Salivary gland function in women with Hashimoto’s thyroiditis without xerostomia and the correlation with auto-thyroid antibodies

Abstract

Background Hashimoto’s thyroiditis (HT) may cause salivary dysfunction in patients resulting in xerostomia, but little is known about changes in salivary function in patients with no obvious dry mouth symptoms. In this study we assessed salivary function in women with HT, who had not experienced xerostomia and, for the first time, evaluated the effects of thyroid auto-antibodies on this function.

Methods Sixty consecutive subjects were included, comprising 32 women (mean age, 36 ± 12 years) diagnosed with HT accompanied by differentiated thyroid cancer (DTC) in the study group (HT group), along with a control group (DTC group) of 28 women (mean age, 40 ± 12 years) diagnosed with DTC only. Salivary gland scintigraphy was used to assess salivary function with the semi-quantitative parameters of maximum absorption ratio and maximum secretion ratio, the decrease of which indicate impaired salivary function. Moreover, the HT and DTC groups were divided into four subgroups (Anti^– HT, Anti⁺ HT, Anti^– DTC, and Anti⁺ DTC), based on the presence of anti-thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb). Finally, salivary gland semi-quantitative parameters were correlated with levels of thyroid-stimulating hormone (TSH), TGAb, and TPOAb in the HT and DTC groups.

Results None of the semi-quantitative parameters examined in parotid or submandibular glands differed significantly between the HT and DTC groups. However, the maximum secretion ratio for the parotid and submandibular glands were significantly different in the subgroup comparison (p < 0.05). Furthermore, the TgAb, TPOAb, and TSH values correlated significantly with salivary excretive function (p ≤ 0.05).

Conclusion Women with HT without xerostomia may not have salivary functional impairment during hypothyroidism. Serum thyroid autoantibody and TSH levels may mainly influence salivary excretive function but not uptake function.

Zusammenfasung

Hintergrund Die Hashimoto-Thyreoiditis (HT) kann bei Patienten eine Speichelfunktionsstörung verursachen, die zu einer Xerostomie führt. Allerdings ist wenig bekannt über Veränderungen der Speichelfunktion bei Patienten ohne eindeutige Symptome von Mundtrockenheit. In dieser Studie untersuchten wir die Speichelfunktion bei Frauen mit HT ohne Xerostomie und bewerteten zum ersten Mal die Auswirkungen von Schilddrüsen-Autoantikörpern auf diese Funktion.

Methoden Sechzig konsekutive Probanden wurden eingeschlossen, darunter 32 Frauen (mittleres Alter: 36 ± 12 Jahre), bei denen in der Studiengruppe (HT-Gruppe) eine HT mit differenziertem Schilddrüsenkarzinom (DTC) diagnostiziert wurde, sowie eine Kontrollgruppe (DTC-Gruppe) von 28 Frauen (mittleres Alter: 40 ± 12 Jahre), bei denen nur DTC diagnostiziert wurde. Die Speicheldrüsen-Szintigrafie wurde zur Beurteilung der Speichelfunktion mit den semi-quantitativen Parametern maximale Absorptionsratio und maximale Sekretionsratio durchgeführt, deren Abnahme auf eine gestörte Speichelfunktion hinweisen. Darüber hinaus wurden die HT- und DTC-Gruppen in vier Untergruppen unterteilt (Anti^- HT, Anti⁺ HT, Anti^- DTC und Anti⁺ DTC), entsprechend dem Nachweis von Anti-Tyreoperoxidase-Antikörpern (TPO-AK) und Anti-Thyreoglobulin-Antikörpern (Tg-AK). Schließlich wurden die semi-quantitativen Speicheldrüsenparameter mit den Konzentrationen von Thyroidea-Stimulierendem Hormon (TSH), TG-AK und TPO-AK in den HT- und DTC-Gruppen korreliert.

Ergebnisse Keiner der semi-quantitativen Parameter, die in der Parotis und Glandula submandibularis untersucht wurden, wies signifikante Unterschiede zwischen der HT- und der DTC-Gruppe auf. Die maximale Sekretionsratio für die Parotis und Glandula submandibularis zeigte jedoch innerhalb der Subgruppen signifikante Unterschiede (p < 0,05). Darüber hinaus korrelierten die Werte für Tg-AK, TPO-AK und TSH signifikant mit der Ausscheidungsfunktion des Speichels (p ≤ 0,05).

Schlussfolgerung Frauen mit HT ohne Xerostomie haben möglicherweise keine Beeinträchtigung der Speichelfunktion bei Hypothyreose. Die Schilddrüsen-Autoantikörper- und TSH-Werte im Serum können vor allem die Exkretionsfunktion, nicht aber die Uptake-Funktion der Speicheldrüsen beeinflussen.

Schlüsselwörter

Speicheldrüse - Speicheldrüsen-Szintigraphie - Hashimoto-Thyreoiditis - Schilddrüsen-Autoantikörper

Key word

salivary gland - salivary gland scintigraphy - Hashimoto’s thyroiditis - thyroid auto-antibodies

Publication History

Received: 13 April 2020

Accepted: 16 June 2020

Article published online:
29 October 2020

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