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在怀孕期间甲状腺过氧化酶抗体和甲状腺功能之间的关联的解释:单个参与者数据的元分析

Yindi Liu¹, Joris A J Osinga¹, Ulla Feldt-Rasmussen²

¹Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands; Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands.

Journal of autoimmunity

|October 11, 2025

概括

怀孕期间甲状腺过氧化酶抗体 (TPOAb) 的阳性与甲状腺功能障碍有关. 即使低于标准切断值的TPOAb水平也可能表明甲状腺功能较低,这表明需要积极监测.

科学领域:

内分泌学在内分泌学.
免疫学免疫学免疫学
生殖医学生殖医学

背景情况:

甲状腺过氧化酶抗体 (TPOAb) 的阳性是甲状腺功能低下症的关键危险因素.
标准的TPOAb切断值通常基于非怀孕人口,可能误解与怀孕相关的免疫耐受性影响.
了解TPOAb水平在怀孕中的临床相关性对于母亲的甲状腺健康至关重要.

研究的目的:

调查孕期TPOAb度与母亲甲状腺功能之间的关联.
为了确定TPOAb水平低于当前阳性截止值是否具有临床意义.
为孕妇具有不同TPOAb水平的后续策略提供信息.

主要方法:

从24个队列中对62,634名孕妇的个人参与者数据进行元分析.
排除了多胎妊娠,先前存在的甲状腺疾病或特定药物的参与者.
混合效应回归模型分析TPOAb百分位数与母亲甲状腺功能 (TSH,FT4) 相比.

主要成果:

逐渐更高的TPOAb百分位与增加的TSH和降低的FT4水平相关.
从第89个TPOAb百分位数上升,提升TSH (>4.0mU/L) 和甲状腺功能低下的风险显著增加.
在0.4-6.3%的女性中,观察到TPOAb度低于标准阳性截止值,但高于89百分位,显示与甲状腺功能障碍有关.

结论:

在怀孕期间,TPOAbs与TSH,FT4和甲状腺功能异常风险具有剂量依赖的关联.
较高的TPOAb水平,即使低于传统的阳性值,也表明临床相关的甲状腺自身免疫.
怀孕早期高正常TPOAb度可能需要主动监测甲状腺功能.

关键词:

在FT4中,FT4是FT4的类型.怀孕怀孕怀孕怀孕这就是TPOAb TPOAb.在 TSH 中,您可以使用甲状腺是什么?甲状腺是什么?甲状腺功能测试测试甲状腺功能测试

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