合肥地区正常人群血清TSH、TT3、TT4的季节变化

目的 利用体检中心获得的大数据探讨血清促甲状腺激素(TSH)、血清三碘甲状原氨酸(TT3)、血清总甲状腺素(TT4)浓度的季节性变化。 方法 选取2017年6月—2019年5月安徽医科大学第一附属医院体检中心19 434例(年龄>20岁)含甲状腺功能检测的健康体检者信息,按照气象季节定义,春、夏、秋、冬分别为3~5月,6~8月,9~11月,12~来年2月,其中春季5 182例,夏季5 384例,秋季6 500例,冬季2 368例,比较不同季节间TSH、TT3、TT4浓度以及每日TSH、TT3、TT4浓度与每日最高气温、最低气温、平均气温、日照时间、降水量的Spearman相关性分析。 结果 血清TSH浓度在2年间呈季节性变化,差异有统计学意义(P<0.05),TSH在冬春季(2.300μIU/mL;2.316μIU/mL)增多,夏秋季(2.220μIU/mL)减少;TT3在4个季节都有所不同,差异有统计学意义(P<0.05),秋季TT3水平(1.89 nmol/L)最高,其次为冬季TT3(1.88 nmol/L)水平;春季、夏季的TT4水平与其他季节比较差异均有统计学意义(P<0.05),秋冬季TT4水平(97.44 nmol/L;96.18 nmol/L)最高,春季TT4水平(95.76 nmol/L)大于夏季TT4水平(95.74 nmol/L)。每日TSH、TT3、TT4浓度与相关指标的Spearman相关性分析显示,相关系数均较小,差异无统计学意义(P>0.05)。 结论 季节明显影响血清TSH、TT3、TT4浓度。临床上解释甲状腺激素水平结果时,应考虑到季节变化对血清TSH、TT3、TT4水平的影响。 

Seasonal variation of serum TSH,TT3,TT4 in normal population in Hefei

Objective To explore the seasonal changes of serum thyroid stimulating hormone(TSH), serum triiodothyronine(TT3) and serum total thyroxine(TT4) concentrations using big data obtained from the physical examination center. Methods Information of 19 434 individuals(aged>20 years) undergoing physical examination in the First Affiliated Hospital of Anhui Medical University from June 2017 to May 2019 were collected. Thyroid hormone of these subjects were detected. According to the definition of meteorological seasons, spring, summer, autumn and winter were respectively from march to May, June to August, September to November and December to February. There were 5 182 cases in spring, 5 384 cases in summer, 6 500 cases in autumn, and 2 368 cases in winter. The concentrations of TSH, TT3 and TT4 in different seasons were compared. The Spearman correlation analysis of daily TSH, TT3 and TT4 concentrations with daily maximum temperature, minimum temperature, average temperature, sunshine duration and precipitation were performed. Results Serum TSH concentration showed seasonal changes during the two years, with statistically significant difference(P<0.05). They increased in winter(2.300 μIU/mL)and spring(2.316 μIU/mL), while they decreased in summer and autumn(2.200 μIU/mL). The TT3 level was different in the four seasons, and the difference was statistically significant(P<0.05), with the highest TT3 level in autumn(1.89 nmol/L), the TT3 level in winter(1.88 nmol/L) was next. The TT4 levels in spring and summer were significantly different from those in other seasons(P<0.05), TT4 level in autumn(97.44 nmol/L) and winter(96.18 nmol/L) was the highest,and TT4 level in spring(95.76 nmol/L) was higher than that in summer(95.74 nmol/L). Spearman correlation analysis of daily TSH, TT3 and TT4 concentrations and related indicators showed that the correlation coefficients were all small, with no statistical significance(P>0.05). Conclusion The serum TSH, TT3 and TT4 concentration were significantly affected by season. The effect of seasonal change on serum TSH, TT3 and TT4 level should be considered when interpreting the results of thyroid hormone level in clinic.