不同基础代谢率计算公式对慢性甲状腺功能亢进性肌病的诊断价值

Diagnostic value of diverse formulas of basal metabolic rate for chronic hyperthyroid myopathy

  • 摘要: 目的:探索不同基础代谢率(BMR)公式在慢性甲状腺功能亢进性肌病(CTM)中的诊断价值。方法:选取2022 年1—8月在广西医科大学第一附属医院初诊且未治疗的CTM患者46例(CTM组),同期选取年龄和性别匹配的甲亢不伴CTM患者49例(甲亢不伴CTM组)和健康体检者46例作为健康对照组。选择Gale、Reed、Read、Takeda、Kosa、Jenkins、RPP、Harris-Benedict、Cunningham等共9个BMR公式进行描述。比较各组临床资料(包括年龄、性别、体重、上臂围等)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)、促甲状腺激素受体抗体(TRAb)和不同公式计算下的BMR。采用受试者工作特征(ROC)曲线评估9个BMR公式对CTM的诊断效能。结果:CTM组BMR(Gale、Reed、Read、Takeda、Kosa、Jenkins、心率收缩压乘积)、FT3、FT4、TRAb 均高于甲亢不伴CTM 组、健康对照组(P< 0.05)。Gale 公式诊断CTM 的ROC 曲线下面积(AUC)为0.83(95%CI:0.74~0.91)(P< 0.05),灵敏度为73.91%,特异度为81.63%,诊断CTM 截断值BMR> 46.00,其特异性优于Read 公式法(P< 0.05)。结论:用Gale公式评估的BMR对于CTM诊断有一定的参考价值。

     

    Abstract: Objective:To investigate the diagnostic value of diverse formulas of basal metabolic rate (BMR) in patients with chronic hyperthyroid myopathy (CTM).Methods:A total of 46 untreated CTM patients (CTM group) who were initially diagnosed in the First Affiliated Hospital of Guangxi Medical University from January 2022 to August 2022 were selected, along with 49 age-and gender-matched patients with hyperthyroidism without CTM (hyperthyroidism without CTM group) and 46 healthy subjects as healthy control group during the same period.Nine BMR formulas, including Gale, Reed, Read, Takeda, Kosa, Jenkins, RPP, Harris-Benedict and Cunningham, were selected for description.Clinical data(including age, sex, body weight and upper arm circumference, etc.), free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin receptor antibody (TRAb) and BMR calculated by different formulas were compared in each group.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of nine BMR formulas for CTM.Results:BMR(including Gale, Reed, Read, Takeda, Kosa, Jenkins and rate pressure product), FT3, FT4 and TRAb in CTM group were higher than those in hyperthyroidism without CTM group and healthy control group (P< 0.05).The area under ROC curve(AUC) for CTM diagnosis using the Gale formula was 0.83 (95% CI: 0.74-0.91) (P< 0.05) with a sensitivity 73.91% and specificity 81.63%.The cut-off value for CTM was more than 46.00, which had better specificity than the Read formula(P< 0.05).Conclusion:BMR evaluated by Gale formula has a certain reference value for the diagnosis of CTM.

     

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