Palabras clave
hipotiroidismo
valores de referencia
tiroxina
tirotropina
tiroides
Cómo citar
Resumen
Introducción: durante el embarazo, se producen múltiples cambios hormonales en el eje tiroideo, lo que puede predisponer a trastornos hormonales y asociarse con desenlaces materno-fetales adversos. Las asociaciones internacionales indican que los niveles normales de TSH son entre 0,1 y 4,0 mUI/L; sin embargo, estos valores pueden variar según la raza, la ubicación geográfica y la suficiencia de yodo, entre otros factores,
Objetivo: determinar los intervalos de referencia de la hormona tiroestimulante (TSH) y la tiroxina libre (T4L) en gestantes colombianas.
Materiales y métodos: estudio observacional de corte transversal. Se analizaron los registros de 729 gestantes colombianas con mediciones concurrentes de TSH y T4L. Se excluyeron aquellas con antecedentes de enfermedad tiroidea, tratamiento con hormona tiroidea o presencia de anticuerpos a-TPO positivos. Los intervalos de referencia se calcularon siguiendo las recomendaciones del CLSI/IFCC C28-A3 (de noviembre de 2008) para el primer trimestre y el segundo/tercer trimestre de gestación.
Resultados: la mediana de edad de la población estudiada fue de 32,3 años (DE?=?5,58). Los intervalos de referencia obtenidos fueron: primer trimestre: TSH?=?0,37-4,84 mUI/L; T4L?=?0,64-1,11 ng/dL; segundo y tercer trimestre: TSH?=?0,33-4,56 mUI/L; T4L?=?0,60-1,12 ng/dL. No se encontraron diferencias significativas entre los trimestres.
Conclusiones: este es el primer estudio que establece los intervalos de referencia de TSH y T4L en gestantes colombianas. Los valores encontrados son superiores a los recomendados por guías internacionales, lo que sugiere un posible sobrediagnóstico y tratamiento innecesario del hipotiroidismo en esta población.
Citas
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