Assessment of subclinical hypothyroidism for a clinical score and thyroid peroxidase antibody: a comparison with euthyroidism grouped by different thyroid-stimulating hormone levels
Assessment of subclinical hypothyroidism for a clinical score and thyroid peroxidase antibody: a comparison with euthyroidism grouped by different thyroid-stimulating hormone levels
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DOI：
10.1515/abm-2019-0045
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发表时间：
2019-06-01
影响因子：
0.6
通讯作者：
Mahwi, Taha O.
中科院分区：
文献类型：
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作者：
Abdulateef, Darya S.;Mahwi, Taha O.
背景：亚临床甲状腺功能减退症(SCH)可有多种甲状腺功能减退的症状。目的：采用Zulewski临床评分和生化指标对SCH患者进行临床评分和生化指标的评估，并评价TSH正常的患者是否有临床症状或生化指标异常。方法：采用前瞻性横断面研究方法，对67例SCH患者和166例正常甲状腺功能正常患者进行前瞻性研究。甲状腺功能正常的受试者按TSH水平分为HNT(>；2.5mIU/L)和低-正常TSH(0.5mIu/L)。检查受试者的临床特征，包括Zulewski临床评分和生化指标，包括甲状腺过氧化物酶抗体(TPO-Ab)滴度。组间比较采用独立样本t检验，变量间相关性采用Pearson相关分析。结果：SCH组的临床评分和症状发生率明显高于甲状腺功能正常组。最常见的症状是疲劳。甲状腺功能正常的HNT患者的TPO-Ab滴度高于TSH低正常者，P<0.05。Zulewski临床评分与TSH、TPO-Ab呈正相关，与FT4水平呈负相关。结论：SCH患者Zulewski临床评分高于正常甲状腺患者，有助于SCH患者的评估。Zulewski临床评分与TSH、FT4和TPO-Ab滴度水平存在显著相关性。TPO-Ab阳性率在SCH中较高。此外，TSH水平高的甲状腺功能正常患者TPO-Ab滴度较高，但临床积分不高。
Background: Subclinical hypothyroidism (SCH) might have many symptoms of hypothyroidism. The controversy appears to lower the level of thyroid-stimulating hormone (TSH) and group subjects with TSH of more than 3 or even 2.5 mIU/L as SCH subjects.Objectives: To assess SCH subjects both clinically using Zulewski clinical score and biochemically and to evaluate whether the euthyroid subjects with high-normal TSH (HNT) have any clinical symptom or subnormal biochemical finding.Methods: A prospective cross-sectional study of 233 subjects, 67 with SCH and 166 euthyroidism, was conducted. Euthyroid subjects were divided according to the level of TSH as HNT (>2.5 mIU/L) and low-normal TSH (0.5-2.5 mIU/L). The subjects were examined for clinical feature including Zulewski clinical score and biochemical evaluations including thyroid peroxidase antibody (TPO-Ab) titer. The comparisons between groups were assessed using independent sample t test, and correlations between variables were evaluated using Pearson correlation.Results: A significantly higher clinical score and higher frequencies of symptoms were found in the SCH group compared to the euthyroid group. The most frequent symptom was fatigue. Euthyroid subjects with HNT were found to have higher TPO-Ab titers than those with low-normal TSH, P < 0.05. The Zulewski clinical score was positively correlated with TSH and TPO-Ab titer but negatively correlated with the FT4 level, P < 0.05.Conclusions: Zulewski clinical score is higher in SCH subjects compared to euthyroid subjects and can aid in assessing SCH subjects. A significant correlation exists between Zulewski clinical score and each of the TSH, FT4, and TPO-Ab titer levels. The frequency of TPO-Ab positivity is high in SCH. Additionally, euthyroid with higher TSH levels has higher level of TPO-Ab titer but not higher clinical score.