As one of the most important endocrine organs in the human body. The thyroid gland is mainly composed of thyroid follicles, Thyroid gland have the function of synthesizing, storing and secreting thyroid hormones. Thyroid hormone-triiodothyronine(T3) and Thyroxine(T4) are important regulatory hormones in the human body, which can promote the metabolism of the body, maintain the normal growth and development of the body, and also have an important influence on the development of bone and nervous system[1,2].
Since drugs and diseases may result in abnormality of total thyroid hormones, but free thyroid hormones (FT3 and FT4) are maintained at normal levels, so the detection of FT3 and FT4 has important clinical significance[3].
Thyroid-stimulating hormone (TSH) secreted by the pituitary gland participates in the regulation of the hypothalamus-pituitary-thyroid axis, so as to achieve the dynamic balance of thyroid hormones in the body[4].
Autoimmune Thyroid Disease is caused by disorders of the patient's Autoimmune system, mainly including Hashimoto's thyroiditis and Graves' Disease, etc., and the formation of these thyroid diseases is closely related to thyroglobulin (TG) and Thyroid peroxidase (TPO)[5].
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Accurate determination of TSH is the first choice to judge whether the thyroid and hypothalamic-pituitary-thyroid axis function is normal.
T3 test can effectively assess thyroid function:(1) diagnosis and early diagnosis of hyperthyroidism;(2) To evaluate the therapeutic effect of hyperthyroidism;(3) Diagnosis of hypothyroidism, course observation and curative effect diagnosis.[6]
Serum T4 is often used in combination with other thyroid function tests to assess thyroid function :(1) diagnose hyperthyroidism/hypothyroidism;(2) Evaluate the therapeutic effect.
FT3 can accurately assess the thyroid function:(1) Diagnosis of hyperthyroidism and triiodothyroidine type hyperthyroidism;Guide course observation, treatment and judgment of curative effect; (2) To diagnose primary, secondary and peripheral hypothyroidism, and guide the observation of the course of disease and the judgment of curative effect.
Measurement of FT4 can accurately assess thyroid function :(1) diagnosis of hyperthyroidism/hypothyroidism;(2) Evaluate the therapeutic effect.
Patients with various thyroid diseases will have different degrees of abnormal TG in serum.Serum TG detection can be used for the differential diagnosis of various thyroid diseases and non-thyroid diseases.
In addition, the presence of anti-thyroglobulin (TgAb) antibody in serum will interfere with the immunoassay of thyroglobulin, resulting in false positive or false negative results. Therefore, it is very important to detect the concentration of TgAb antibody in serum for the correct measurement of serum TG.
Elevated TgAb is mainly seen in: (1) patients with Hashimoto's thyroiditis, primary hypothyroidism, and hyperthyroidism;(2) specific liver diseases, various collagenous diseases and myasthenia gravis;(3) The positive rate of normal women increased with age, and the positive rate reached 18% for women over 40 years old.
Elevated TPOAb is mainly seen in: (1) patients with Hashimoto's thyroiditis, primary hypothyroidism, and hyperthyroidism; (2) Some patients were TgAb negative, but TpoAb positive, so the combined detection of two antibodies could improve the positive detection rate of anti-thyroid autoantibodies.
[1] Bassett JH, Williams GR. Critical role of the hypothalamic-pituitary-thyroid axis in bone. Bone 2008;43:41 8.
[2] Flamant F, Cheng SY, Hollenberg AN, et al. Thyroid Hormone Signaling Pathways: Time for a More Precise Nomenclature. Endocrinology 2017;158:2052.
[3] Ekins R. The free hormone hypothesis and measurement of free hormones. Clin Chem 1992; Pining sickness, 89.
[4] Spencer CA, LoPresti JS, Patel A, et al. Applications of a new chemiluminometric thyrotropin assay to subnormal measurement. J Clin Endocrinol Metab 1990; 70:453.
[5] Verburg FA, Luster M, Cupini C, et al. Implications of thyroglobulin antibody positivity in patients with differentiated thyroid cancer: a clinical position statement. Thyroid 2013; Now 11.
[6] Lieblich J, Utiger R D. Triiodothyronine radioimmunoassay. J Clin Invest, 1972, 51(1): 157-166
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