Arce-Sánchez Lidia, Vitale Salvatore Giovanni, Flores-Robles Claudia Montserrat, Godines-Enriquez Myrna Souraye, Noventa Marco, Urquia-Figueroa Carmen Marcela, Martínez-Cruz Nayeli, Estrada-Gutierrez Guadalupe, Espino Y Sosa Salvador, Romo-Yañez José, Montoya-Estrada Araceli, Reyes-Muñoz Enrique
Department of Endocrinology, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Montes Urales 800, Mexico City 11000, Mexico.
Unit of Gynecology and Obstetrics, Department of General Surgery and Medical Surgical Specialties, Uni versity of Catania, 95123 Catania, Italy.
Diagnostics (Basel). 2021 Mar 1;11(3):417. doi: 10.3390/diagnostics11030417.
The primary aim of this study was to compare the prevalence of subclinical hypothyroidism (SCH) using two different cut-off levels for TSH values (≥2.5 mIU/L versus ≥4.1 mIU/L). The secondary objective was to analyze the clinical-biochemical characteristics in women with and without SCH. This was a retrospective cross-sectional study. In total, 1496 Mexican women with infertility were included: Group 1, women with TSH levels ranging between 0.3 and 2.49 mIU/L, = 886; Group 2, women with TSH between 2.5 and 4.09 mIU/L, = 390; and Group 3, women with TSH ≥4.1 mIU/L = 220. SCH prevalence was 40.7% (CI 95%: 38.3-43.3%) with TSH cut-off ≥ 2.5 mIU/L, and 14.7% (CI 95%: 12.7-16.5%) with TSH cut-off ≥ 4.1 mIU/L, ( = 0.0001). The prevalence of overweight was higher in Group 2 than in Groups 1 and 3. Thyroid autoimmunity, obesity and insulin resistance were higher in Group 3 than in Group 1 ( < 0.05). No other differences were observed between groups. Conclusions: The prevalence of SCH in our selected patients increased almost three times using a TSH cut-off ≥ 2.5 mIU/L compared with a TSH cut-off ≥ 4.1 mIU/L. Women with TSH ≥4.1 mIU/L compared with TSH cut-off ≤ 2.5 mIU/L more often presented with obesity, thyroid autoimmunity and insulin resistance.
本研究的主要目的是比较采用两种不同促甲状腺激素（TSH）值临界水平（≥2.5 mIU/L与≥4.1 mIU/L）时亚临床甲状腺功能减退症（SCH）的患病率。次要目标是分析患有和未患有SCH的女性的临床生化特征。这是一项回顾性横断面研究。总共纳入了1496名墨西哥不孕症女性：第1组，TSH水平在0.3至2.49 mIU/L之间的女性，n = 886；第2组，TSH在2.5至4.09 mIU/L之间的女性，n = 390；第3组，TSH≥4.1 mIU/L的女性，n = 220。当TSH临界值≥2.5 mIU/L时，SCH患病率为40.7%（95%置信区间：38.3 - 43.3%），当TSH临界值≥4.1 mIU/L时，患病率为14.7%（95%置信区间：12.7 - 16.5%），（P = 0.0001）。第2组超重患病率高于第1组和第3组。第3组甲状腺自身免疫、肥胖和胰岛素抵抗高于第1组（P < 0.05）。组间未观察到其他差异。结论：与TSH临界值≥4.1 mIU/L相比，在我们所选患者中，采用TSH临界值≥2.5 mIU/L时SCH患病率增加了近三倍。与TSH临界值≤2.5 mIU/L相比，TSH≥4.1 mIU/L的女性更常出现肥胖、甲状腺自身免疫和胰岛素抵抗。
