Integrated Immune-Endocrine Biomarker Framework for Differentiating Thyroid Dysfunction in Women
DOI:
https://doi.org/10.14500/aro.12882Keywords:
Anti-thyroid peroxidase, Autoimmune thyroid disease, Cytokines, ThyroglobulinAbstract
Autoimmune thyroid diseases are the result of multiple interactions among inflammatory cytokines, thyroid autoantibodies, and endocrine dysregulation. However, these biomarkers are commonly studied one by one, and it is not possible to appreciate how immune-endocrine axes collectively discriminate between a hyperthyroid and hypothyroid profile in women, the group at maximum risk. This study has three objectives: To profile endocrine biomarkers (thyroid-stimulating hormone [TSH], T3, and T4) across autoantibody-defined categories; to assess relationships among interleukin (IL)-6, IL-17, and the spectrum of thyroid autoantibodies examined; and to determine whether combined signatures improve distinction of thyroid dysfunction over individual markers. In a cross-sectional study, 103 adult females, 38 euthyroid, 23 hyperthyroid, and 42 hypothyroid, were included. Serum (TSH, T3, T4, anti-thyroid peroxidase [TPO], thyroglobulin [TG], IL-6, and IL-17) was measured using Cobas e411 immunoassay/Enzyme-Linked Immunosorbent Assay kits. Women with hyperthyroidism had a cytokine-dominant pattern with strikingly high IL-6, IL-17, and anti-TPO, whereas hypothyroid ones showed a damage-dominant profile with elevated TSH and TG. IL-6 and anti-TPO were the parameters that showed significant correlation with hormonal imbalances. Anti-TPO and IL-6 had high diagnostic performance for hyperthyroidism. Combination analysis of inflammatory, autoimmune, and endocrine biomarkers provides superior discrimination of hyperthyroidism compared with an individual marker. In this study, a unique multivariate analytical model was used simultaneously for IL-6, IL-17, anti-TPO, TG, and thyroid hormones in order to define immune‐endocrine phenotypes in a homogeneous female population.
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Copyright (c) 2026 Aveen M. Asaad, Ismail S. Kakey

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Accepted 2026-08-16
Published 2026-09-23








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