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Objective To investigate the clinical value of thyroid globulin antibody(TgAb)and thyroid peroxidase antibody(TPOAb)in the diagnosis and treatment of papillary thyroid microcarcinoma(PTMC).Methods A total of 346 patients with thyroid nodules who underwent surgical treatment in the hospital from August 2012 to October 2021 were selected as the research objects.According to the postoperative pathologi-cal results,the patients were divided into the benign nodule group,PTMC group and non-micro papillary thy-roid carcinoma(PTC)group.The general data of the patients and thyroid function indexes[free triiodothyro-nine(FT3),free tetraiodothyronine(FT4),thyroid stimulating hormone(TSH),TgAb and TPOAb]before and after operation were collected,the tumor recurrence or lymph node metastasis after operation were ob-served,and the relationship between serum TgAb and TPOAb and the risk and prognosis of PTMC was ana-lyzed.Results The positivity rate of TgAb in the PTMC and non-micro PTC groups was significantly higher than that in the benign nodule group(P<0.05).The TPOAb positivity rate was not significantly different among the three groups(P>0.05).Only the TSH level in the PTMC group was higher than that in the non-micro PTC group(P<0.05).Multivariate logistic analysis showed that younger age,higher TSH and positive TgAb were independent risk factors for PTMC and non-micro PTC(P<0.05).However,the risk of PTC didn't increase with increasing TgAb titres.The positivity rate of TgAb in the PTMC and non-micro PTC groups didn't change significantly within one month after operation,but decreased in one year after operation(P<0.05).The TPOAb positivity rate decreased after operation,but the difference was not statistically sig-nificant(P>0.05).In the PTMC group,four cases had tumor recurrence or lymph node metastasis,and the TgAb level increased by 88.4%,49.5%,5.7%and 84.0%respectively when the tumor recurred or metasta-sized.Among them,the TPOAb level increased by 51.6%,30.0%and 2.9%respectively in three cases and decreased by 53.9%in one case.In the PTMC group,there were 11 patients with cervical lymph node enlarge-ment,and there was no statistical difference in TgAb and TPOAb levels when the condition changed(P>0.05).Conclusion TgAb is a risk factor for PTMC,and can be followed up regularly during the diagnosis and treatment of PTMC.The specificity of TPOAb is not as good as that of TgAb,and appropriate follow-up can be chosen during the course of the disease.
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Objective To explore the value of serum Irisin and thyroid peroxidase antibody(TPOAb)in the diagnosis of hypothyroidism during pregnancy.Methods A total of 107 pregnant women with hypothy-roidism during pregnancy who were diagnosed and treated in the hospital from October 2020 to October 2022 were regarded as the study group,another 107 healthy pregnant women who were examined in the hospital at the same time and whose general data matched with cases of hypothyroidism during pregnancy and 107 non pregnant healthy women were taken as the control group and health group.Pearson method was applied to an-alyze the correlation between the levels of serum Irisin and TPOAb in pregnant women with hypothyroidism during pregnancy.Logistic regression was applied to analyze the related factors affecting the occurrence of hy-pothyroidism during pregnancy.The diagnostic value of serum Irisin and TPOAb levels for hypothyroidism during pregnancy was analyzed by the receiver operating characteristic(ROC)curve.Results The levels of serum Irisin and TPOAb in the study group were significantly higher than those in the health group and con-trol group(P<0.05).The levels of serum Irisin and TPOAb in pregnant women with hypothyroidism during pregnancy were positively correlated(r=0.641,P<0.05).The proportions of pregnant women with BMI<20 kg/m2 and iodine deficiency before pregnancy in the study group were obviously higher than those in the control group(P<0.05).BMI<20 kg/m2 before pregnancy,iodine deficiency,increased levels of Irisin and TPOAb were all risk factors for hypothyroidism during pregnancy(P<0.05).The area under the curve(AUC)of serum Irisin and TPOAb in the diagnosis of hypothyroidism during pregnancy was 0.765 and 0.835,respectively,while the AUC of the combined diagnosis of the two was 0.926,the combined diagnosis of the two was better than that of serum Irisin and TPOAb alone(Zcombination-Irisin=6.105,Zcombination-TPOAb=4.951,P<0.001).Conclusion The increased levels of serum Irisin and TPOAb are closely related to the occurrence of hypothyroidism during pregnancy,and the combination of them has high diagnostic value for hypothyroid-ism during pregnancy.
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OBJECTIVE@#To investigate the association of isolated thyroid peroxidase antibody (TPOAb) positive in the first trimester with fetal growth.@*METHODS@#A total of 16 446 pregnant women were included in the birth cohort study, whose last menstrual period was between May 2016 and April 2019 and with singleton pregnancy. Maternal serum samples were collected when they firstly came for prenatal care in the first trimester. The pregnant women were consecutively seen and followed in the hospital and the information of pregnant women was extracted from the electronic medical information system. The pregnant women were divided into isolated TPOAb positive group (n=1 654) and euthyroid group (n=14 792). Three fetal ultrasound examinations were scheduled during the routine prenatal visits at the hospital and were performed by trained sonographers. All fetal growth indicators were quantified as gestational age- and gender- adjusted standard deviation score (Z-score) using the generalized additive models for location, scale and shape (GAMLSS). Fetal growth indicators included estimated fetal weight (EFW), abdominal circumference (AC), biparietal diameter (BPD), femur length (FL) and head circumference (HC). Fetal growth restriction (FGR) was defined as AC or EFW Z-score<3rd centile based on clinical consensus. Generalized estimating equation (GEE) analysis was applied to assess the association of maternal isolated TPOAb positive with fetal growth. The generalized linear model was further used to analyze the association between isolated TPOAb positive and fetal growth indicator at different gestational ages when the fetal growth indicator was significantly associated with isolated TPOAb positive in the GEE mo-del.@*RESULTS@#The median gestational age at three ultrasound measurements was 23.6 (23.3, 24.1), 30.3 (29.7, 30.9), 37.3 (37.0, 37.7) weeks, respectively. The BPD Z-score was higher in isolated TPOAb positive women, compared with the euthyroid pregnant women after adjustment (β=0.057, 95%CI: 0.014-0.100, P=0.009). The generalized linear model showed the BPD Z-score was higher in the isolated TPOAb positive women at the end of 21-25 weeks (β=0.052, 95%CI: 0.001-0.103, P=0.044), 29-32 weeks (β=0.055, 95%CI: 0.004-0.107, P=0.035) and 36-40 weeks (β=0.068, 95%CI: 0.011-0.125, P=0.020), compared with the euthyroid pregnant women. There was no difference in other fetal growth indicators (EFW, AC, FL and HC) and FGR between the isolated TPOAb positive and euthyroid pregnant women.@*CONCLUSION@#The BPD Z-score was slightly increased in the isolated TPOAb positive pregnant women in the first trimester, while other fetal growth indicators were not changed. The reproducibility and practical significance of this result need to be confirmed.
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Pregnancy , Female , Humans , Pregnancy Trimester, First , Iodide Peroxidase , Cohort Studies , Reproducibility of Results , Fetal Development , Fetal Weight , Fetal Growth Retardation , Ultrasonography, PrenatalРеферат
Objective:To explore the relationship between serum levels of thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (Tg-Ab) and the development of papillary thyroid carcinoma.Methods:The clinical data of 574 patients with thyroid nodules who received surgical treatment in Tengzhou Central People's Hospital from January to December 2021 were retrospectively analyzed. Using histopathological diagnosis as the gold standard, the patients were divided into papillary thyroid carcinoma group (malignant group, 267 cases) and benign thyroid nodules group (benign group, 307 cases). The clinical data and the preoperative serum TSH, TPO-Ab and Tg-Ab levels were compared between the two groups. The correlation between preoperative serum TSH, TPO-Ab and Tg-Ab levels and papillary thyroid cancer was analyzed by logistic regression.Results:There were no statistical differences in the age and gender of patients between the malignant group and the benign group (all P > 0.05). TSH [2.37 mIU/L (1.43 mIU/L, 5.09 mIU/L)], TPO-Ab [17.84 IU/ml (11.94 IU/ml, 40.68 IU/ml)] and Tg-Ab [15.69 IU/ml (10.57 IU/ml, 132.00 IU/ml)] in the malignant group were higher than those in the benign group [TSH 1.60 mIU/L (0.88 mIU/L, 2.57mIU/L), TPO-Ab 14.29 IU/ml (10.00 IU/ml, 21.17 IU/ml), Tg-Ab 12.23 IU/ml (10.00 IU/ml, 16.51 IU/ml)], and the differences were statistically significant ( Z values were -6.43, -4.60 and -6.15, all P < 0.05). Multivariate logistic regression analysis showed that positive TPO-Ab ( OR = 0.996, 95% CI 0.993-0.999, P = 0.013) and positive Tg-Ab ( OR = 0.996, 95% CI 0.994-0.998, P < 0.05) were independent risk factors for papillary thyroid cancer. Conclusions:Preoperative serum TSH, TPO-Ab and Tg-Ab levels are closely related to papillary thyroid cancer, among which positive serum TPO-Ab and positive Tg-Ab are independent risk factors for papillary thyroid cancer and have important values in the differential diagnosis of benign and malignant thyroid nodules.
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ObjectiveTo investigate the patterns of changes in routine blood parameters, thyroid hormone levels, and their correlations with thyroid peroxidase antibodies (TPOAb) among women at different stages of pregnancy, so as to provide a theoretical basis for maternal and child health care and diagnosis and treatment. MethodsA total of 732 pregnant women at different stages of pregnancy who underwent health examinations at the First Maternity and Infant Hospital affiliated to Tongji University from May 2020 to August 2022 were selected as the observation group. The group comprised 245 women in the first trimester (≤12 weeks), 247 women in the second trimester (between13 and 27 weeks) and 240 women in the third trimester (≥28 weeks). Additionally, 240 non-pregnant, healthy women of child-bearing age who conducted their health checkups in the same hospital were selected as the control group. All the research subjects were required to provide peripheral venous blood samples to measure hemoglobin (Hb), standard deviation of red blood cell distribution width (RDW-SD), coefficient of variation of red blood cell distribution width (RDW-CV), platelet (Plt) count, platelet distribution width (PDW), as well as thyroid stimulating hormone (TSH), total thyroxine (TT4), total triiodothyronine (TT3), free thyroxine (FT4), free triiodothyronine (FT3), and TPOAb. The results were statistically analyzed. ResultsWith advancing gestational age, Hb levels were significantly lower in the second and third trimesters than in the first trimester and the control group (F=68.25, P<0.001), while RDW-SD and RDW-CV were significantly higher (F=41.34, P<0.001; F=3.64, P=0.012). Plt levels throughout pregnancy were significantly lower than that in the control group (F=43.21, P<0.001). TSH levels were significantly lower in the first and second trimesters than in the control group (Z=53.49, P<0.001), but gradually increased with gestational age. TT3 and TT4 levels were significantly higher than those in the control group throughout pregnancy (F=148.25, P<0.001; F=210.83, P<0.001), while FT3 and FT4 levels were significantly lower in the second and third trimesters than in the first trimester and the control group (F=42.95, P<0.001; F=101.73, P<0.001). The abnormal rate of TPOAb was significantly higher than that in the control group throughout pregnancy (χ2=25.61, P<0.001). Among pregnant women, those with TPOAb positivity had significantly higher TSH levels and RDW-CV than those with TPOAb negativity (Z=5.70, P<0.001; t=2.39, P=0.018). ConclusionThe levels of Hb, Plt, and thyroid hormones in pregnant women are closely related to gestational age. With increasing gestational age, the abnormal rate of TPOAb decreases, but the TSH levels and RDW-CV of TPOAb positive pregnant women are higher, requiring clinical attention and screening to improve maternal and child health.
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Antecedentes. El efecto del hipotiroidismo subclínico (HSC) en los resultados perinatales adversos no está claro, y los valores de referencia de la hormona tiroestimulante (TSH) en el embarazo son controvertidos. Objetivo. Evaluar los efectos del HSC negativo para los anticuerpos de la peroxidasa tiroidea (TPOAbs) sobre los resultados perinatales según los diferentes valores de referencia de la TSH. Métodos. Un total de 554 mujeres embarazadas, incluyendo 509 eutiroideas y 45 gestantes hipotiroideas subclínicas (TSH > 3 mIU/L), fueron incluidas en este estudio prospectivo de casos y controles. Todas las gestantes estaban en el tercer trimestre y eran negativas a los TPOAbs. Las funciones tiroideas fueron evaluadas utilizando los valores de referencia específicos para el trimestre recomendados por el Colegio Americano de Obstetricia y Ginecología (ACOG) (TSH > 3 mIU/L) y la Asociación Americana de Tiroides (ATA) (TSH > 4 mIU/L). Resultados. La mortalidad neonatal en el hipotiroidismo subclínico con un límite superior de TSH de 4 mIU/L fue significativamente menor que en el grupo eutiroideo (2 (0,4%) frente a 1 (4,5%); p=0,009). No hubo diferencias significativas en resultados maternos y perinatales adversos en las gestantes con HSC y eutiroideas en ambos valores de referencia de la TSH. No hubo correlación significativa entre los valores de TSH y las semanas de parto de las gestantes con parto prematuro (r=0,169, p=0,146). Conclusiones. En este estudio, utilizando los diferentes valores basales de TSH recomendados por las directrices del ACOG de 2020 y de la ATA de 2017 en el tercer trimestre del embarazo para el diagnóstico de hipotiroidismo subclínico, no hubo una relación significativa entre los casos de hipotiroidismo subclínico con TPOAbs negativos y los resultados perinatales adversos.
Background: The effect of subclinical hypothyroidism (SCH) on adverse perinatal outcomes is unclear, and thyroid-stimulating hormone (TSH) reference values in pregnancy are controversial. Objective: To evaluate the effects of thyroid peroxidase antibody (TPOAbs) negative SCH on perinatal outcomes according to the different TSH reference values. Methods: A total of 554 pregnant women, including 509 euthyroid and 45 subclinical hypothyroid (TSH > 3 mIU/L) pregnant women, were included in this prospective case-controlled study. All pregnant women were in the third trimester and were TPOAbs negative. Thyroid functions were evaluated using trimester-specific reference values recommended by the American College of Obstetrics and Gynecology (ACOG) (TSH > 3 mIU/L) and the American Thyroid Association (ATA) (TSH > 4 mIU/L) guidelines. Results: Neonatal mortality in subclinical hypothyroidism with a TSH upper limit of 4 mIU/L was significantly lower than in the euthyroid group (2 (0.4%) vs 1 (4.5%); p=0.009). There was no significant difference in terms of adverse maternal and perinatal outcomes in SCH and euthyroid pregnant women in both TSH reference values. There was no significant correlation between TSH values and delivery weeks of pregnant women with preterm delivery (r=0.169, p=0.146). Conclusions: In this study, using different baseline TSH values recommended by the 2020 ACOG and 2017 ATA guidelines in the third trimester of pregnancy for the diagnosis of subclinical hypothyroidism, it was shown that there was no significant relationship between cases of subclinical hypothyroidism with negative TPOAbs and adverse perinatal outcomes.
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Hashimoto’s thyroiditis (HT) is one of the most common autoimmune diseases, and often combined with papillary thyroid carcinoma (PTC) .Thyroglobulin antibody and thyroid peroxidase antibody are used as HT marker antibodies and effective indicators for diagnosis. By activating the corresponding immune response, chronic inflammation of the thyroid gland is caused, which is related to the development of tumors. In this review, we analyze the significance of Tg and TgAb in diagnosis and treatment of HT-PTC to provide evidence for future clinical studies.
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OBJECTIVES@#To examine the expression of serum thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) in children with immune thrombocytopenia (ITP).@*METHODS@#A total of 120 children with ITP who were admitted from October 2019 to October 2021 were enrolled as the ITP group. A total of 60 children without ITP were enrolled as the non-ITP group. According to the clinical classification of ITP, the children in the ITP group were further divided into a newly diagnosed ITP group, a persistent ITP group, and a chronic ITP group. The clinical data were compared between the ITP group and the non-ITP group and between the children with different clinical classifications of ITP. The expression levels of serum TGAb and TPOAb in children with ITP were measured and their association with the clinical classification of ITP was analyzed.@*RESULTS@#Compared with the non-ITP group, the ITP group had significantly lower levels of CD3+, CD4+, and platelet count (PLT) and significantly higher levels of CD8+, TGAb, and TPOAb (P<0.05). The children with chronic ITP had significantly lower levels of CD3+, CD4+, and PLT and significantly higher levels of CD8+, TGAb, and TPOAb than those with newly diagnosed ITP or persistent ITP (P<0.05). The logistic regression analysis showed that CD3+, CD4+, CD8+, TGAb, and TPOAb were the influencing factors for chronic ITP (P<0.05). A decision curve was plotted, and the results showed that TGAb combined with TPOAb within the high-risk threshold range of 0.0-1.0 had a net benefit rate of >0 in evaluating the clinical classification of ITP in children.@*CONCLUSIONS@#TGAb and TPOAb are abnormally expressed in children with ITP and are associated with the clinical classification of ITP in children.
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Child , Humans , Autoantibodies , Iodide Peroxidase , Platelet Count , Purpura, Thrombocytopenic, Idiopathic , Thrombocytopenia , ThyroglobulinРеферат
Background: Vitamin D deficiency is prevalent worldwide and it is believed to have a role as an immune modulator. However, the association between vitamin D levels and anti-thyroid peroxidase positive (TPOAb) hypothyroidism is still controversial. Aim: To elucidate the association between vitamin D levels and anti-thyroid peroxidase (TPOAb) positive hypothyroidism. Materials and Methods: Serum Vitamin D, thyroid peroxidase antibody, and thyroid function test were measured in 105 patients, who were sub-grouped into the TPOAb positive and TPOAb negative hypothyroidism category. Results: Vitamin D level, was found significantly lower in patients with TPOAb positive hypothyroidism as compared to patients TPOAb negative hypothyroidism (13.275.18vs. 17.746.03ng/ml, respectively, P<0.05), as well as between patients with TPOAb positive hypothyroidism and control group (13.275.18vs. 29.669.41 ng/ml, respectively, P<0.05). Within the patients' group, there was a significant negative correlation between serum 25 (OH) vitamin D and TSH (r=−0.438, P<0.05), anti-TPO (r=−0.275, P<0.05). Furthermore, insignificant positive correlations were recorded between serum 25 (OH) vitamin D, and each of T3, T4 (r=–0.056, 0.097, P>0.05). Conclusion: The current study observed significant low levels of 25(OH)D3 in TPOAb positive hypothyroid patients.
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Objective: To evaluate data from a five-year period (2014-2018) regarding the presence of thyroid dysfunctionand thyroid antibodies among subjects with gestational diabetes mellitus (GDM) and pre-gestational diabetesmellitus (pre-GDM) at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia (SA). Subjects andMethods: The present retrospective analysis was conducted from January to June 2019; it evaluated five years’(2014-2018) data of patients with GDM and pre-GDM from the patients’ electronic record. Results: Of the 485subjects, 348 (71.8%) were Saudi nationals; whereas, 137 (28.2%) were non-Saudis, and 318 (65.6%) had GDMand 167 (34.4%) had pre-GDM. Five (3.2%) hyperthyroid subjects were in the GDM group as compared to 6(4.7%) in the pre-GDM group; whereas, 21 (13.3%) hypothyroid subjects were found in the GDM group ascompared to 26 (20.3%) in the pre-GDM group. Thyroglobulin antibody (TgAb) was positive among 6 (4.7%)pre-GDM subjects as compared to 2 (1.3%) among GDM subjects (p=0.03). In the GDM group, 5 (3.2%) subjectshad positive thyroid peroxidase antibody (TPOAb); whereas, in the pre-GDM group, 7 (5.5%) were TPOAbpositive (p=0.54). TgAb was positive among 1 (0.44%), 3 (27.27%), and 4 (8.51%) euthyroid, hyperthyroid, andhypothyroid subjects, respectively. TPOAb was positive among 4 (1.76%), 4 (36.36%), and 4 (8.51%) euthyroid,hyperthyroid, and hypothyroid subjects, respectively. Thyroid dysfunction was more common in pregnant femalesof age range 35-44.9 years. Conclusions: Hypo- and hyperthyroid cases were present in both GDM and pre-GDMgroups. Thyroid antibodies were found more frequently in the pre-GDM group, and thyroid dysfunction was morecommon in the older age group.
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BACKGROUND@#Anti-thyroid peroxidase antibody (TPO-Ab) has been shown to cause autoimmune thyroiditis by inducing a deleterious influence on thyroid hormone synthesis. Further, thyroglobulin, which has an important role in thyroid hormone synthesis, is reported to be high in the fluid from thyroid cysts. Therefore, TPO-Ab could be associated with the presence of thyroid cyst, partly by affecting the activity of thyroid hormone synthesis.@*METHODS@#To investigate the association between TPO-Ab and thyroid cysts, we conducted a cross-sectional study of 1432 Japanese with normal thyroid function [i.e., normal range of free triiodothyronine (free T3) and free thyroxine (free T4)] between the ages of 40 and 74 years, who participated in an annual health check-up.@*RESULTS@#In men, the statistical power did not reach a statistical significance value. Additionally, subjects with TPO-Ab showed lower odds ratios (ORs) of thyroid cysts than those without TPO-Ab. In women, subjects with TPO-Ab showed significantly lower ORs of thyroid cysts than those without TPO-Ab. The fully adjusted ORs were 0.68 (0.40, 1.18) for men and 0.40 (0.27, 0.60) for women. When evaluating the association between logarithmic values of TPO-Ab titer and thyroid cysts in both men and women, a notable inverse correlation was observed. The fully adjusted ORs were 0.68 (0.50, 0.92) for men and 0.68 (0.57, 0.81) for women.@*CONCLUSION@#TPO-Ab titer revealed to be inversely associated with thyroid cysts among Japanese with normal thyroid function. The presence of a thyroid cyst could indicate a lower risk of having TPO-Ab among the general population with normal thyroid function.
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BACKGROUND: Graves' disease (GD) is an autoimmune thyroid disorder caused by antibodies stimulating the thyrotropin (TSH) receptor. TSH receptor antibody (TRAb) measurement is useful for predicting GD relapse after antithyroid drug (ATD) treatment. However, the association of other thyroid autoantibodies with GD relapse remains obscure. METHODS: This retrospective study enrolled patients with GD who were initially treated with ATD. TRAb, thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured at the initial diagnosis and at the time of ATD discontinuation. RESULTS: A total of 55 patients were enrolled. The mean age was 49.7 years, and 39 patients (70.9%) were female. Antibody positivity at diagnosis was 90.9%, 69.1%, and 61.9% for TRAb, TPOAb, TgAb, respectively. Median ATD treatment period was 15.1 months. At the time of ATD withdrawal, TRAb titers decreased uniformly overall. Conversely, TPOAb and TgAb showed various changes. After withdrawal of ATD, 19 patients (34.5%) experienced relapse. No clinical features or laboratory results were significantly related to relapse in the overall patient group. However, in the TPOAb positive group at diagnosis, increasing titer of TPOAb or TgAb after ATD treatment was significantly and independently related to relapse free survival (TPOAb: hazard ratio [HR], 17.99; 95% confidence interval [CI], 1.66 to 195.43; P=0.02) (TgAb: HR, 5.73; 95% CI, 1.21 to 27.26; P=0.03). CONCLUSION: Changes in TPOAb or TgAb titers during treatment might be useful for predicting relapse after ATD treatment in patients with positive TPOAb at diagnosis.
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Female , Humans , Antibodies , Autoantibodies , Diagnosis , Drug Therapy , Graves Disease , Iodide Peroxidase , Receptors, Thyrotropin , Recurrence , Retrospective Studies , Thyroglobulin , Thyroid Gland , ThyrotropinРеферат
Objective To investigate the relationship of TSH levels and TPOAb status before 20 weeks gestation with adverse pregnancy outcomes. Methods A total of 2885 pregnant women who underwent regular prenatal examination in Zhujiang Hospital of Southern Medical University during April 1, 2017 to October 31, 2018 were retrospectively analyzed. According to the TSH level before 20 weeks of gestation, they were classified into normal TSH (0.1 mU/L≤TSH0.05). In multi-factor logistic regression analysis results show that the risk of a preterm birth in group D, group E, group F were higher than that in control group, the risk of gestational diabetes in group F was higher than that in control group (OR>1, P<0.05). Conclusions Women with subclinical hypothyroidism and high TSH before 20 weeks of gestation combined with TPOAb positive have an increased risk of preterm labor, and women with subclinical hypothyroidism combined with TPOAb positive have an increased risk of gestational diabetes. Therefore, clinical attention should be paid to such women, and the management of gestation should be strengthened to prevent the occurrence of mid-to-late complications.
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Objectives To investigate the features of thyroid ultrasonographic manifestations in patients with subclinical thyroid serological anomalies during pregnancy. Methods In present study, a total of 53 women who attended the obstetrics clinic in Beijing Obstetrics and Gynecology Hospital from January 2014 to December 2015 underwent thyroid ultrasound scanning. All women included in this study were checked up for the serological levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibody (TPoAb) in the first trimester and were diagnosed as thyroid dysfunction or abnormal level of serological antibody for the first time. The χ2test was used to compare the incidences of abnormal thyroid echogenicity and increased blood flow in thyroid between groups with serological TPoAb level≥1300 IU/L and<1300 IU/L. Results Among 53 cases, 21 were subclinical hyperthyroidism, 10 were subclinical hypothyroidism, and 22 were isolated elevated serum TPoAb cases. Among 21 subclinical hyperthyroid patients, 16 cases without elevated TPoAb were unremarkable on thyroid scanning, while 2 out of the rest 5 cases (40.0%) with increased serum TPoAb demonstrated mild thyroid diffuse abnormal echogenicity. Among 10 subclinical hypothyroid cases, 2 out of 5 cases (40.0%) without elevated TPoAb manifested mild thyroid diffuse abnormal echogenicity, while 4 of 5 cases (80.0%) with elevated TPoAb showed diffuse abnormal echogenicity of thyroid. In 22 women with isolated elevated serum TPoAb, 11(50.0%) demonstrated diffuse thyroid abnormal echogenicity. In all 32 cases with elevated serum TPoAb, the serum TPoAb level was ≥ 1300 IU/L in 9 cases and < 1300 IU/L in 23 cases. The incidence of thyroid abnormal echogenicity was higher in women with serum TPoAb level≥1300 IU/L than in women with<1300 IU/L (8/9 vs 9/23), which was statistically significant ( χ2=6.432, P=0.018); while no significant difference in the incidence of increased blood flow in both groups was identified(6/9 vs 9/23, χ2=1.970, P=0.080). Conclusion The thyroid ultrasonographic manifestations varied in patients with thyroid serologic anomalies during pregnancy, and were not closely consistent with the serological findings.
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Objective To explore the detection value of resistance to thyroid peroxidase(TPO-Ab)antibodies in patients with coronary heart disease.Methods A retrospective analysis was performed on 240 patients with coronary angiography in our hospital from January 2014 to December 2015.Research objects were given coronary angiography examination,4 and 2 positions were projected for left coronary artery and right coronary artery,respectively.Counted the imaging results,and the Gensini score method was used for assessing.Spearman method was used for the correlation analysis.Results of A total of 16 cases were diagnosed with TPO-Ab drops increased,among which 2 case of coronary atherosclerosis and 14 cases of coronary atherosclerotic heart disease.Compared with the TPO-Ab negative patients (17.20-8.85)the Gensini score for TPO-Ab positive patients (39.56 4±10.23)increased significantly(P<0.05).TPO-Ab and Gensini score has a significant positive correlation (r =0.113 2,95 % CI 0.099 8-0.269 1,P<0.05).Conclusion TPO-Ab increased the risk of coronary heart disease,and more severe coronary artery stenosis in patients with normal thyroid function.
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Objective To investigate the prevalence of thyroid diseases in women within 20-week gestation,and to discuss necessity of thyroid diseases screening in women within 20-week gestation.Methods 4986 singleton pregnant women performing prenatal examination in the Maternity and Child Health Care Hospital of Huzhou were recruited into this study.TSH,FT4,and TPOAb levels were detected with ABBOTT ARCHITECT i4000SR.Results ① The median value of TSH rised,the median value of FT4 went down with increase of the gestational weeks.There was significant difference of median value of TSH and FT4 between early and second trimester of pregnancy(P<0.01).② Rate of abnormal thyroid function was 12.88%,which was higher in the sec ond trimester of pregnancy than that in early pregnancy,and the difference had statistical significance (P<0.05).③ Positive rate of TPOAb in pregnant women was 11.41%.TPOAb levels were positively correlated with TSH,and no correlation with FT.TSH levels were negatively correlated with FT4.Prevalance of clinical hypothyroidism and subclinical hypothyroidism in TPOAb positive group was significantly higher than that in TPOAb negative group,and the difference had significant difference (P<0.05).Conclusions Prevalence of thyroid diseases during pregnancy is high.TPOAb is a risk factor and important predictor for hypothyroidism during pregnancy.It is very necessary to perform thyroid diseases screening for pregnant women as early as possible to ensure safety of pregnant women and their babies.
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Objective:To investigate the correlation between positive rate of thyroid autoantibodies in healthy people and thy -roid dysfunction.Methods:Fasting blood from 3218 healthy examined people in Cangzhou were collected and the serum was separa -ted.Automatic electrochemiluminescence immunoassay systems and reagents were used to determine the concentration of thyroid stimu -lating hormone(TSH),free triiodothyroninthyroid(FT3),free thyroxine(FT4),peroxidase antibody(TPOAb)and thyroglobulin antibody ( TgAb ) .TPOAb>34 U/ml and TgAb>115 U/ml was positives.Statistical analysis of test results .statistica analysis of test reults.Results:The positive rate of thyroid autoantibodies of tested population was 16.19%.The positive rates of TPOAb and TgAb were 14.57%,12.74%separately.The detection rate of TPOAb and TgAb was 11.12%in tested population.The positive rate of TPO-Ab and TgAb and TPOAb+TgAb were 6.92%,5.68%,5.03%separately in 1532 male subjects and were 21.53%,19.16 ,16.67%separately in 1686 female subjects,which were significantly higher in female group than that in male group (P<0.001).They gradually increased with age and reached a peak above 70 years old in female group and in 50-59 in male group.The positive rate and OR of thy-roid autoantibodies in hyperthyroidism and subclinical hyperthyroidism and in hypothyroidism and subclinical hypothyroidism and in hy -pothyroidism and subclinical hypothyroidism were statistically significant .Conclusion:The positive incidence of thyroid autoantibodies is higher in healthy people of Cangzhou .It is essential to follow-up these people of normal thyroid function with positive autoantibodies in order to facilitate prevention and early diagnosis and treatment of thyroid disease .
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Objective To analysis the expression of thyroid peroxidase antibody (TPOAb) ,thyroglobulin antibody (TGAb) and thyrotropin receptor antibody (TRAb) in vitiligo patients with different stages .Methods A total of 161 cases of vitiligo patients were divided into advanced group (n=84) and stable group (n=77) according to their condition ,and 60 healthy subjects were cho-sen as the control group .The serum levels of TPOAb ,TGAb and TRAb were detected in 3 groups ,and the difference of the expres-sion level and positive rate between the 3 groups were compared .Results The difference of TPOAb ,TGAb and TRAb levels a-mong the 3 groups was statistically significant (H=14 .371 ,6 .335 ,8 .284 ,P<0 .05) .Multiple comparison showed that :TPOAb , TGAb ,TRAb levels of the advanced group were higher than those of the stable group and the control group (Uvs .stable group =9 .380 , 7 .923 ,8 .381 ,P<0 .05 ;Uvs .control group =23 .244 ,19 .026 ,25 .873 ,P<0 .05);TPOAb ,TGAb ,TRAb levels of the stable group were higher than those of the control group(U=11 .356 ,12 .450 ,16 .351 ,P<0 .05) .The levels of TPOAb ,TGAb and TRAb in the 3 groups were as follows :the advanced group> the stable group> the control group .The positive rates of TPOAb ,TGAb and TRAb in the 3 groups were statistically significant(χ2 =18 .676 ,23 .618 ,23 .857 ,P<0 .05) .Multiple comparison showed that :the positive rates of TPOAb ,TGAb ,TRAb of the advanced group were higher than those of the stable group and the control group (χ2vs .stable group=5 .273 ,6 .484 ,6 .305 ,P< 0 .017;χ2vs .control group = 14 .997 ,18 .352 ,17 .829 ,P< 0 .017);the positive rates of TPOAb , TGAb ,TRAb of the stable group were higher than those of the control group(χ2 =5 .233 ,5 .036 ,6 .719 ,P<0 .017) .The positive rates of TPOAb ,TGAb and TRAb in the 3 groups were as follows :the advanced group> the stable group> the control group .Con-clusion The expression of thyroid autoantibodies (TPOAb ,TGAb ,TRAb) is abnormal in vitiligo patients ,and the progression of the disease is also related to the expression level of such antibodies .
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Objective To investigate the changes of serum thyroid peroxidase(TPOAb)and thyroglobulin antibody(TGAb)and their relationship with thyroid function in pregnant women during different gestation period Methods Totally 341 cases of primiparae were selected from October 2015 to September 2016 and levels of se-rum thyrotropin(TSH),free triiodothyronine(FT3),free thyroxine(FT4),thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TgAb)were measured by electrochemiluminescence. Results The prevalence of thy-roid dysfunction and positive serum thyroid autoantibodies were 13.2%and 12.61%respectively,which mainly oc-curred in early and middle pregnancy. Thyroid dysfunction in subjects included hypothyroidism(0.59%),subclini-cal hypothyroidism(7.92%),low T4 hyperlipidemia(3.23%),hyperthyroidism(0.88%)and subclinical hyper-thyroidism(0.59%). The positive rate of TPOAb was significantly higher than that of TgAb(10.85% vs. 4.99%, P<0.01). The positive rate of TPOAb in women with thyroid disfunction was significantly higher than that in those with normal thyroid function(44.44%vs. 5.74%,P<0.01). TSH level of TPOAb positive subjects was higher than that of TPOAb negative ones(P<0.05,P<0.01);TSH level of TPOAb positive subjects with thyroid dysfunction were significantly higher than those of TPOAb negative subjects and TPOAb positive pregnant women but with nor-mal thyroid function(P < 0.01). The hypothyroidism prevalence rate of TPOAb positive subjects was significantly higher than that of TPOAb negative subjects in early and middle stage of pregnancy (P < 0.01). The prevalence rates of subclinical hypothyroidism ,low T4 hyperlipidemia and clinical hypothyroidism were significantly higher in TPOAb positive pregnant women(29.17%,20.83% and 8.33%)than those in TPOAb negative pregnant women (P < 0.01). Conclusions Thyroid dysfunction is closely related to positive status of TPOAb and TgAb in pregnancy,which could influence the outcome of pregnancy and the development of offspring. Since levels of TSH, FT3 and FT4 could not fully reveal thyroid function ,it is necessary to monitor the status of TPOAb and TgAb as early as possible for the early diagnosis and treatment of thyroid disease in pregnancy.
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Objective To analysis the expression of thyroid peroxidase antibody (TPOAb) ,thyroglobulin antibody (TGAb) and thyrotropin receptor antibody (TRAb) in vitiligo patients with different stages .Methods A total of 161 cases of vitiligo patients were divided into advanced group (n=84) and stable group (n=77) according to their condition ,and 60 healthy subjects were cho-sen as the control group .The serum levels of TPOAb ,TGAb and TRAb were detected in 3 groups ,and the difference of the expres-sion level and positive rate between the 3 groups were compared .Results The difference of TPOAb ,TGAb and TRAb levels a-mong the 3 groups was statistically significant (H=14 .371 ,6 .335 ,8 .284 ,P<0 .05) .Multiple comparison showed that :TPOAb , TGAb ,TRAb levels of the advanced group were higher than those of the stable group and the control group (Uvs .stable group =9 .380 , 7 .923 ,8 .381 ,P<0 .05 ;Uvs .control group =23 .244 ,19 .026 ,25 .873 ,P<0 .05);TPOAb ,TGAb ,TRAb levels of the stable group were higher than those of the control group(U=11 .356 ,12 .450 ,16 .351 ,P<0 .05) .The levels of TPOAb ,TGAb and TRAb in the 3 groups were as follows :the advanced group> the stable group> the control group .The positive rates of TPOAb ,TGAb and TRAb in the 3 groups were statistically significant(χ2 =18 .676 ,23 .618 ,23 .857 ,P<0 .05) .Multiple comparison showed that :the positive rates of TPOAb ,TGAb ,TRAb of the advanced group were higher than those of the stable group and the control group (χ2vs .stable group=5 .273 ,6 .484 ,6 .305 ,P< 0 .017;χ2vs .control group = 14 .997 ,18 .352 ,17 .829 ,P< 0 .017);the positive rates of TPOAb , TGAb ,TRAb of the stable group were higher than those of the control group(χ2 =5 .233 ,5 .036 ,6 .719 ,P<0 .017) .The positive rates of TPOAb ,TGAb and TRAb in the 3 groups were as follows :the advanced group> the stable group> the control group .Con-clusion The expression of thyroid autoantibodies (TPOAb ,TGAb ,TRAb) is abnormal in vitiligo patients ,and the progression of the disease is also related to the expression level of such antibodies .