基于年龄和采样时间对不孕女性基础血清 TSH、FT3 和 FT4 水平的分析。
Analysis of basal serum TSH, FT3, and FT4 levels based on age, sampling time in women with infertility.
机构信息
Department of Reproductive Medicine, The Third Affiliated Hospital of Zhengzhou University, No. 7 Kangfuqian Street, Erqi, Zhengzhou, Henan, China.
Neonatal Screening Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
出版信息
BMC Womens Health. 2021 Aug 28;21(1):317. doi: 10.1186/s12905-021-01453-8.
BACKGROUND
To analyze the characteristics of basal thyroid hormone levels in infertile women consulting for assisted reproductive technology (ART) treatment.
METHODS
This was a retrospective study. Serum TSH, FT3 and FT4 levels of women seeking ART consultation were tested routinely. Analyses were performed based on age and sampling time. One-way ANOVA or Kruskal-Wallis rank sum test was used to compare the continuous data among the groups, and the chi-square test or Fisher's exact test was used to compare categorical data where appropriate.
RESULTS
A total of 6426 women were initially included in the study. After exclusion criteria were applied, the remaining 4126 women were categorized into different groups. The prevalence of subclinical hypothyroidism significantly decreased with age and sampling time, from 21.09 to 11.91% and from 28.57 to 10.67%, respectively (P < 0.001, respectively). Mean serum TSH, FT3, and FT4 levels decreased significantly with age (P = 0.017, < 0.001, < 0.001, respectively). In the context of sampling time, TSH levels from early in the morning were significantly higher (P < 0.001), while FT4 and FT3 levels were similar in different groups (P = 0.258, 0.300, respectively).
CONCLUSIONS
The prevalence of subclinical hypothyroidism significantly decreased with increasing age and sampling time, as did the serum TSH levels. Even though, the establishment of reference interval of TSH level based on age or sampling time was not recommended. Full consideration of age and sampling time should be carefully taken before initiation of treatment.
背景
分析不孕女性接受辅助生殖技术（ART）治疗时基础甲状腺激素水平的特征。
方法
这是一项回顾性研究。常规检测寻求 ART 咨询的女性的血清 TSH、FT3 和 FT4 水平。根据年龄和采样时间进行分析。使用单因素方差分析或 Kruskal-Wallis 秩和检验比较组间的连续数据，使用卡方检验或 Fisher 确切检验比较适当的分类数据。
结果
共有 6426 名女性最初纳入研究。应用排除标准后，剩余 4126 名女性被分为不同组。亚临床甲状腺功能减退症的患病率随年龄和采样时间的变化而显著降低，从 21.09%降至 11.91%，从 28.57%降至 10.67%（P<0.001，分别）。血清 TSH、FT3 和 FT4 水平随年龄显著降低（P=0.017，<0.001，<0.001，分别）。在采样时间方面，清晨的 TSH 水平显著升高（P<0.001），而不同组之间的 FT4 和 FT3 水平相似（P=0.258，0.300，分别）。
结论
随着年龄和采样时间的增加，亚临床甲状腺功能减退症的患病率和血清 TSH 水平显著降低。尽管如此，仍不建议根据年龄或采样时间建立 TSH 水平的参考区间。在开始治疗之前，应充分考虑年龄和采样时间。
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