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通过挖掘真实世界大数据来确定甲状腺球蛋白和甲状腺过氧化物酶抗体的性别、年龄和季节阈值及其影响。

Establishing thresholds and effects of gender, age, and season for thyroglobulin and thyroid peroxidase antibodies by mining real-world big data.

机构信息

Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, PR China.

Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, PR China.

出版信息

Clin Biochem. 2019 Dec;74:36-41. doi: 10.1016/j.clinbiochem.2019.08.011. Epub 2019 Aug 30.

DOI:10.1016/j.clinbiochem.2019.08.011
PMID:31476287
Abstract

BACKGROUND

Thyroglobulin antibody (TG-Ab) and thyroid peroxidase antibody (TPO-Ab) are cornerstone biomarkers for autoimmune thyroid diseases, and establishment of appropriate thresholds is crucial for physicians to appropriately interpret test results. Therefore, we established the thresholds of TG-Ab and TPO-Ab in the Chinese population through analysis of real-world big data, and explored the influence of age, gender, and seasonal factors on their levels.

METHODS

The data of 35,869 subjects downloaded from electronic health records were analyzed after filtering based on exclusion criteria and outliers. The influence of each factor on antibody levels was analyzed by stratification. Thresholds of TG-Ab and TPO-Ab were established through Clinical Laboratory Standards Institute document C28-A3 and National Academy of Clinical Biochemistry (NACB) guidelines, respectively.

RESULTS

There were significant differences according to gender after age stratification; the level of TG-Ab gradually increased with age in females. There were significant differences in TG-Ab and TPO-Ab distributions with respect to age after gender stratification. Moreover, differences were observed between seasons for TG-Ab and TPO-Ab. The thresholds of TG-Ab and TPO-Ab were 107 [90% confidence interval (CI):101-115] IU/mL and 29 (90% CI: 28-30) IU/mL, respectively, using C28-A3 guidelines, but were 84 (90% l CI: 50-126) IU/mL and 29 (90% CI: 27-34) IU/mL, respectively, using NACB guidelines.

CONCLUSION

The levels of TG-Ab and TPO-Ab were significantly affected by gender, age, and season. The thresholds for TG-Ab and TPO-Ab for the Chinese population were established by big data analysis.

摘要

背景

甲状腺球蛋白抗体(TG-Ab)和甲状腺过氧化物酶抗体(TPO-Ab)是自身免疫性甲状腺疾病的基石生物标志物,建立适当的阈值对于医生正确解读检测结果至关重要。因此,我们通过对真实世界大数据进行分析,建立了中国人 TG-Ab 和 TPO-Ab 的阈值,并探讨了年龄、性别和季节因素对其水平的影响。

方法

根据排除标准和离群值对从电子健康记录中下载的 35869 例患者的数据进行分析。通过分层分析每个因素对抗体水平的影响。分别通过临床实验室标准协会文件 C28-A3 和美国国家临床生物化学学会(NACB)指南建立 TG-Ab 和 TPO-Ab 的阈值。

结果

在年龄分层后,根据性别存在显著差异;女性的 TG-Ab 水平随年龄逐渐升高。在性别分层后,根据年龄对 TG-Ab 和 TPO-Ab 的分布存在显著差异。此外,TG-Ab 和 TPO-Ab 的分布存在季节差异。使用 C28-A3 指南,TG-Ab 和 TPO-Ab 的阈值分别为 107[90%置信区间(CI):101-115]IU/ml 和 29(90%CI:28-30)IU/ml,但使用 NACB 指南时,阈值分别为 84(90%lCI:50-126)IU/ml 和 29(90%CI:27-34)IU/ml。

结论

TG-Ab 和 TPO-Ab 的水平受到性别、年龄和季节的显著影响。通过大数据分析,建立了中国人 TG-Ab 和 TPO-Ab 的阈值。

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