻮﻧژ هﺪـﻨﻫد نﺎـﺸﻧ وAA
تﺎــﻌﻄﻗ 454bp
، 320 و 252 ﭗــﻴﺗﻮﻧژ فﺮــﻌﻣ GA
ﺪﻧدﻮﺑ . ﭗﻴﺗﻮﻧژ تﺎـﻌﻄﻗ ﺎﺑ GG
454bp و 320 ﻦﻴـﻴﻌﺗ
ﺪﻳدﺮﮔ ) لوﺪﺟ 1 .(
درﻮﻣ يﺎﻫ ﻢﺴﻴﻓرﻮﻣ ﻲﻠﭘ ﻲﺳرﺮﺑ ﺎﺑ
ﻪﻌﻟﺎﻄﻣ
، رد 10 % ﻪﻧﻮﻤﻧ ﻞﻛ زا ﻲﻟاﻮﺗ ﻦﻴﻴﻌﺗ شور ﻪﺑ ﺎﻫ
،
ﺎﺘﻧ
ﻲﻠﻜـﺷ ﺪـﻨﭼ ﻲـﻠﭘ ﻦﻴـﻴﻌﺗ ﻪﺑ طﻮﺑﺮﻣ ﺞﻳ ﺪـﻴﻳﺎﺗ ﺎـﻫ
ﺪﻳدﺮﮔ .
ﺰﺠﺗ ﻪﻳ ﻠﺤﺗ و ﻞﻴ رﺎﻣآ ي
يدرﺎـﻫ لدﺎـﻌﺗ زا يوﺮـﻴﭘ ﻲﺳرﺮﺑ ﺶﻫوﮋﭘ ﻦﻳا رد -
ﻪـﻌﻟﺎﻄﻣ درﻮـﻣ ﺖـﻴﻌﻤﺟ ﻲـﻠﻟا ﻲﻧاواﺮﻓ و گﺮﺒﻨﻳاو
، ﺎـﺑ
ﻲﻠﻜﺷ ﺪﻨﭼ
يﺎﻫ Poly morphisms) (
ﺪﻴﻳوﺮﻴﺗ زاﺪﻴﺴﻛاﺮﭘ نژ ...
13
لوﺪﺟ 2 . درﻮﻣ يﺎﻫ ﺖﻧﺎﻳراو ﻦﻴﺑ ﻲﮕﺘﺳﻮﻴﭘ لدﺎﻌﺗ مﺪﻋ ﻦﻴﻴﻌﺗ ﺺﺧﺎﺷ
ﻪﻌﻟﺎﻄﻣ TPO نژ
T1936C T2229C A2257C C1936T 0/494 (1/82) 0/007 (0/969) T2229C 0/227 (0/446)
A2257C
لوﺪﺟ 3 . يﺪﻴﻳوﺮﻴﺗ زاﺪﻴﺴﻛاﺮﭘ نژ يﺎﻫ ﭗﻴﺗﻮﻠﭘﺎﻫ ﻲﻧاواﺮﻓ
ﭗﻴﺗﻮﻠﭘﺎﻫ (%) ﺖﻴﻌﻤﺟ
ATC 048 *
/ 0
066 CTT / 0
146 CTC / 0
011 ATT / 0
153 ACC / 0
031 CCT / 0
536 CCC / 0
* ﺎﻫ ﭗﻴﺗﻮﻠﭘﺎﻫ رد ﺎﻫ ﻢﺴﻴﻓرﻮﻣ ﻲﻠﭘ يﺮﻴﮔراﺮﻗ ﺐﻴﺗﺮﺗ C :
T2229 Cو T1936 C ، A2257
ترﻮـﺻ ﺮﻛرﺎـﻣ روﺎﭘ راﺰﻓا مﺮﻧ زا هدﺎﻔﺘﺳا ﺖـﻓﺮﮔ
) 13 ( .
راﺰــﻓا مﺮــﻧ ﻚــﻤﻛ ﻪــﺑ يرﺎــﻣآ يﺎــﻫ هداد ﻪﺒــﺳﺎﺤﻣ ﻪﺨﺴﻧspss 16 راﺰﻓا مﺮﻧ و ﻪﺨﺴﻧR
1 / 10 / 2 ﻦﻴﻨﭽﻤﻫ و
STATA ﻪﺨﺴﻧ
1 / 9 ﺪﺷ مﺎﺠﻧا .
ﺮـﻴﻐﺘﻣ ﻊﻳزﻮﺗ ﻲـﻤﻛ
فوﺮﮔﻮــﻤﻟﻮﻛ نﻮــﻣزآ زا هدﺎﻔﺘــﺳا ﺎــﺑ ﻪــﻌﻟﺎﻄﻣ درﻮــﻣ -
ﺖـﻓﺮﮔ راﺮـﻗ ﻲﺳرﺮﺑ درﻮﻣ فﻮﻧﺮﻴﻤﺳا .
ﻪـﻛ ﻲﻳﺎـﺠﻧآ زا
زاﺪﻴـﺴﻛاﺮﭘ ﺪــﺿ يدﺎـﺑ ﻲــﺘﻧآ ﻊـﻳزﻮﺗ ﺪــﻴﺋوﺮﻴﺗ
رد ي
ﻲﻤﺘﻳرﺎﮕﻟ مﺮﻓ زا ،دﻮﺒﻧ لﺎﻣﺮﻧ ،ﻲﺑﺎﺨﺘﻧا ﺖﻴﻌﻤﺟ رد نآ
ﺪﺷ هدﺎﻔﺘﺳا ﺎﻫ ﺰﻴﻟﺎﻧآ .
ﻦﻴﮕﻧﺎـﻴﻣ ﻪـﺴﻳﺎﻘﻣ Anti-TPO
ﻞﻴﻠﺤﺗ يرﺎﻣآ شور زا هدﺎﻔﺘﺳا ﺎﺑ ﻲﭙﻴﺗﻮﻧژ هوﺮﮔ ﻪﺳ رد ﻪﻓﺮﻄﻜﻳ ﺲﻧﺎﻳراو (ANOVA)
ﻞـﻣاﻮﻋ ﺶـﻘﻧ ﻞﻳﺪﻌﺗ و
ﻞـــﻴﻠﺤﺗ ﺰﻴﻟﺎـــﻧآ ﻚـــﻤﻛ ﻪـــﺑ هﺪـــﻨﻨﻛ شوﺪـــﺨﻣ ﺲﻧﺎـــﻳراوﻮﻛ (ANCOVA)
ﺪـــﺷ مﺎـــﺠﻧا .
ﻦﻴـــﻴﻌﺗ
ﺺﺧﺎﺷ ﻲﮕﺘـﺳﻮﻴﭘ لدﺎﻌﺗ مﺪﻋ يﺎﻫ (LD =Linkage
Disequilibrium) درﻮـﻣ يﺎـﻫ ﻢـﺴﻴﻓرﻮﻣ ﻲـﻠﭘ ياﺮﺑ
شور ﺎــﺑ ﻲــﺳرﺮﺑ Pairwise Lewontin's D'
ﺎــﺑ و
ﻪﺘﺴﺑ زا هدﺎﻔﺘﺳا راﺰﻓا مﺮﻧLD
ﺪﻳدﺮﮔ ﻦﻴﻴﻌﺗR .
ﭗــﻳﺎﺗﻮﻠﭘﺎﻫ ﻲــﻧاواﺮﻓ هدﺎﻔﺘــﺳا ﺎــﺑ ﺎــﻫ
ﻲــﻳاﺮﺟا ﻞــﻳﺎﻓ
haplo.em ﻢﺘﻳرﻮﮕﻟا زا
ﻪﺘـﺴﺑ رد EM
“haplo.stas”
راﺰﻓا مﺮﻧ ﺪﺷ دروآﺮﺑ R
طﺎﺒﺗرا. زا ﻚﻳ ﺮﻫ ﺎﻫ ﭗﻴﺗﻮﻠﭘﺎﻫ
ﺎﺑ ﺢﻄـﺳ Anti-TPO
ﻚـﻤﻛ ﻪـﺑ ﻊﺑﺎـﺗ
haplo.glm رد
“haplo. stats”ﻪﺘﺴﺑ راﺰﻓا مﺮﻧ زا
راﺮﻗ ﻲﺳرﺮﺑ درﻮﻣR
ﺖﻓﺮﮔ . يرﺎﻣآ يﺎﻫ ﺰﻴﻟﺎﻧآ مﺎﻤﺗ ياﺮﺑ يراد ﻲﻨﻌﻣ ﺢﻄﺳ
05 / 0 ﺪﺷ ﻪﺘﻓﺮﮔ ﺮﻈﻧ رد .
ﻪﺘﻓﺎﻳ
ﺎﻫ
ﻪﺘﻓﺎﻳ ﺎﻫ ي ا ﻦﻳ ﻣ ﻪﻛ داد نﺎﺸﻧ ﺶﻫوﮋﭘ ﻦﻴﮕﻧﺎﻴ
ﻲـﺘﻧآ
دﺎﺑ ي ﺴﻛاﺮﭘ ﺪﺿ زاﺪﻴ
ﺪﻴﺋوﺮﻴﺗ ي ﺖﻴﻌﻤﺟرد 188
ﺮﻔﻧ ي
ﻌﻤﺟ زا هﺪﺷ بﺎﺨﺘﻧا TLGSﺖﻴ
IU/L، 36 /
±6 105 دﻮﺑ .
ﺖﻴﻌﻤﺟرد ﻲﺘﻧآ ﻦﻳا ناﺰﻴﻣ ﻪﺴﻳﺎﻘﻣ نادﺮﻣ
نﺎـﻧزو ﻪـﺑ
ﻜﻔﺗ
،ﻚﻴ ﻣ ﻪﻛ داد نﺎﺸﻧ ﻦﻴﮕﻧﺎﻴ
Anti-TPO ـﺑ
ﻦﻴ ﺎـﻬﻧآ
دﻮــــﺑ توﺎــــﻔﺘﻣ )
001 / p<0 IU/L؛ 05 /
±7 147 رد
ﻞــﺑﺎﻘﻣ 56 /
±4 1 / 41 .( ﻲــﻠﭘ ﻲﭙﻴﺗﻮــﻧژ و ﻲــﻠﻟا ﻲــﻧاواﺮﻓ
يﺎﻫ ﻢﺴﻴﻓرﻮﻣ 1936C
، T 2229C وT 2257C نژA
يدرﺎﻫ لدﺎﻌﺗ زاTPO -
دﺮﻛ ﻲﻣ ﺖﻴﻌﺒﺗ گﺮﺒﻨﻳاو .
ﺎـﺑ
ﻪــﺑ ﻪــﺟﻮﺗ رد ﻪــﻛﺎﻫ ﭗــﻴﺗﻮﻧژ و ﺎــﻫ ﻞــﻟا ﻲــﻧاواﺮﻓ
لوﺪــﺟ 1 ﻲــﻠﻟا ﻲــﻧاواﺮﻓ ،ﺖــﺳا هﺪــﺷ هداد نﺎــﺸﻧ
ﻲﻠﭘ ﻢﺴﻴﻓرﻮﻣ و نادﺮـﻣ ﺖـﻴﻌﻤﺠﻨﻴﺑ هﺪﺷ بﺎﺨﺘﻧا يﺎﻫ
ﺖﺷاﺪﻧ يراد ﻲﻨﻌﻣ توﺎﻔﺗ نﺎﻧز .
عﻮﻴﺷ ﻪﻛ ﻲﺗرﻮﺻ رد
ﻢﺴﻴﻓرﻮﻣ ﻲﻠﭘ يﺎﻫ ﭗﻴﺗﻮﻧژ 1936C
ﺲﻨﺟ ود ﻦﻴﺑT
دﻮﺑ توﺎﻔﺘﻣ )
001 / (p<0 . ﻪـﺑ يﺎـﻫ ﻪـﺘﻓﺎﻳ سﺎـﺳا ﺮﺑ
ﺣ ،هﺪﻣآ ﺖﺳد ﻞﻟا رﻮﻀ
ﻢﺴﻴﻓرﻮﻣ ﻲﻠﭘ C 1936C
ﺎﺑT
ناﺰــــﻴﻣ Anti-TPO
نﺎــــﺸﻧ ﻲــــﺸﻳاﺰﻓا طﺎــــﺒﺗرا
داد ) 002 / p=0 IU/L؛ 3 /
±11 1 / TT:74 ﻞــــــﺑﺎﻘﻣ رد
9 /
±15 7 / CT:47
، 3 /
±43 (CC:238 ﻦـــﻳا ﻪـــﭼﺮﮔا
ﻪـﻠﻤﺟ زا هﺪﻨﻨﻛ شوﺪﺨﻣ ﻞﻣاﻮﻋ لﺎﻤﻋا زا ﺲﭘ طﺎﺒﺗرا ﺪـﻧﺎﻤﻧ ﻲﻗﺎﺑ راد ﻲﻨﻌﻣ ﺲﻨﺟ و ﻦﺳ )
059 / (p=0 . ﻲـﻠﭘ
ﻢــﺴﻴﻓرﻮﻣ 2229C
ﺪــﺿ يدﺎــﺑ ﻲــﺘﻧآ ناﺰــﻴﻣ ﺎــﺑT
زاﺪﻴــﺴﻛاﺮﭘ ﺪــﻴﺋوﺮﻴﺗ
ي ﺖــﺷاﺪﻧ يراد ﻲــﻨﻌﻣ ﻪــﻄﺑار
) 196 / IU/L; P=0 8
/
±13 TT:126 و 6 /
±12 5 / 43
،CT:
5 /
±24 CC:129 ( ﺮﺛا ﻞﻳﺪﻌﺗ زا ﺲﭘ طﺎﺒﺗرا ﻦﻳا ،
دﻮﺒﻧ راد ﻲﻨﻌﻣ ﺰﻴﻧ ﺲﻨﺟ و ﻦﺳ )
480 / p=0 .(
ﻪﭼ ﺮﮔا
ناﺰﻴﻣ Anti-TPO ﺮـﮔ ﻪـﻠﺧاﺪﻣ ﻞﻣاﻮﻋ ﻞﻳﺪﻌﺗ زا ﺶﻴﭘ
ﺎــﺑ ﭗــﻴﺗﻮﻧژ ﻢــﺴﻴﻓرﻮﻣ ﻲــﻠﭘ يﺎــﻫ 2257C
طﺎــﺒﺗراA
ﻲــﻨﻌﻣ ﺖــﺷاﺪﻧ يراد )
233 / P=IU/L;0 59
/
±6 9 / 66
وAA:
3 /
±15 7 / CA:96
، 6 /
±23 CC:113 ( ﺲﭘ ﻲﻟو ،
راد ﻲﻨﻌﻣ ﺎﻬﻧآ ﻦﻴﺑ طﺎﺒﺗرا ،ﺲﻨﺟ و ﻦﺳ ﺮﺛا لﺎﻤﻋا زا ﺪﻳدﺮﮔ ) 007 / p=0 .(
ﻲﮕﺘـﺳﻮﻴﭘ لدﺎـﻌﺗ مﺪـﻋ ﺺﺧﺎـﺷ ﻲﺳرﺮﺑ و ﻦﻴﻴﻌﺗ ﻪـــﻛ داد نﺎـــﺸﻧ(LD) ﻲـــﻠﭘ
ﻢـــﺴﻴﻓرﻮﻣ 1936C
T
Cﺎﺑ T2229 C و
ﻢـﺴﻴﻓرﻮﻣ ﻲﻠﭘ T2229
Cﺎـﺑ 2257
ﺖـﺷاد ﺖﺒﺜﻣ طﺎﺒﺗراA )
ﺐـﻴﺗﺮﺗ ﻪـﺑ 494
/ 0 و 227 / 0
)(D′=
لوﺪﺟ 2 .(
زا هﺪـﻣآ ﺖـﺳد ﻪـﺑ يﺎـﻫ ﻪﺘﻓﺎﻳ سﺎﺳا ﺮﺑ و ﻪـﻳﺰﺠﺗ
ﻞﻴﻠﺤﺗ ﺎﻫ
،ﺎﻫ ﭗﻴﺗﻮﻠﭘ درﻮـﻣ ﻢـﺴﻴﻓرﻮﻣ ﻲـﻠﭘ ﻪﺳ ياﺮﺑ
مﺎﻓ ﺎﺘﻴﺑ
نارﺎﻜﻤﻫ و 14
زا ،ﻲﺳرﺮﺑ يﺮﻈﻧ ظﺎﺤﻟ
، 12 رﺎﺘﺧﺎﺳ ﻲﭙﻴﺗﻮﻠﭘﺎـﻫ ﻦـﻜﻤﻣ
ﻪﻛدﻮﺑ ﺎﻬﻨﺗ ﺖﻔﻫ ﺎـﻬﻧآ زا درﻮـﻣ
ﻲـﻧاواﺮﻓ ﺎـﺑ زا ﺮﺘـﺸﻴﺑ
1
% لوﺪﺟ رد 3
ﺪـﻧا هﺪﺷ هدروآ ﭗـﻴﺗﻮﻠﭘﺎﻫ.
ﺎـﺑCCC
ﻞﻟا ﻲـﻧاواﺮﻓ و ﻲـﻜﻴﺘﻧژ هﺎﮕﻳﺎﺟ ﻪﺳ ﺮﻫ رد ﻲﻌﻴﺒﻃ يﺎﻫ
53
%
ﺪـﺷ ﻪـﺘﻓﺮﮔ ﺮـﻈﻧ رد ﻪـﻳﺎﭘ ﭗﻴﺗﻮﻠﭘﺎﻫ ناﻮﻨﻋ ﻪﺑ ، .
ناﺰـﻴﻣ ﺎﺑ رﻮﻛﺬﻣ ﭗﻴﺗﻮﻠﭘﺎﻫ طﺎﺒﺗرا Anti-TPO
ﺮـﻈﻧ زا
دﻮﺒﻧراد ﻲﻨﻌﻣ يرﺎﻣآ .
يﺎﻫ ﭗﻴﺗﻮﻠﭘﺎﻫ وATC
ﺎﺑCTT
ﺮﭘ ﺪﺿ يدﺎﺑ ﻲﺘﻧآ ﺢﻄﺳ زاﺪﻴﺴﻛا
ﺪﻴﺋوﺮﻴﺗ طﺎـﺒﺗرا ،ي
ﺪﻧداد نﺎﺸﻧ يراد ﻲﻨﻌﻣ )
021 / 0 و 023 / p=0 .(
ﻪـﻄﺑار
ﭗـﻴﺗﻮﻠﭘﺎﻫ ﻦﻴﺑ ناﺰـﻴﻣ ﺎـﺑCTT
Anti-TPO زا ﺲـﭘ
ﻦﺳ ﺮﺛا ﻞﻳﺪﻌﺗ دﻮﺑ راد ﻲﻨﻌﻣ نﺎﻨﭽﻤﻫ
) 014 / p=0 (
، رد
ﭗـﻴﺗﻮﻠﭘﺎﻫ طﺎﺒﺗرا ﻪﻛ ﻲﺗرﻮﺻ ATC
ناﺰـﻴﻣ ﺎـﺑ Anti-
راد ﻲﻨﻌﻣ هﺪﻨﻨﻛ شوﺪﺨﻣ ﻞﻣاﻮﻋ ﻞﻳﺪﻌﺗ زا ﺲﭘTPO ﻲﻗﺎﺑ ﺪﻧﺎﻤﻧ ) 418 / p=0 .(
يﺮﻴﮔ ﻪﺠﻴﺘﻧ و ﺚﺤﺑ ﻲـﻠﭘ ﻪـﺳ ﻦﻴـﺑ طﺎـﺒﺗرا ﻲـﺳرﺮﺑ ﺎـﺑ ﻲﻧﻮﻨﻛ ﺶﻫوﮋﭘ
ﻢـــــــﺴﻴﻓرﻮﻣ 1936C
،T 2229C وT 2257C نژA
زاﺪﻴﺴﻛاﺮﭘ ﺪﻴﺋوﺮﻴﺗ
نآ ﺪـﺿ يدﺎـﺑ ﻲﺘﻧآ ناﺰﻴﻣ ﺎﺑ ي
نژ رد ﻲـﻜﻴﺘﻧژ تاﺮـﻴﻴﻐﺗ زوﺮـﺑ ﻪﻛ داد نﺎﺸﻧ ﺎـﺑTPO
ﻦﺳ و دراد طﺎﺒﺗرا نآ ﻪﻴﻠﻋ يﺪﻴﻟﻮﺗ يدﺎﺑ ﻲﺘﻧآ ناﺰﻴﻣ و ﺪﻧﻮﺷ ﻲﻣ بﻮﺴﺤﻣ ﺮﺛﻮﻣ ﻞﻣاﻮﻋ ﻪﻠﻤﺟ زﺎﺴﻨﺟ .
ﺞﻳﺎﺘﻧ
يﺎـﻫ ﭗـﻴﺗﻮﻠﭘﺎﻫ ﻦﻴـﺑ ﻪﻄﺑار ﻲﺳرﺮﺑ زا هﺪﻣآ ﺖﺳد ﻪﺑ ﺮـﺑ هﺪـﺷ بﺎـﺨﺘﻧا ﻚﻴﻓرﻮﻣ ﻲﻠﭘ هﺎﮕﻳﺎﺟ ﻪﺳ زا ﻞﺻﺎﺣ نژ يور ﻲﻣﺮﺳ ﺢﻄﺳ ﺎﺑTPO
Anti-TPO
، ﺶﻘﻧ ﺪﻳﻮﻣ
ﻲﺘﻧآ ناﺰﻴﻣ ﺎﺑ ﻪﻌﻟﺎﻄﻣ درﻮﻣ ﻲﻜﻴﺘﻧژ تاﺮﻴﻴﻐﺗ ﺮﺛﻮﻣ يدﺎﺑ
زاﺪﻴﺴﻛاﺮﭘ ﺪﺿ
ﺪﻴﺋوﺮﻴﺗ ﺖﺳا ي .
نﺎﻤﺘﺧﺎـﺳ،ﻲﻟﻮﻜﻟﻮﻣ تﺎـﻌﻟﺎﻄﻣ سﺎﺳا ﺮﺑ ﺗوﺮﭘ
ﺌ ﻲـﻨﻴ
ﻢﻳﺰﻧآ ﺎـﺑ ﻪـﻛ ،ﺖﺳا نآ هﺪﻨﻨﻛ ﺪﻛ نژ ﻪﺑ ﻪﺘﺴﺑاو TPO
ﺰﺘﻨــﺳ رد يﺪــﻴﻠﻛ ﺶــﻘﻧ ،ﻲــﻌﻴﺒﻃ رﺎﺘﺧﺎــﺳ ﻚــﻳ نﻮﻣرﻮﻫ يﺎـﻫ ﺪـﻴﺋوﺮﻴﺗ
ﻲـﻣ ﺎـﻔﻳا ي ﺪـﻨﻛ
) 9 و 14 ( . رد
رﺎﺘﺧﺎﺳ ﺮﻴﻴﻐﺗ ﻪﺑ ﻲﻬﺘﻨﻣ ﻲﻜﻴﺘﻧژ تاﺮﻴﻴﻐﺗ زوﺮﺑ ترﻮﺻ ﺗوﺮﭘ ﺌ ﻲﻨﻴ TPO ، ﻂـﺳﻮﺗ ﻲﺟرﺎـﺧ ﻢﺴﺟ ﻚﻳ ناﻮﻨﻋ ﻪﺑ
ﻲـﺘﻧآ نآ ﻪـﻴﻠﻋ و هﺪﺷ ﻲﻳﺎﺳﺎﻨﺷ نﺪﺑ ﻲﻨﻤﻳا ﻢﺘﺴﻴﺳ ﺪﻨﻜﻴﻣ ﺢﺷﺮﺗ و ﺪﻴﻟﻮﺗ يدﺎﺑ .
ﻲﻨﻳﺰﮕﻳﺎﺟ لﺎﺜﻣ ناﻮﻨﻋ ﻪﺑ
Cﻞﻟا ﻢـﺴﻴﻓرﻮﻣ ﻲﻠﭘ 1936C
T
ﻪـﺑ ﺮـﺠﻨﻣ ﻲﻨﻳﺰﮕﻳﺎـﺟ
رﺎﺘﺧﺎـﺳ رد ﻦﻴﻧﻮـﻴﺘﻣ ﺎﺑ ﻦﻴﻟاو ﻪﻨﻴﻣآ ﺪﻴﺳا ﺗوﺮﭘ
ﺌ ﻲـﻨﻴ
ﻲﻣTPO ﻲـﻣ هﺪﺷ دﺎﺠﻳا ﺮﻴﻴﻐﺗ ،دﻮﺷ ﺎـﺑ ﺪـﻧاﻮﺗ
دﺎـﺠﻳا
ﻦـﻳا ﻲـﻌﻴﺒﻃ نﺎﻤﺘﺧﺎـﺳ رد ﺮﻴﻴﻐﺗ
ﺗوﺮـﭘ ﺌ ﻦﻴ
، ﻲﻠﻣﺎـﻋ
يدﺎﺑ ﻲﺘﻧآ ﺢﺷﺮﺗ ﺖﻬﺟ ﺪﺷﺎﺑ نآ ﻪﻴﻠﻋ
. ﻪـﻌﻟﺎﻄﻣ ﺞﻳﺎﺘﻧ
ﻦﻴـﻴﻌﺗ شور زا هدﺎﻔﺘـﺳا ﺎـﺑ ﻪـﻛ يا
نژ ﻲﻟاﻮﺗ ﺪﺷ مﺎﺠﻧاTPO
، زوﺮﺑ ﻪﻛ داد نﺎﺸﻧ تاﺮـﻴﻴﻐﺗ
يرﺎـﻛ ﻢـﻛ يرﺎـﻤﻴﺑ ﺎـﺑ نژ ﻦـﻳا رد ﻲﻜﻴﺘﻧژ ﺪـﻴﺋوﺮﻴﺗ
دراد طﺎﺒﺗرا يدازردﺎﻣ )
15 (.
يور ﺮـﺑ يﺮﮕﻳد ﻖﻴﻘﺤﺗ
ﻲﻋﻮـﻧ ﻪـﻛ داد نﺎـﺸﻧ ﻲـﻨﻴﺘﻧاژرآ نﻻﺎﺴﮔرﺰﺑ ﺖﻴﻌﻤﺟ نوﺰـﮔا رد ﺐﻟﺎﻗ ﺮﻴﻴﻐﺗ ﺶﻬﺟ 8
TPO نژ ﻲـﻣ ﺪـﻧاﻮﺗ
هﺪـﻏ ﻲـﻨﻤﻳا دﻮـﺧ يرﺎـﻤﻴﺑ زوﺮﺑ ﻪﺑ ﺮﺠﻨﻣ ﺪـﻴﺋوﺮﻴﺗ
دﻮﺷ ) 9 (.
ﻪﺘﻓﺎﻳ يﺎﻫ ﻪـﻛ داد نﺎـﺸﻧ ﺮـﮕﻳد ناﺪﻨﻤـﺸﻧاد
نوﺰــﮔا رد ﻲــﻜﻴﺘﻧژ تاﺮــﻴﻴﻐﺗ 10
TPO نژ يور ﺮــﺑ
ﻲﻤﻳﺰﻧآ ﺖﻴﻟﺎﻌﻓ ﺪﻴﺋوﺮﻴﺗ
ﺖـﺳا ﺮﺛﻮﻣ زاﺪﻴﺴﻛاﺮﭘ )
16 ( .
ﻲـﻣ ،ﻲﻧﻮﻨﻛ ﺶﻫوﮋﭘ و نﻮﮔﺎﻧﻮﮔ تﺎﻌﻟﺎﻄﻣ ﺞﻳﺎﺘﻧ ﺪـﻧاﻮﺗ
زاﺪﻴـﺴﻛاﺮﭘ نژ ﻲـﻜﻴﺘﻧژ تاﺮـﻴﻴﻐﺗ ﺮﺛﻮـﻣ ﺶـﻘﻧ ﺪﻛﻮﻣ ﺪــﻴﺋوﺮﻴﺗ ﻲﻨﻤﻳادﻮــﺧ يﺎــﻫ يرﺎــﻤﻴﺑ زوﺮــﺑ رد ي هﺪــﻏ
ﺪﻴﺋوﺮﻴﺗ ﺪﺷﺎﺑ . ﻦـﻳا يﺎـﻫ ﻪـﺘﻓﺎﻳ سﺎـﺳا ﺮـﺑ هوﻼـﻋ ﻪﺑ
،ﺶﻫوﮋﭘ رﻮﺘﻛﺎﻓ ،ﻲﺳرﺮﺑ درﻮﻣ ﻲﻧاﺮﻬﺗ ﺖﻴﻌﻤﺟ رد
يﺎﻫ
ﻲـﻠﭘ ﻦﻴـﺑ طﺎـﺒﺗرا يور ﺮﺑ ﻲﻤﻬﻣ ﺶﻘﻧ ﺲﻨﺟ و ﻦﺳ نژ يﺎﻫ ﻢﺴﻴﻓرﻮﻣ ﺪـﺿ يدﺎـﺑ ﻲـﺘﻧآ ناﺰـﻴﻣ ﺎﺑTPO
زاﺪﻴﺴﻛاﺮﭘ ﺪﻴﺋوﺮﻴﺗ
ﺪﻨﺘﺷاد ي .
زا ﻞـﻳذ دراﻮـﻣ ﻪـﺑ ناﻮـﺗ ﻲﻣ ﻪﻌﻟﺎﻄﻣ ﻦﻳا تﻼﻜﺸﻣ
دﻮﻤﻧ هرﺎﺷا :
1 ( ي ﺎﻫ ﻢﺴﻴﻓرﻮﻣ ﻲﻠﭘ زا يدوﺪﺤﻣ داﺪﻌﺗ
نژ TPO، ﻲﺳرﺮﺑ درﻮﻣ ﻲﻟﺎﻣ يﺎﻫ ﺖﻳدوﺪﺤﻣ ﻞﻴﻟد ﻪﺑ
ﺖﻓﺮﮔ راﺮﻗ .
2 (
هﺪـﺷ بﺎـﺨﺘﻧا داﺮﻓا ندﻮﺑ ﻢﻛ ﺖﻠﻋ ﻪﺑ
،
نﺎـﻜﻣا ﻲـﻧاﺮﻳا ﺖـﻴﻌﻤﺟ ﻪﺑ ﻪﻌﻟﺎﻄﻣ ﻦﻳا ﺞﻳﺎﺘﻧ ﻢﻴﻤﻌﺗ ﺖﺴﻴﻧﺮﻳﺬﭘ .
3 (
رﻮﻫ ﻪـﺑ طﻮـﺑﺮﻣ تﺎـﻋﻼﻃا يﺎـﻫ نﻮـﻣ
ﺪﻴﺋوﺮﻴﺗ دﻮﺒﻧ سﺮﺘﺳد رد هﺪﺷ بﺎﺨﺘﻧا داﺮﻓا ي .
ﺮﻳﺪﻘﺗ ﺮﻜﺸﺗ و
ﺪﻛ ياراد ﺶﻫوﮋﭘ ﻦﻳا 240
ﻲﻟﺎﻣ يﺎﻫ ﺖﻳﺎﻤﺣ ﺎﺑ و
و ﺰــﻳر نورد دﺪــﻏ مﻮــﻠﻋ هﺪﻜــﺸﻫوﮋﭘ تﺎــﻧﺎﻜﻣا و مﺎﺠﻧا ﻲﺘﺸﻬﺑ ﺪﻴﻬﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺪﻜﺸﻧاد ﻢﺴﻴﻟﻮﺑﺎﺘﻣ ﺖﻓﺮﮔ . يﺎـﻗآ بﺎـﻨﺟ هﮋـﻳو ﻪﺑ هﺪﻜﺸﻫوﮋﭘ نارﺎﻜﻤﻫ زا
دﻮﺷ ﻲﻣ ﺮﻜﺸﺗ ﻲﺘﻴﮔ ناﺮﻣﺎﻛ .
ﻊﺑﺎﻨﻣ
1. Andersen S, Pedersen K M, Bruun N H, Laurberg
P. Narrow individual variations in serum T(4) and T(3) in normal subjects: a clue to the understanding of subclinical thyroid disease. J Clin Endocrinol Metab.2002;87: 1068-72.
2. Nunez J, Pommier J. Formation of thyroid hormones. Vitam Horm. 1982;39: 175-229.
ﻲﻠﻜﺷ ﺪﻨﭼ
يﺎﻫ Poly morphisms) (
ﺪﻴﻳوﺮﻴﺗ زاﺪﻴﺴﻛاﺮﭘ نژ ...
15
3. Degroot L J,Niepomniszcze H. Biosynthesis of thyroid hormone: basic and clinical aspects, Metabolism.1977;26: 665-718.
4. Libert F, Ruel J, Ludgate M, Swillens S, Alexander N, Vassart G, et al .Thyroperoxidase, an auto-antigen with a mosaic structure made of nuclear and mitochondrial gene modules. EMBO J.1987;6:
4193-6.
5. Seto P, Hirayu H, Magnusson R P, Gestautas J, Portmann L, DeGroot L J, et al. Isolation of a complementary DNA clone for thyroid microsomal antigen. Homology with the gene for thyroid peroxidase. J Clin Invest.1987;80: 1205-8.
6. Kimura S, Kotani T, McBride O W, Umeki K, Hirai K, Nakayama T, et al. Human thyroid peroxidase: complete cDNA and protein sequence, chromosome mapping, and identification of two alternately spliced mRNAs. Proc Natl Acad Sci U S A.1987;84: 5555-9.
7. Endo Y, Onogi S, Umeki K, Yamamoto I, Kotani T, Ohtaki S, et al. Regional localization of the gene for thyroid peroxidase to human chromosome 2p25 and mouse chromosome 12C. Genomics.1995;25: 760-1.
8. Fugazzola L, Mannavola D, Vigone M C, Cirello V, Weber G, Beck-Peccoz P, et al. Total iodide organification defect: clinical and molecular characterization of an Italian family. Thyroid.2005;15:
105-8.
9. Abramowicz M J, Targovnik H M, Varela V, Cochaux P, Krawiec L, Pisarev M A, et al.
Identification of a mutation in the coding sequence of the human thyroid peroxidase gene causing congenital goiter. J Clin Invest.1992;90: 1200-4.
10. Pfarr N, Borck G, Turk A, Napiontek U, Keilmann A, Muller-Forell W, et al. Goitrous congenital hypothyroidism and hearing impairment associated with mutations in the TPO and SLC26A4/PDS genes. J Clin Endocrinol Metab.
2006;91: 2678-81.
11. Azizi F, Rahmani M, EmamiH, Mirmiran P, Hajipour R, Madjid M, et al. Cardiovascular risk factors in an Iranian urban population: Tehran lipid and glucose study (phase 1). Soz Preventivmed 2002;47:
408-26. [Persian].
12. Azizi F, Mirmiran P, Azadbakht L. Predictors of cardiovascular risk factors in Tehranian adolescents:
Tehran Lipid and Glucose Study. Int J Vitam Nutr Res.2004;74: 307-12. [Persian]
13. PowerMakerR Software, Version 3.25 released on 2/5/2006. Available from (Original Site): http://statgen.
ncsu.edu/powermarker/
14. Kotani T, Umeki K, Kawano J, Suganuma T, Hishinuma A, Ieiri T, et al. Partial iodide organification defect caused by a novel mutation of the thyroid peroxidase gene in three siblings. Clin Endocrinol (Oxf).2003;59: 198-206.
15. Fugazzola L, Cerutti N, Mannavola D, Vannucchi G, Fallini C, Persani L, et al. Monoallelic expression of mutant thyroid peroxidase allele causing total iodide organification defect.J Clin Endocrinol
Metab.2003;88: 3264-71.
16. Bikker H, Baas F, De Vijlder JJ. Molecular analysis of mutated thyroid peroxidase detected in patients with total iodide organification defects. J Clin Endocrinol Metab.1997;82: 649-53.
Original Article
Thyroid Peroxidase Gene Polymorphisms and Anti-TPO level in Tehranian adults
Bita Faam, MSc. Biochemistry, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. [email protected]
Maryam Sadat Daneshpour, PhD. Genetics, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. [email protected]
Marziyeh Salehi MSc. Genetics, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. [email protected]
*Mehdi Hedayati, PhD. Assistant Professor of Biochemistry, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.(*Corresponding Author) [email protected] Fereydoon Azizi, MD. Professor of Endocrinology,Endocrine Research Center, Research Institute for endocrine sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. [email protected]
Abstract
Background: TPO gene variations are one of the causes of thyroid autoimmune diseases. The aim of this study was to examine the association between the T1936C, T2229C and A2257C SNPs (single nucleotide polymorphisms)of the TPO gene and Anti-TPO level.
Methods: In this case-control study, 188 individuals (86 males and 102 females), aged 20-80 years, were randomly selected from the Tehran Lipid and Glucose Study population (TLGS). A2257C and T2229C SNPs were detected with RFLP by use of BsrI and Eco57I as restrictive enzymes respectively, while the T1936C SNP was determined with ARMS-PCR.
Results: In the presence of the C allele of T1936C, Anti-TPO level was significantly increased (CC:
238±43.3, CT: 47.7±15.9, TT: 74.1±11.3 IU/L; p 0.002); however, it disappeared after adjustment for sex and age (p 0.059). No significant difference, before and after adjustment, was found in Anti-TPO level in the presence of T2229C SNP (CC: 129.1±24.5, CT: 43.5±12.6, TT: 126.5±13.8 IU/L; p 0.196). The association of A2257C with Anti-TPO level was only significant after adjustment for sex and age (p 0.007),and between the ATC ,CTT haplotypes and Anti-TPO level ,the association was significant (p 0.023, 0.021); however, the association it was dominant between CTT and anti-TPO concentration was significant only after adjustment for sex (p 0.014).
Conclusion: The result of this study, showed age and sex as potential confounders which could modify the association between TPO polymorphisms and Anti-TPO level in a Tehranian population.
Keywords: Thyroid Peroxidase, Polymorphism, Anti-TPO, TLGS.
