方法:先前的研究探讨了抗甲状腺抗体与复发性流产(RM)之间的关联,然而,抗甲状腺抗体在RM患者中的作用尚有争议.
目标:因此,我们进行了这项荟萃分析,本研究的目的是评估抗甲状腺过氧化物酶(anti-TPO)和/或抗甲状腺球蛋白(anti-TG)抗体阳性是否与RM相关.
方法:进行荟萃分析。
方法:复发性流产患者。
方法:应用STATA12.0软件计算抗TPO和抗TG抗体与RM患病率相关的比值比(ORs)/相对风险(RRs)和95%CI。
结果:N=28项研究(8875名参与者)探讨了抗甲状腺抗体对RM的影响。对28项研究的分析表明,抗TPO之间存在显着关联,抗TG抗体和随机效应模型的RM患病率(OR/RR=2.02;95%CI:1.63-2.51,p<0.001;I2=44.3%,Q试验的p值=0.004)。对20项研究的分析显示,使用随机效应模型,抗TPO抗体与RM的患病率之间存在显着关联(OR/RR=1.59;95%CI:1.25-2.03,p<0.001;I2=43.1%,Q试验的p值=0.022)。对14项研究的分析表明,抗TG抗体与随机效应模型的RM患病率之间存在显着关联(OR/RR=2.25;95%CI:1.56-3.23,p<0.001;I2=49.2%,Q试验的p值=0.019)。
结论:根据当前可用的分析,我们的研究结果表明,与抗体阴性的女性相比,具有抗TPO和/或抗TG抗体的女性患RM的风险更高.需要进一步研究以更好地阐明抗甲状腺抗体在RM中的确切作用以及治疗是否有益。
结论:首先,不同研究中使用的各种检测方法和试剂的差异可能会影响抗甲状腺抗体的诊断解释,这可能会影响荟萃分析的准确性。第二,抗甲状腺抗体阳性似乎可能是母体免疫系统更普遍的疾病的一部分,由于资金和条件的限制,很难在所有参与者中进行完整的自身抗体筛查调查,这可能是所有纳入研究的限制。第三,RM没有提到甲状腺素治疗,使荟萃分析更加有限。
METHODS: Previous studies addressed the association between anti-thyroid antibodies and recurrent miscarriage (RM), however, the role of anti-thyroid antibodies in RM patients is debatable.
OBJECTIVE: Therefore, we conducted this meta-analysis and the aim of this current study was to assess whether anti-thyroid peroxidase (anti-TPO) and/or anti-thyroglobulin (anti-TG) antibody positivity was associated with RM.
METHODS: A meta-analysis was conducted.
METHODS: Recurrent miscarriage patients.
METHODS: STATA 12.0 software were applied to compute odds ratios (ORs)/relative risks (RRs) and 95% CIs regarding association between anti-TPO and anti-TG antibodies and the prevalence of RM.
RESULTS: N = 28 studies (8875 participants) explored effect of anti-thyroid antibodies on RM. Analysis of the 28 studies revealed significant association between anti-TPO, anti-TG antibodies and the prevalence of RM with a random effects model (OR/RR = 2.02; 95% CI: 1.63-2.51, p < 0.001; I2 = 44.3%, p value for Q test = 0.004). Analysis of the 20 studies revealed significant association between anti-TPO antibodies and the prevalence of RM with a random effects model (OR/RR = 1.59; 95% CI: 1.25-2.03, p < 0.001; I2 = 43.1%, p value for Q test = 0.022). Analysis of the 14 studies revealed significant association between anti-TG antibodies and the prevalence of RM with a random effects model (OR/RR = 2.25; 95% CI: 1.56-3.23, p < 0.001; I2 = 49.2%, p value for Q test = 0.019).
CONCLUSIONS: Based on the currently available analysis, our findings suggest that women with anti-TPO and/or anti-TG antibodies have a higher risk of RM than that in negative antibody women. Further investigation is needed to better clarify the exact role of the anti-thyroid antibodies in RM and whether treatment is of benefit.
CONCLUSIONS: First, differences from various detection methods and reagents used in different studies may affect the diagnostic interpretation of anti-thyroid antibodies, which might influence the accuracy of this meta-analysis. Second, positive anti-thyroid antibodies seem likely to be part of a more general disorder of maternal immune system, due to restrictions of funding and condition, a complete autoantibody screening investigation is hardly to conduct in all participants, and this could be a possible limitation of all included studies. Third, there is no mention of thyroxine therapy on RM, making the meta-analysis even more limited.