Bromińska Barbara, Bromiński Gabriel, Owecki Maciej, Michalak Michał, Czarnywojtek Agata, Waśko Ryszard, Ruchała Marek
Department of Endocrinology, Metabolism and Internal Medicine, University of Medical Sciences, Poznań, Poland.
Department of Informatics and Statistics, University of Medical Sciences, Poznań, Poland.
Ann Agric Environ Med. 2017 Sep 21;24(3):431-434. doi: 10.5604/12321966.1232090. Epub 2017 May 11.
The study was designed to evaluate the relationship between thyroid antibodies and gland dysfunction, with the aim of finding a clinically useful threshold value of thyreoperoxidase antibodies, which could prove to be predictive for thyroid failure.
The study was conducted on 99 women, ages ranging from 18-91 years (mean age: 45.5 ±17.0), were treated as outpatients in the Department of Endocrinology, Metabolism and Internal Medicine. Analysis of serum samples for TSH concentration and anti-TPO titers was conducted.
The most common disorder was hypothyroidism. Anti-TPO titers above reference range values were observed in 35 patients (35.4%): 21 (60%) were hypothyroid and 11 (31.4 %) were euthyroid. The anti-TPO and TSH serum levels correlated both in patients with high thyroid antibody titers, and in the anti-TPO negative groups. To find the threshold value of anti- TPO that would help predict hypothyroidism, receiver operating curves were used. With this approach, TPO antibody titers over 17 IU/ml indicated hypothyroidism with a 90% sensitivity and 75% sensibility.
It can be postulated that the cutoff values of anti-TPO in the general population should be decreased in order to improve autoimmune thyroid disorder screening. Obviously, using that margin may lead initially to the detection of some false positive subjects. However, with lower cut-off values, more patients can be enrolled into thyroid follow-up groups. In this way, many people could avoid complications of undiagnosed, insidious thyroid failure.
本研究旨在评估甲状腺抗体与腺体功能障碍之间的关系，以期找到临床实用的甲状腺过氧化物酶抗体阈值，该阈值可能对预测甲状腺功能减退具有指导意义。
本研究对99名年龄在18 - 91岁（平均年龄：45.5±17.0岁）的女性进行，她们在内分泌、代谢与内科门诊接受治疗。对血清样本进行促甲状腺激素（TSH）浓度和抗甲状腺过氧化物酶（anti - TPO）滴度分析。
最常见的病症是甲状腺功能减退。35名患者（35.4%）的抗甲状腺过氧化物酶滴度高于参考范围值：21名（60%）为甲状腺功能减退，11名（31.4%）甲状腺功能正常。在甲状腺抗体滴度高的患者组以及抗甲状腺过氧化物酶阴性组中，抗甲状腺过氧化物酶和促甲状腺激素的血清水平均具有相关性。为了找到有助于预测甲状腺功能减退的抗甲状腺过氧化物酶阈值，采用了受试者工作特征曲线。通过这种方法，抗甲状腺过氧化物酶抗体滴度超过17 IU/ml表明甲状腺功能减退，敏感性为90%，特异性为75%。
可以推测，为了改善自身免疫性甲状腺疾病的筛查，一般人群中抗甲状腺过氧化物酶的临界值应降低。显然，采用该临界值最初可能会检测到一些假阳性个体。然而，采用较低的临界值，可以将更多患者纳入甲状腺随访组。这样，许多人可以避免未诊断出的隐匿性甲状腺功能减退的并发症。
