Lin L, Zhang X L, Long Y
Department of Gynecology & Obstetrics, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China.
Department of Gynecology & Obstetrics, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
Genet Mol Res. 2014 Jul 7;13(3):5107-14. doi: 10.4238/2014.July.7.3.
This study aimed to investigate the thyroid peroxidase antibody (TPOAb) positive rate and how TPOAb affects thyroid function between 7 and 12 weeks of gestation. Six hundred and eleven cases of healthy primipara were enrolled in this study between September 2010 and June 2011, and all of them were given a regular prenatal check in Beijing Friendship Hospital. By detecting the levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), and TPOAb between 7 to 12 weeks gestation, we developed an early thyroid function normal reference interval during pregnancy. Additionally, we analyzed the TPOAb-positivity cutoff value, the positive rate, and the affect of TSH and FT4. We found that the TPOAb median values and changes in the range were 38.9 (6.4-1300+) mU/L. By establishing an 7-12 week gestational-specific reference standard for pregnancy, we set a positive cutoff value of 206.77 mU/L according to the 90th percentile TPOAb. The TPOAb positive rate was 10.8% (66/611). Regression analysis showed that, during gestation between 7 and 12 weeks, the titers of TPOAb and TSH correlate positively and negatively with FT4, β = 1.406 and 0.820, respectively [95%CI (1.349-1.413, 0.805-0.835), P = 0.000]. Pregnant TPOAb positive women are more likely to suffer from markedly increased TSH levels, with increased risk being 3-4-fold greater than in a normal pregnancy.
本研究旨在调查妊娠7至12周期间甲状腺过氧化物酶抗体(TPOAb)阳性率以及TPOAb如何影响甲状腺功能。2010年9月至2011年6月,本研究纳入了611例健康初产妇,她们均在北京友谊医院接受常规产前检查。通过检测妊娠7至12周期间的促甲状腺激素(TSH)、游离甲状腺素(FT4)和TPOAb水平,我们制定了孕期早期甲状腺功能正常参考区间。此外,我们分析了TPOAb阳性临界值、阳性率以及TSH和FT4的影响。我们发现TPOAb中位数及其变化范围为38.9(6.4 - 1300+)mU/L。通过建立妊娠7至12周的特定孕周参考标准,我们根据第90百分位数的TPOAb设定阳性临界值为206.77 mU/L。TPOAb阳性率为10.8%(66/611)。回归分析表明,在妊娠7至12周期间,TPOAb和TSH的滴度与FT4分别呈正相关和负相关,β分别为1.406和0.820 [95%可信区间(1.349 - 1.413,0.805 - 0.835),P = 0.000]。妊娠TPOAb阳性女性更易出现TSH水平显著升高,其风险比正常妊娠增加3至4倍。