不同基础代谢率计算公式对慢性甲状腺功能亢进性肌病的诊断价值

Diagnostic value of diverse formulas of basal metabolic rate for chronic hyperthyroid myopathy

目的:探索不同基础代谢率(BMR)公式在慢性甲状腺功能亢进性肌病(CTM)中的诊断价值。方法:选取2022年1—8月在广西医科大学第一附属医院初诊且未治疗的CTM患者46例(CTM组),同期选取年龄和性别匹配的甲亢不伴CTM患者49例(甲亢不伴CTM组)和健康体检者46例作为健康对照组。选择Gale、Reed、Read、Takeda、Kosa、Jenkins、RPP、Harris-Benedict、Cunningham等共9个BMR公式进行描述。比较各组临床资料(包括年龄、性别、体重、上臂围等)、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺激素(FT_(4))、促甲状腺激素受体抗体(TRAb)和不同公式计算下的BMR。采用受试者工作特征(ROC)曲线评估9个BMR公式对CTM的诊断效能。结果:CTM组BMR(Gale、Reed、Read、Takeda、Kosa、Jenkins、心率收缩压乘积)、FT_(3)、FT_(4)、TRAb均高于甲亢不伴CTM组、健康对照组(P<0.05)。Gale公式诊断CTM的ROC曲线下面积(AUC)为0.83(95%CI:0.74~0.91)(P<0.05),灵敏度为73.91%,特异度为81.63%,诊断CTM截断值BMR>46.00,其特异性优于Read公式法(P<0.05)。结论:用Gale公式评估的BMR对于CTM诊断有一定的参考价值。

Objective:To investigate the diagnostic value of diverse formulas of basal metabolic rate(BMR)in patients with chronic hyperthyroid myopathy(CTM).Methods:A total of 46 untreated CTM patients(CTM group)who were initially diagnosed in the First Affiliated Hospital of Guangxi Medical University from January 2022 to August 2022 were selected,along with 49 age-and gender-matched patients with hyperthyroidism without CTM(hyperthyroidism without CTM group)and 46 healthy subjects as healthy control group during the same period.Nine BMR formulas,including Gale,Reed,Read,Takeda,Kosa,Jenkins,RPP,Harris-Benedict and Cunningham,were selected for description.Clinical data(including age,sex,body weight and upper arm circumference,etc.),free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),thyrotropin receptor antibody(TRAb)and BMR calculated by different formulas were compared in each group.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of nine BMR formulas for CTM.Results:BMR(including Gale,Reed,Read,Takeda,Kosa,Jenkins and rate pressure product),FT_(3),FT_(4) and TRAb in CTM group were higher than those in hyperthyroidism without CTM group and healthy control group(P<0.05).The area under ROC curve(AUC)for CTM diagnosis using the Gale formula was 0.83(95%CI:0.74-0.91)(P<0.05)with a sensitivity 73.91%and specificity 81.63%.The cut-off value for CTM was more than 46.00,which had better specificity than the Read formula(P<0.05).Conclusion:BMR evaluated by Gale formula has a certain reference value for the diagnosis of CTM.