1 河北北方学院附属第一医院内分泌科，河北 张家口 075000
目的：分析血清鸢尾素在妊娠期甲状腺功能减退症(以下简称甲减)诊断中的价值，为妊娠期甲减的诊断筛查工作提供依据。方法：选取120例妊娠期甲减患者作为病例组，选取同期100名接受产检的健康孕妇作为对照组。对两组患者的一般资料、血清促甲状腺激素(thyroid stimulating hormone，TSH)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(thyroid peroxidase antibody，TPO-Ab)、鸢尾素水平进行检测，采用受试者工作特征(receiver operating characteristic，ROC)曲线分析血清指标对妊娠期甲减的诊断价值。结果：病例组患者的体重指数(body mass index，BMI)水平及血清TSH、TPO-Ab、鸢尾素水平高于对照组，差异均有统计学意义(均P<0.05)。Logistic多元回归模型结果显示：妊娠期甲减的发生与血清TSH、鸢尾素水平相关(均P<0.05)。血清TSH、鸢尾素水平诊断妊娠期甲减的ROC曲线下面积(AUC)分别为0.812和0.735(均P<0.05)，在取最佳筛选界值时，灵敏度和特异度分别为0.900、0.608和0.610、0.810，当将二者进行联合检测时，AUC提升到0.928(P<0.05)，在取最佳筛选界值时，灵敏度和特异度分别为0.792和1.000。结论：妊娠期血清鸢尾素水平的升高对于妊娠期甲减患者具有一定的诊断价值，将血清鸢尾素与TSH等常规指标进行联合检测，可提高妊娠期甲减的筛查和诊断效果。
Value of serum irisin in the diagnosis of hypothyroidism during pregnancy
CorrespondingAuthor: DENG Wenjuan
This work was supported by Scientific Research Fund of Hebei Provincial Health Department, China (20180850).
Objective: To analyze the value of serum irisin in the diagnosis of hypothyroidism during pregnancy so as to provide the basis for the diagnosis and screening of hypothyroidism in pregnancy. Methods: A total of 120 patients with hypothyroidism during pregnancy were selected as a case group, and 100 healthy pregnant women who had received prenatal examination in the same period were selected as a control group. The general information and the serum levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibody (TPO-Ab), irisin in the two groups were detected, and the diagnostic values of serum indexes in hypothyroidism during pregnancy were analyzed by receiver operating characteristic (ROC) curve. Results: The body mass index (BMI) level and the serum TSH, TPO-Ab, irisin levels of the patients in the case group were higher than those in the control group, and the differences between the two groups were statistically significant (P<0.05). The results of logistic multiple regression model analysis showed that the occurrence of hypothyroidism during pregnancy was correlated with serum TSH and irisin levels (P<0.05). The area under ROC curve (AUC) of serum TSH and irisin levels in the diagnosis of hypothyroidism during pregnancy was 0.812 and 0.735, respectively (P<0.05), and the sensitivity and specificity were 0.900, 0.608 and 0.610, 0.810, respectively at the cut-off value. When the two indicators were jointly detected, AUC was increased to 0.928 (P<0.05), and the sensitivity and specificity were 0.792 and 1.000, respectively at the cut-off value. Conclusion: The increase of serum irisin level during pregnancy has certain diagnostic value for patients with hypothyroidism. The combined detection of serum irisin and the routine indexes such as TSH can improve the effects on screening and diagnosis of hypothyroidism during pregnancy.
serum; irisin; pregnancy; hypothyroidism; diagnosis