健康受试者甲状腺功能生物标志物的日内变化及临床应用。
Intraday Changes and Clinical Applications of Thyroid Function Biomarkers in Healthy Subjects.
机构信息
Department of Clinical Laboratory, Traditional Chinese Medicine Hospital of the Pidu District, Chengdu, China.
出版信息
Lab Med. 2023 May 2;54(3):282-286. doi: 10.1093/labmed/lmac105.
OBJECTIVE
We evaluated the intraday changes of thyroid function biomarkers in healthy subjects to help clinicians diagnose thyroid diseases in appropriate timing.
METHODS
Blood samples were collected from 31 subjects at 0:00, 4:00, 8:00, 12:00, 16:00 and 20:00 on the sampling day and analyzed for thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free T3 (FT3), and free T4 (FT4). The intraday concentration changes were analyzed using Friedman's 2-way analysis of variance by ranks.
RESULTS
The concentrations of TSH, T3, T4, FT3, and FT4 in males were significantly higher than those in females (P < .01). The obvious peak circadian rhythm of TSH was observed at 0:00 AM with gradual decline thereafter, whereas other biomarkers showed no rhythmic changes.
CONCLUSION
Sex differences should be considered in interpreting thyroid function tests. It is important to select the sampling time according to the clinician's diagnostic needs, especially at night when TSH secretion peaks.
目的
我们评估了健康受试者的甲状腺功能生物标志物的日内变化，以帮助临床医生在适当的时间诊断甲状腺疾病。
方法
在采样日，采集 31 名受试者的血液样本，分别在 0:00、4:00、8:00、12:00、16:00 和 20:00 进行分析，检测促甲状腺激素（TSH）、三碘甲状腺原氨酸（T3）、甲状腺素（T4）、游离 T3（FT3）和游离 T4（FT4）。采用 Friedman 双向等级方差分析对日内浓度变化进行分析。
结果
男性 TSH、T3、T4、FT3 和 FT4 浓度明显高于女性（P<0.01）。TSH 呈明显的昼夜节律性高峰，于凌晨 0 点达到峰值，此后逐渐下降，而其他生物标志物则无节律性变化。
结论
在解释甲状腺功能检测结果时，应考虑性别差异。根据临床医生的诊断需求选择采样时间非常重要，尤其是在 TSH 分泌高峰的夜间。
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