title: Elevated thyroid autoantibodies and intracranial stenosis in stroke at an early age.
abstract: BACKGROUND
  Previous studies have shown that hyperthyroidism was related to Moyamoya disease and intracranial artery stenosis. However, it is not clear whether thyroid hormone or thyroid autoantibodies was associated with them.
  
  
  OBJECTIVE
  Thyroid autoimmunity was previously shown to be associated with Moyamoya disease. Our study aimed to investigate the association between thyroid autoantibodies and intracranial large artery stenosis in young ischemic stroke patients with apparent euthyroid states.
  
  
  METHODS
  We retrospectively reviewed first-onset ischemic stroke patients (age ≤55 years old) consecutively admitted to a single academic center. Intracranial large artery stenosis was defined as ≥50% luminal diameter narrowing. We compared demographic profiles, risk factors (age, hypertension, diabetes, current smoker, atrial fibrillation, hyperlipidemia), thyroid function test, and thyroid autoantibodies including antithyroperoxidase antibody and antithyroglobulin antibody between patients with and without intracranial large artery stenosis. We also performed multivariate logistic regression analysis to evaluate the association between thyroid autoantibodies and intracranial large artery stenosis.
  
  
  RESULTS
  A total of 351 patients were analyzed. The mean age of the patients was 47·0 ± 7·7 (range, 10-55 years), and 252 (71·8%) patients were male. We identified intracranial large artery stenosis in 121 (34·5%) patients. Patients with intracranial large artery stenosis showed a higher frequency of elevated antithyroperpxidase antibody levels in comparison with nonintracranial large artery stenosis group (16·5% vs. 3·9%, P < 0·001). After adjusting for covariates, the presence of elevated antithyroperpxidase antibody levels (odds ratio: 5·318; 95% confidence interval: 2·157-13·110, P < 0·001), age (odds ratio: 1·037; 95% confidence interval: 1·002-1·073, P = 0·039), and atrial fibrillation (odds ratio: 0·091; 95% confidence interval: 0·011-0·756, P = 0·027) was independently associated with intracranial large artery stenosis.
  
  
  CONCLUSIONS
  Thyroid autoantibodies may be associated with the presence of intracranial large artery stenosis in young stroke patients, potentially providing insight on immune pathogenesis of intracranial large artery stenosis.
authors.affiliation: Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
authors.forename: Zhenghao
authors.initials: Z
authors.lastname: Shi
authors.forename: Xuting
authors.initials: X
authors.lastname: Zhang
authors.forename: Zhicai
authors.initials: Z
authors.lastname: Chen
authors.forename: David S
authors.initials: DS
authors.lastname: Liebeskind
authors.forename: Min
authors.initials: M
authors.lastname: Lou
mesh_terms: D000328:Adult; D017668:Age of Onset; D001323:Autoantibodies / Q000378:metabolism*; D001921:Brain / Q000473:pathology*; D002545:Brain Ischemia / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D002648:Child; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000276:immunology*; D055815:Young Adult
chemical_list: D001323:Autoantibodies; C006606:anti-thyroglobulin
keywords: age; antithyroperoxidase antibody; stenosis; stroke; thyroid
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