Correlation Study of Aortic Velocity Propagation, Abdominal Aortic Intima-Media Thickness, and Epicardial Adipose Tissue Thickness in Subclinical Hypothyroidism Patients

Objective:To explore the correlation between epicardial fat thickness(EFT),aortic velocity propagation(AVP),and abdominal aortic intima-media thickness(AA-IMT)in patients with subclinical hypothyroidism(SH).Additionally,to compare these indicators between SH patients and healthy individuals,providing a new theoretical basis for the clinical prevention and treatment of cardiovascular diseases.Method:Clinical data from 50 SH patients(23 males and 27 females)and 50 healthy outpatient examinees(22 males and 28 females)were analyzed.The participants were selected from January 2022 to December 2023 at Loudi Central Hospital.EFT,AVP,and AA-IMT were measured,and their correlations were analyzed.Results:SH patients had significantly higher EFT and AA-IMT levels than the control group,while their AVP was significantly lower,with these differences being statistically significant(P<0.05).Correlation analysis revealed a significant negative correlation between EFT and AVP(P<0.001),a significant positive correlation between EFT and AAO-IMT(P<0.001),and a significant negative correlation between AVP and AAO-IMT(P<0.001).Multivariate binary logistic regression analysis identified increased EFT,decreased AVP,and increased AAO-IMT as independent risk factors for SH patients.Conclusion:In SH patients,EFT and AAO-IMT are elevated,whereas AVP is reduced.EFT and AVP are significantly correlated with AAO-IMT.EFT and AAO-IMT can serve as reliable indicators for evaluating subclinical atherosclerosis in SH patients,providing a diagnostic basis for clinical practice.

左甲状腺素钠片治疗妊娠合并SCH患者的临床疗效及对其TSH、hs-CRP水平及不良妊娠结局的影响研究

目的探析左甲状腺素钠片治疗妊娠合并亚临床甲状腺功能减退症(SCH)患者的临床疗效及对促甲状腺激素(TSH)、超敏C反应蛋白(hs-CRP)水平及不良妊娠结局的影响。方法130例妊娠合并SCH患者,以数字随机表法为依据分为对照组(65例)和观察组(65例)。对照组采用常规治疗,观察组采用常规治疗+左甲状腺素钠片治疗。比较两组疗效,血清激素[TSH、游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)]及hs-CRP水平,血脂指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)],不良妊娠结局,妊娠合并症发生情况。结果观察组总有效率96.9%较对照组的70.8%高(P<0.05)。治疗前,两组TSH、hs-CRP、FT_3、FT_4水平无差异(P>0.05)。治疗后,两组TSH、hs-CRP均较治疗前明显降低,FT_3、FT_4较治疗前升高;且观察组TSH(5.34±0.32)mU/L、hs-CRP(5.21±0.28)mg/L较对照组的(7.23±1.27)mU/L、(6.89±0.23)mg/L低,FT_3(4.56±0.54)pmol/L、FT_4(13.68±3.27)pmol/L较对照组的(3.28±0.27)、(10.28±3.17)pmol/L高(P<0.05)。治疗前,两组TG、TC、LDL-C、HDL-C水平对比无差异(P>0.05);治疗后,观察组TG、TC、LDL-C、HDL-C水平分别为(1.31±0.05)、(5.06±0.13)、(2.46±0.13)、(1.39±0.26)mmol/L,优于对照组的(2.06±0.11)、(5.92±0.26)、(3.06±0.16)、(1.24±0.24)mmol/L(P<0.05)。两组产后大出血率、胎盘剥落率、流产率、早产率无差异(P>0.05)。观察组中有6例(9.2%)合并胎儿异常、5例(7.7%)合并贫血、6例(9.2%)合并妊娠期糖尿病、3例(4.6%)合并妊娠高血压;对照组中有18例(27.7%)合并胎儿异常、15例(23.1%)合并贫血、17例(26.2%)合并妊娠期糖尿病、18例(27.7%)合并妊娠高血压。观察组合并胎儿异常、贫血、妊娠期糖尿病、妊娠高血压的几率均低于对照组(P<0.05)。结论妊娠合并SCH患者治疗时选择左甲状腺素钠片,取得了显著疗效,可借鉴。

T2DM合并SCH患者肾功能变化研究

目的 探讨单纯2型糖尿病(T2DM)及T2DM合并亚临床甲状腺功能减退症(SCH)患者肾功能指标之间的差异。方法 选取2020年1月至2022年7月安徽省蚌埠市第一人民医院收治的88例T2DM合并SCH患者作为观察组,将同期128例T2DM患者(甲状腺功能正常)作为对照组。比较两组病人的促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)及甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)、血β2微球蛋白(β2-Mg)、尿β2微球蛋白(β2-Mg)、尿微量白蛋白(mALb)、尿素氮(BUN)、胱抑素C(Cys C)水平。结果 与对照组相比,观察组TSH、TGAb、TPOAb水平明显升高,FT4水平明显降低,差异有统计学意义(Z=-12.479、-0.404、-2.220、-2.674,P<0.05);与对照组相比,观察组血β2-Mg、尿β2-Mg、尿mALb、BUN、Cys C水平明显升高,差异有统计学意义(Z=-3.069、-2.459、-3.561、-2.218、-2.669,P<0.05);Spearman秩相关分析结果显示:TSH与血β2-Mg、尿β2-Mg、尿mALb、Cys C呈正相关(rs=0.279、0.186、0.210、0.254,P<0.05)。结论 SCH对于T2DM患者的肾功能有较大影响,因此T2DM患者入院应进行甲状腺激素水平筛查,以便尽早诊断和干预SCH,以减缓糖尿病肾脏疾病的发生和发展。

Subclinical Hypothyroidism and Isolated Hypothyroxinemia during Pregnancy and Their Association with Pregnancy Outcome: A 2-Year Study

INTRODUCTION: Overt hypothyroidism in pregnancy is associated with adverse outcomes, but the effects of subclinical hypothyroidism and isolated hypothyroxinemia on pregnancy outcomes are still controversial. Subclinical hypothyroidism might be associated with preterm delivery, low Apgar score, fetal death and miscarriages and isolated hypothyroxinemia with preterm labor, high birth weight and neurocognitive deficits in children. Other studies show no association with any complications at all. In the present study we tried to estimate whether maternal subclinical hypothyroidism and isolated hypothyroxinemia are associated with complications during pregnancy in our population which represents the pregnant population of Western Greece. METHODS: In a total of 469 pregnant women, third trimester serum was assayed for thyroid-stimulating hormone (TSH) and free thyroxine (free T4). Thyroid hypofunction was defined as 1) subclinical hypothyroidism with TSH levels above 3 mIU/L for the 3rd trimester and normal free T4 and 2) isolated hypothyroxinemia with TSH levels below 3 mIU/L for the 3rd trimester and free T4 below the 5th percentile. The results were associated with birth weight, week of labor, history of miscarriages and demographic characteristics. Patients with thyroid hypofunction were compared with euthyroid patients (TSH and free T4 between normal limits). The results were analyzed with one-way ANOVA and χ2 test. RESULTS: Subclinical hypothyroidism was documented in 10.9% and isolated hypothyroxinemia in 21.7% of pregnant women. Subclinical hypothyroidism was not associated with birth weight, week of labor, or history of miscarriages. On the contrary, hypothyroxinemia was associated with high birth weight (P < 0.05). CONCLUSION: In our study, we did not find a link between subclinical hypothyroidism and adverse pregnancy outcomes. Similarly, hypothyroxinemia was not associated with pregnancy complications. However, it was associated with higher birth weight. Our studies contribute to our understanding, whether or not subclinical hypothyroidism and isolated hypothyroxinemia are associated with pregnancy adverse outcomes and whether treatment and test for hypothyroidism should become routine during pregnancy.

Subclinical hypothyroidism is associated with lipid-rich plaques in patients with coronary artery disease as assessed by optical coherence tomography

Background Subclinical hypothyroidism （SCH） has recently been acknowledged as an unconventional risk factor for coronary artery disease （CAD） and characterized by poor prognosis, which may be due to atherosclerotic plaque characteristics. We conducted this study to observe coronary plaque characteristics in coronary artery disease patients with concomitant SCH. Methods Patients with coronary artery disease were enrolled in the study and divided into an SCH group （patients, n = 26; plaques, n = 35） and a non-SCH group （patients, n = 52; plaques, n = 66）. They were divided 1：2 according to propensity-matched analysis including age, diabetes mellitus, gender, CAD severity and culprit vessel. Optical coherence tomography （OCT） imaging was performed on all patients, and images were analyzed by two inde- pendent investigators. Lipid-rich plaques （LRP）, the precursor of vulnerable plaques, were defined as having more than one quadrant occu- pied with lipid pool. Maximum lipid arcs were simultaneously recorded. Fibrotic plaques and calcific plaques were also identified. The pres- ence of coronary dissection, plaque erosion, thrombus, macrophage, calcific nodule, thin-cap fibroatheroma and micro channel were all noted. Results The ratio of LRP in SCH group was significantly higher than that in non-SCH group （54% vs. 30.3%, P = 0.037）. That was the case as well for the maximum lipid arcs value （181.5°± 61.6° vs. 142.1° 4± 35.9°, p = 0.046）. While thin-cap fibroatheroma （TCFA） was detected, no difference was identified between the two groups in either TCFA ratio （20% vs. 16.7%, P = 0.579） or fibrous cap thickness （57.5 4± 14.0 vs. 63.5 4±10.7 gin, P = 0.319）. Other OCT characteristics such as dissection, plaque erosion, thrombus, macrophage shadow and calcific nodule were also similar. ConcLusion Higher ratio of LRP with greater lipid arc in SCH patients may be related to the plaque instability and poor prognosis in CAD patients with SCH.

Inhibited 131I Uptake but Normal Release of Thyroid Hormone by Thyroid Gland in Response to TSH Administration in Subclinical Hypothyroidism

Background: Subclinical hypothyroidism is characterized by normal circulating thyroid hormone levels with super-normal TSH concentrations in absence of clinical manifestations. In majority of subjects, an etiologic factor is often identified. Moreover, therapy with levothyroxine normalizes serum TSH concentration while maintaining normal thyroid hormone concentrations. However, the exact pathophysiology of these thyroid hormone alterations is not well defined. Objective: Major steps in synthesis i.e. iodine uptake and the release of thyroid hormones in response to SC TSH administration were assessed in subjects with subclinical hypothyroidism. Methods: 10 men and 5 women with subclinical hypothyroidism, ages 42 - 76 years and 10 euthyroid men (39 - 70 years) participated. 24 hr 131Iodine thyroid uptake and serum T3, T4 and TSH concentrations were determined prior to and after SC administration of recombinant human TSH, 0.9 mg for two consecutive days. Comparisons were conducted for 24 hour uptake values as well as serum T3, T4 and TSH levels obtained prior to and after TSH administration. Results: In subjects with subclinical hypothyroidism 24 hour 131I thyroidal uptakes were normal (10% - 30%). However, the mean value was significantly lower, (p 3 and T4 concentrations in subjects with subclinical hypothyroidism were not significantly different in comparison to normal subjects. Serum TSH concentrations were supernormal and therefore were significantly higher in subjects with subclinical hypothyroidism in comparison to normal subjects and rose markedly in both groups following TSH administration with no significant difference among groups. Serum T4 and T3 rose significantly from PreTSH levels in both groups (p 131I Thyroid uptake is inhibited prior to as well as following SC TSH administration in comparison to normal subjects with maintenance of normal hormone release.

The effectiveness and safety of thyroxine replacement therapy for children with down syndrome and subclinical or congenital hypothyroidism—A systematic review

Introduction: Down syndrome (DS) is the most common chromosomal abnormality causing mental handicap in humans. Children with DS have significant medical problems and developmental delay which are further impaired by hypothyroidism. Those clinical features are potentially improved by using thyroxine replacement therapy. Objectives: To examine the evidence of effectiveness (motor & mental development) and safety of thyroxine supplementation in the treatment of SH and CH in children with DS. Methods: Several medical data bases (MEDLINE, EMBASE, CINAHL, Cochrane, Clinical Trials Gov, Essential Evidence and Google) were searched until 20 October, 2011, for randomized control trials (RCTs) that had examined thyroxine’s effectiveness and safety in the treatment of SH or CH in children with DS. Results: There were two high quality RCTs that examined thyroxine in the treatment of CH in children with DS, and no RCTs were found to have examined the effectiveness of thyroxine for SH in children with DS. Conclusion: The RCT which met our inclusion criteria provides the reliable evidence in recommending thyroxine for the treatment of CH in children with DS which is similar to the guidelines for general population. The absence of RCTs examining the treatment of SH in Children with DS indicates the need to conduct such trials.

Subclinical Hypothyroidism in Children Can Normalize after Changes in Dietary Intake

Background: There is no effective treatment for children with subclinical hypothyroidism. The natural course of subclinical hypothyroidism shows a normalization rate of 41% for Thyroid Stimulating Hormone (TSH). Objective;The thyroid needs (among others) iron, iodine, and vitamin A for a proper thyroid hormone synthesis. We hypothesize that with a dietary change, more children can normalize their TSH. Design: In this case-control study, 54 children aged 1 - 14 years with subclinical hypothyroidism were divided into a diet group and a control group. The diet consisted of green vegetables, beef, full fat milk, and butter. The diet was followed for at least 3 months. A total of 27 patients comprised the diet group and 27 the control group. TSH, Free T4 (FT4), and Body Mass Index (BMI) were evaluated during the follow up. Results: By following this diet, TSH levels decreased significantly compared to when following the natural course. FT4 levels did not change during the follow up. The diet group realized a change of normalizing their TSH with a RR 2.8 (95% CI 1.45 - 5.61). There were no changes in BMI after following the diet. Conclusions: Even though our study population was small, we observed the association of a dietary change and normalization of TSH in children with subclinical hypothyroidism, without adverse effects.

Subclinical hypothyroidism and the metabolic syndrome:A meta-analysis of cross-sectional studies

AIM： To determine the relationship between subclini-cal hypothyroidism （SCH） and the metabolic syndrome（MS）. METHODS： We performed a systematic search of da-tabases [MEDLINE （July 1950 to July 2012）, EMBASE（July 1966 to July 2012）] and the references of identi-fied studies. Completely published cross-sectional stud-ies of a general population involving SCH and the MSwere included. The pooled odds ratio and weightedmean difference （WMD） for the outcomes were calcu-lated using random-effects models.RESULTS： Six cross-sectional studies with 19546 partic-ipants were included. In total, 398 of 1324 participants（30.06%） in the SCH group had the MS compared with 4975 of 18222 participants （27.30%） in the euthyroid group [OR = 1.20; 95%CI： 1.05-1.36; P = 0.004; χ2 = 2.53 （P = 0.773）; I2 = 0%]. Further analysis of the components of the MS showed that SCH was associatedwith increased body mass index （WMD, 0.32 kg/m2; 95%CI： 0.04-0.61; P = 0.026）, systolic blood pressure （WMD, 2.62 mmHg; 95%CI： 1.35-3.89; P 〈 0.001） and triglyceride （WMD, 0.25 mmol/L; 95%CI： 0.23-0.28; P 〈 0.001）.CONCLUSION： Based on the cross-sectional data, SCH may be associated with an increased risk of the MS, which could be attributed to the increased risk of metabolic components.

Subclinical hypothyroidism in atopic South Italian children

AIM:To verify if subclinical hypothyroidism(SCH) could be associated to atopy in children.METHODS:Seven hundred and thirty-two Caucasian children from South Italy presenting symptoms of allergic disease were enrolled and submitted to atopy,obesity,chronic low grade inflammation,and SCH work up.RESULTS:Four hundred and forty-five out of 705(63.12%) children affected by allergic disease were diagnosed as atopic and 260(36.88%) as not atopic.The SCH prevalence was 6.3%.Significant higher prevalence of SCH among atopic children with average(group 2) and high(group 3) low grade chronic inflammation compared to atopic children with mild(group 1)low grade chronic inflammation was present.Moreover,group 1 and group 2 presented an OR to show SCH of2.57(95%CI:1.55-6.26) and 2.96(95%CI:1.01-8.65),respectively.Both in atopic and not atopic children we found C3 serum levels significantly higher in group 3respect to group 2 and group 1.Noteworthy,among atopic patients,also total immunoglobulin E(IgE) serum levels,were significantly higher in group 3 compared to group 2 and group 1 children.In atopic children,C3 and total IgE serum values increased in parallel with the increase of C-reactive protein values,while in not atopic children this phenomenon was not evident.CONCLUSION:The possibility exists that an increasing atopic inflammation contributes to SCH occurrence.So far this is the first report in literature showing an association between SCH and atopy but further studies are needed to confirm our data.

Correlation of Cognitive Performance and Thyroid Hormone Levels in Adolescents with Subclinical Hypothyroidism

Subclinical hypothyroidism (SCH) can negatively affect cognitive functioning. This study aimed at correlating serum T3, T4, TSH with adolescent’s performance on a learning disability scale. Methods: A cross-sectional study was conducted on 100 schoolchildren, (10 - 15 years). Thyroid hormones were estimated and classified into two groups: euthyroid and subclinical hypothyroid. NIMHANS index for Specific Learning Disabilities was used to assess the learning ability and cognitive functions. Results: Subclinical hypothyroid group made more mistakes than euthyroid group. In SCH male group, T3 correlated with language and T4 levels correlated in all areas except in language. In the females, there is no significant correlation between T3 and ability parameters except in partial correlation coeffeicient among euthyroid children in arithmetic, visual-motor skills and memory. T4 results did not correlate in language skills. There was a statistical significance between T4 and ability skills in girls except in language. TSH and language skills correlated in females. Conclusion: T3 and T4 levels have correlation with cognitive skills other than TSH. It is necessary to measure both T3 and T4 in addition to TSH in adolescents.

血清钙、磷、促甲状腺激素水平在妊娠期SCH中的相关性及对其妊娠结局的预测价值

目的探讨血清钙、磷、促甲状腺激素(TSH)水平在妊娠期亚临床甲状腺功能减退症(SCH)中的相关性及对其妊娠结局的预测价值。方法选取2020年8月至2021年8月于该院接受治疗并建档的50例妊娠期SCH患者作为SCH组,按照妊娠结局情况将SCH组又分为不良妊娠结局组(19例)和正常妊娠结局组(31例);另选取同期于该院进行常规产前检查的50例健康孕妇作为正常妊娠组。检测两组血清钙、磷及TSH水平,采用Pearson相关分析血清钙、磷水平与TSH水平的相关性,采用受试者工作特征(ROC)曲线分析血清钙、磷、TSH水平单项及联合检测对妊娠期SCH患者妊娠结局的预测价值。结果SCH组血清钙水平低于正常妊娠组,磷、TSH水平均高于正常妊娠组,差异均有统计学意义(P<0.05)。血清钙水平与TSH水平呈负相关(r=-0.469,P<0.05);血清磷水平与TSH水平呈正相关(r=0.597,P<0.05)。不良妊娠结局组血清钙水平低于正常妊娠结局组,磷、TSH水平均高于正常妊娠结局组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,血清钙、磷、TSH水平单项检测对妊娠期SCH患者妊娠结局均有一定的预测价值,其曲线下面积(AUC)分别为0.698、0.748、0.778,而血清钙、磷、TSH水平联合检测的AUC均高于各项指标单项检测。结论妊娠期SCH患者血清钙、磷、TSH水平异常,且血清钙、磷、TSH水平变化与患者妊娠结局具有一定的相关性,血清钙、磷、TSH联合检测对妊娠期SCH患者妊娠结局具有较高的预测价值。

Analysis of the features of TCM and western medicine in the diagnosis and treatment of subclinical hypothyroidism characteristics

The diagnosis and treatment of subclinical hypothyroidism are summarized by reviewing the related English and Chinese literature, the comparative analysis of traditional Chinese medicine （TCM） and western medicine in the understanding of subclinical hypothyroidism, the epidemiology, etiology, pathogenesis, the patterns addition to the therapeutic hypothyroidism, with a pr and the clinical manifestation in principle and drugs of subclinical ospect of providing insight in the clinical treatment of the disease.

Effects of gestational subclinical hypothyroidism and TPO-Ab on pregnancy outcomes

The prevalence of gestational subclinical hypothyroidism has been increasing with years, and it has become one of the common diseases happened to women during pregnancy in China. Gestational subclinical hypothyroidism can not only increase the incidence of adverse pregnancy outcomes, but also have a negative impact on the development of the offspring. Therefore, it is necessary to make an early detection, diagnosis and treatment.

合并亚临床甲状腺功能减退老年抑郁症住院患者的临床特征分析

背景老年抑郁症是一种有别于其他年龄阶段抑郁症的严重精神疾病,具有明显的异质性。亚临床甲状腺功能减退(SCH)是一种临床体征不明显的甲状腺功能减退状态,而SCH对老年抑郁症的影响容易被人们忽视,目前对SCH和老年抑郁症的关联研究较少。目的探讨合并SCH老年抑郁症住院患者的临床特征。方法纳入2019年4月—2023年3月合肥市第四人民医院住院治疗的抑郁症患者为研究对象,将患者分为亚临床甲状腺功能减退抑郁症(SCHD)组(108例)与抑郁症对照(CD)组(110例)。收集研究对象的一般资料,采集空腹静脉血样本检测生化指标,采用汉密尔顿抑郁量表(HAMD-24)评估患者抑郁症状。结果SCHD组患者使用抗精神病药物例数、躯体疾病数、住院治疗天数、病程多于CD组(P<0.05),两组患者使用抗抑郁药物种类、住院治疗次数比较,差异有统计学意义(P<0.05)。HAMD-24评分结果显示,SCHD组患者睡眠障碍评分高于CD组(P<0.05),两组患者体质量、日夜变化评分比较,差异有统计学意义(P<0.05)。SCHD组促甲状腺激素水平高于CD组,血清游离三碘甲状腺原氨酸、血清游离甲状腺素水平低于CD组(P<0.05)。结论合并SCH的老年抑郁症患者临床特征特殊,住院治疗时间更长,病情发作更频繁,较难治愈,针对SCH的干预是非常必要的。

甲状腺功能检测联合TG-Ab、TPO-Ab水平检查对亚临床甲减患者的诊断效果

目的分析甲状腺功能检测联合抗甲状腺球蛋白抗体(TG-Ab)、甲状腺过氧化物酶抗体(TPO-Ab)水平检查对亚临床甲减患者的诊断效果。方法选取2021年10月至2023年10月我院收治的100例疑似亚临床甲减患者为观察组,再选取同期到院进行常规体检的100名健康志愿者为对照组。所有研究对象入院后均进行甲状腺功能与TG-Ab、TPO-Ab水平检测,对比分析两种检查单独与联合应用时的诊断效能。结果两组的游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)水平比较,差异无统计学意义(P>0.05);观察组的促甲状腺激素(TSH)、TG-Ab、TPO-Ab水平高于对照组,差异具有统计学意义(P<0.05)。TSH、FT3、FT4和TG-Ab、TPO-Ab联合检测对亚临床甲减的诊断准确度、灵敏度高于单独检测(P<0.05)。结论甲状腺功能联合TG-Ab、TPO-Ab检测诊断亚临床甲减可取得较高的诊断效能。

血清成纤维细胞生长因子-21、亚甲基四氢叶酸还原酶基因多态性与妊娠期亚临床甲状腺功能减退症的相关性

目的 探究血清成纤维细胞生长因子-21(FGF-21)、亚甲基四氢叶酸还原酶(MTHFR)基因多态性与妊娠期亚临床甲状腺功能减退症(SCH)的相关性。方法 选取2022年7月至2023年7月山西省临汾市人民医院收诊的妊娠期SCH患者106例为SCH组,另选取院内同期孕检的健康妊娠期女性106例为健康组。收集两组病历资料,筛查SCH的相关因素,分析血清FGF-21、MTHFR基因多态性对SCH发生的评估效能。结果 SCH组的空腹血糖、血清促甲状腺素(TSH)、FGF-21高于健康组(P<0.05);两组CC、CT、TT基因型分布频率比较,差异有统计学意义(P<0.05)。SCH组T等位基因分布频率高于健康组(P<0.05)。多因素分析结果显示,血清FGF-21(OR=3.330,95%CI:1.138~9.743)、MTHFR基因多态性(OR=4.104,95%CI:1.403~12.008)是SCH发生的影响因素(P<0.05)。血清FGF-21、MTHFR基因多态性单一及联合诊断SCH发生的受试者操作特征曲线下面积分别为0.738、0.670、0.851。结论 血清FGF-21水平升高、MTHFR基因TT基因型的妊娠期女性SCH发生风险更高,两项联合具有一定的诊断价值。

妊娠早、中期妇女尿碘/尿肌酐比值与亚临床甲状腺功能减退症合并自身抗体阳性的相关性

目的:探讨妊娠早、中期妇女尿碘/尿肌酐比值(UIC/UCr)与亚临床甲状腺功能减退症(SCH)合并自身抗体阳性的相关性。方法:回顾性选取2018年1月—2021年6月贵阳市第一人民医院进行孕检的妊娠早、中期SCH孕妇作为研究对象,依据甲状腺自身抗体检测结果,将其分为:妊娠早、中期甲状腺抗体阳性组;妊娠早、中期甲状腺抗体阴性组;另选取同时期进行检查的妊娠早、中期健康孕妇作为对照组,每组各100例,共计300例,观察甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、UIC/UCr、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)等指标。结果:妊娠早期三组孕妇一般临床资料比较,差异无统计学意义(P>0.05),妊娠中期三组孕妇收缩压(SBP)、舒张压(DBP)比较,差异有统计学意义(F=7.024、11.357,P<0.05);UIC/UCr分析显示,与其他组别比较,妊娠早、中期阳性组孕妇均值和百分位分布数值最低;甲状腺激素及抗体水平比较,除FT3和FT4外,妊娠早、中期阳性组孕妇UIC/UCr、TPOAb、TgAb和TSH水平与健康组和阴性组比较,差异有统计学意义(F=71.710、279.102、130.017、275.949、22.991、220.702、288.882、184.459,P<0.001);相关性分析结果显示,UIC/UCr与TSH、TgAb、TPOAb水平呈负相关;多元线性回归分析结果发现,UIC/UCr、TSH是TPOAb、TgAb的主要影响因素。结论:妊娠早、中期SCH合并自身抗体阳性孕妇,UIC/UCr显著偏低且与TPOAb、TgAb关系密切,建议在临床中加强UIC/UCr指标观察。

脂代谢异常人群亚临床甲状腺功能减退患病率及相关因素研究

目的探讨脂代谢异常人群亚临床甲状腺功能减退(SCH)患病率及相关因素。方法选择梧州市红十字会医院2018年1月至2022年12月收入的3650例脂代谢异常人群,分析SCH患病率,对SHC患者和非SCH患者的临床资料进行对比,将有差异项目带入Logistic回归方程计算,分析其对脂代谢异常人群患SCH的影响。结果脂代谢异常人群中SCH患者962例,患病率26.36%;对SCH患者及非SCH患者一般资料进行单因素Logistic回归分析发现性别、身体质量指数(BMI)、甘油三酯(TG)、舒张压(DP)、抗甲状腺球蛋白抗体(TgAb)、收缩压(SP)、年龄、空腹血浆葡萄糖(FBG)、低密度脂蛋白(LDL-C)、负荷后2 h血糖(2hPG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、谷草转氨酶(AST)、血钙、血磷、血尿酸(UA)、抗甲状腺过氧化物酶抗体(TPOAb)在两组中差异有统计学意义(P<0.05);不同种类脂代谢异常以高TG血症居多,差异有统计学意义(P<0.05),而脂代谢异常人群SCH患病率混合高脂血症最高,差异有统计学意义(P<0.05);将以上对比有差异的影响因素进行多因素Logistic回归分析发现性别、年龄、SP、TC、FBG、2hPG均为影响脂代谢异常人群患SCH的独立因素。结论脂代谢异常与SCH疾病发生之间有紧密联系,患病情况在女性、高龄患者中更突出,血脂可能在一定程度上影响甲状腺激素的分泌,最终引发SCH,因此临床需重视相关因素并进行防治。

糖化血红蛋白变异指数与2型糖尿病患者并发亚临床甲状腺功能减退症的关系

目的探讨糖化血红蛋白变异指数(HGI)与2型糖尿病(T2DM)患者并发亚临床甲状腺功能减退症(SCH)的关系。方法回顾性研究,纳入于2020年5月至2023年5月郑州大学第五附属医院收治的并发SCH的56例T2DM患者病历资料为发生组,另纳入同期于医院就诊的未并发SCH的56例T2DM患者病历资料为未发生组。对比两组一般资料和实验室指标,计算HGI值,通过点二列相关性分析和受试者工作特征(ROC)曲线探讨HGI与T2DM患者并发SCH的关系。结果发生组女性占比、年龄、糖化血红蛋白(HbA1c)、HGI高于未发生组(P<0.05)。经点二列相关性分析显示,HbA1c、HGI与T2DM患者并发SCH呈正相关(r>0,P<0.05)。绘制ROC曲线,结果显示HGI、HbA1c评估T2DM患者并发SCH的曲线下面积(AUC)值分别为0.867、0.813,HGI评估价值最高。结论HGI与T2DM患者并发SCH有关,其值越高,SCH发生可能性越高。