Changes in serum alkaline phosphatase levels before and after treatment in patients with hyperthyroidism
10.3760/cma.j.cn231583-20230612-00138
- VernacularTitle:血清碱性磷酸酶水平在甲状腺功能亢进症患者治疗前后的变化研究
- Author:
Xiaoli WU
1
;
Miao YUE
Author Information
1. 临汾市人民医院 山西医科大学第七临床医学院 山西医科大学附属临汾医院内分泌科，临汾 041000
- Keywords:
Hyperthyroidism;
Serum;
Alkaline phosphatase;
Therapy
- From:
Chinese Journal of Endemiology
2023;42(12):989-993
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the changes and influencing factors of serum alkaline phosphatase (ALP) levels in patients with hyperthyroidism before and after antithyroid drug treapy.Methods:Using the case-control study, a total of 241 hyperthyroidism patients who visited the Department of Endocrinology, Linfen People's Hospital from January 2019 to January 2022 were selected and included in the hyperthyroidism group; and 241 individuals with normal thyroid function who underwent health examinations during the same period were selected as the control group. Basic information such as gender, age, history of underlying diseases, and history of drug use from all subjects were collected. Fasting venous blood samples of all subjects the next day and patients in the hyperthyroidism group after 6 months of antithyroid drug therapy were collected for testing of thyroid function indicators [serum free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid stimulating hormone (TSH), thyroid stimulating hormone receptor antibody (TRAb), anti thyroid peroxidase antibody (TPOAb), anti thyroglobulin antibody (TgAb)] and liver function indicators [serum ALP, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), γ-glutamyl transpeptidase (GGT), and total protein (TP)]. The influencing factors of serum ALP were analyzed. Results:The levels of serum FT 3, FT 4, TRAb, TPOAb, and TgAb in patients with hyperthyroidism were significantly higher than those in the control group ( Z = - 18.94, - 18.78, - 10.62, - 10.39, - 10.33, P < 0.001), while TSH level was significantly lower than that in the control group ( Z = - 19.32, P < 0.001). There were 141, 34, 28, 14, and 8 cases of elevated serum ALP, ALT, AST, GGT, and TBIL levels in the hyperthyroidism group, accounting for 58.51%, 14.11%, 11.62%, 5.81%, and 3.32%, respectively. Among 141 patients with elevated serum ALP level, 104 had only elevated ALP level, while 37 had one or more abnormalities in ALT, AST, GGT, and TBIL. The serum levels of ALP, ALT, AST, GGT, and TBIL in patients with hyperthyroidism were higher than those in the control group ( Z = - 14.83, - 5.10, - 2.57, - 3.30, - 12.36, P < 0.001), and the TP level was lower than that in the control group ( Z = - 4.01, P < 0.001). After 6 months of antithyroid drug therapy, the levels of serum FT 3, FT 4, TSH, ALP, ALT, AST, GGT, and TBIL in patients with hyperthyroidism were statistically significant compared to before treatment ( Z = - 18.48, - 18.69, - 18.07, - 12.79, - 6.21, - 5.71, - 3.99, - 2.95, P < 0.001). There was no statistically significant difference in serum ALP level between the hyperthyroidism group and the control group ( Z = - 1.56, P = 0.118). Spearman correlation analysis showed that serum ALP level in patients with hyperthyroidism were positively correlated with FT 3, FT 4, and TRAb levels ( r = 0.54, 0.59, 0.36, P < 0.001), and negatively correlated with TSH level ( r = - 0.50, P < 0.001). The results of logistic regression analysis showed that elevated of serum FT 4, GGT levels, and decresed of TSH level were independent risk factors for elevated serum ALP level ( OR = 1.38, 1.04, 0.28, P < 0.05). Conclusion:Antithyroid drug therapy can improve the abnormal elevation of serum ALP level in patients with hyperthyroidism, and FT 4, GGT, and TSH levels are independent influencing factors.
