ABSTRACT
Objective@#To investigate the effects of different developmental patterns on the increases of thyroid volume in children from different genders and periods, and to explore whether there is a synergistic effect on the initiation of puberty in girls, so as to provide a theoretical basis for reducing the risk of thyroid abnormalities in adulthood.@*Methods@#A multi-stage cluster sampling was used to select a primary school in Minhang District of Shanghai, Haimen City of Jiangsu Province and Yuhuan city of Zhejiang Province. A total of 784 children aged 8-10 years old were included in "8-10 years school-aged children cohort". At the same time, a total of 491 girls aged 11-13 years were included in the "11-13 years adolescent girls cohort". The content of survey on follow-up was consistent with the one on baseline. B-ultrasonography was used to measure thyroid volume. The physical development indexes such as height (H), weight (W) and waist circumference (WC) were measured. The morning urine samples were collected and the urinary iodine content was detected. The changes of body mass index (BMI), waist circumference (WC), and thyroid volume (V) were calculated (d BMI, d WC, and d V, respectively). According to the changes of BMI and WC, the subjects were classified into four types of developmental changes, namely "B-LW-L (low d BMI, low d WC)" "B-LW-H (low d BMI, high d WC)" "B-HW-L (high d BMI, low d WC)" and "B-HW-H (high d BMI , high d WC)". Results In partial correlation analysis, thyroid volume was significantly correlated with BMI and WC at baseline or follow-up(P<0.05). The changes of thyroid volume in 8-10 years old boys were related to the changes of BMI and WC (P<0.05), the changes of thyroid volume in 8-10 year old girls were only associated with the changes of WC (P=0.03), and no association was found in 11-13 year old girls(P>0.05). In multivariate logistic regression analysis, after adjusting for baseline age, region, and differences of urinary iodine, the risk of thyroid volume increasing in B-HW-H was 2.70 times (95%CI=1.29-5.66) higher than that of B-LW-L in boys aged 8-10 years; among girls aged 11-13 years, the risk of thyroid volume increasing in B-LW-H, B-HW-L and B-HW-H were 2.46 times (95%CI=1.31-4.61), 2.16 times (95%CI=1.15-4.03) and 1.79 times (95%CI=1.07-2.99), respectively; there was no interaction between menarche age and developmental pattern on thyroid volume change trend (P=0.49).@*Conclusion@#The thyroid volume in children and adolescents increases with the development of physical development. Different developmental patterns and estrogens have certain effects on thyroid morphological changes. To avoid obesity in childhood (especially with central obesity), timely identify and effectively intervene thyroid morphological abnormalities in childhood，and to reduce the risk of thyroid diseases in adulthood.
ABSTRACT
Objective To explore the value of human epididymis protein 4(HE4),cancer antigen 125(CA125) and the risk of ovarian malignancy algorithm(ROMA) in the diagnosis of ovarian cancer.Methods Electrochemical luminescence and Enzymelinked immunosorbent assay (ELISA) were used to determine the levels of serum HE4,CA125 in 56 patients with ovarian carcinoma,73 cases of ovarian benign tumor and 50 health women,and the ROMA was calculated by HE4 and CA125 levels depending on the menopause state,drawing the receiver operating characteristics(ROC) curve and calculating the area under the curve(AUC).Results The average levels of the HE4,CA125 and the value of the ROMA were (345.33±605.03)pmol/L,(701.46±1 500.30) U/mL,(58.72±31.00) ％ in the ovarian carcinoma group,(53.84± 14.68)pmol/L,(44.25±45.81)U/mL,(10.80± 6.75) ％ in the ovarian benign tumor group,and (46.03±10.26)pmol/L,(17.39±10.64)U/mL,(6.92±3.85)％ in the health control group respectively,compared with the benign tumor group and the health control group,the ovarian carcinoma group were higher in HE4,CA125 and the ROMA value,and the difference were significantly (P＜0.05),whereas compared in the ovarian benign group and the health group,except the CA125 was higher in the benign group and the difference had statistical significance(P＜0.05),the HE4 level and the value of the ROMA had no statistical significance(P＞0.05).The sensitivities of the HE4,CA125 and ROMA were 71.43％,76.79 ％,89.28％,the specificities were 93.15 ％,53.42％,94.52 ％ and the ROC-AUCs were 0.930,0.809,0.937 respectively.When the specificity for the diagnosis of the ovarian carcinoma was 95.00％,the sensitivities of the HE4,CA125 and ROMA were 80.40％,53.60％,83.90％ respectively.Conclusion HE4 and CA125 combined detection to calculate the ROMA can elevate the sensitivity and specificity for the ovarian carcinoma diagnosis.