Elevated Thyroid Autoantibodies and Intracranial Stenosis in Early-Onset Stroke

Background: The correlation between thyroid autoimmunity and cerebrovascular diseases, particularly intracranial stenosis, is increasingly recognized. Early-onset stroke, occurring in individuals under 50 years, often involves non-traditional risk factors, including autoimmune disorders. Elevated thyroid autoantibodies, such as thyroid peroxidase (TPO) and thyroglobulin (TG) antibodies, have been implicated in vascular abnormalities. In patients with early-onset stroke, the study aims to investigate into the relationship between increased thyroid autoantibodies and intracranial stenosis. Methods: A retrospective cohort study included 180 patients diagnosed with early-onset stroke. Data were collected from medical records, focusing on thyroid function tests, thyroid autoantibody levels, and imaging results for intracranial stenosis. Multivariate logistic regression, t-tests, and chi-square tests were used in the statistical analysis to determine whether higher thyroid autoantibodies independently caused intracranial stenosis. Results: Intracranial stenosis was present in 40% of the patients. Elevated TPO antibodies were found in 62.5% of patients with intracranial stenosis compared to 25.0% without (p<0.001). Elevated TG antibodies were present in 54.2% of patients with intracranial stenosis compared to 25.0% without (p<0.001). Univariate analysis showed that elevated TPO antibodies (OR=4.75) and elevated TG antibodies (OR=3.44) were significantly associated with intracranial stenosis. Multivariate logistic regression confirmed these associations, with adjusted odds ratios of 4.23 for TPO and 3.16 for TG antibodies. Conclusion: Elevated thyroid autoantibodies are significantly related with an elevated risk of intracranial stenosis in early-onset stroke patients. This suggests that thyroid autoimmunity plays a critical role in the pathogenesis of intracranial vascular abnormalities. Recommendations: Routine screening for thyroid autoantibodies in young stroke patients is recommended to identify those at higher risk for intracranial stenosis. Further research is needed to explore the mechanisms linking thyroid autoimmunity to vascular abnormalities and to develop targeted therapeutic strategies. Keywords: Thyroid Autoantibodies, Intracranial Stenosis, Early-Onset Stroke, Thyroid Peroxidase Antibodies, Thyroglobulin Antibodies