甲状腺疾患, 妊娠および先天性チロキシン結合グロブリン (TBG) 欠損症における血中TBGの臨床的意義

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  • 今村 理喜代
    天理よろづ相談所病院臨床病理部RI部門 天理よろづ相談所病院内分泌内科
  • 吉政 康直
    天理よろづ相談所病院臨床病理部RI部門 天理よろづ相談所病院内分泌内科
  • 浜田 哲
    天理よろづ相談所病院臨床病理部RI部門 天理よろづ相談所病院内分泌内科

書誌事項

タイトル別名
  • Measurement for Serum Thyroxine-Binding Globulin (TBG) and Its Clinical Assessment in Diagnosis of Thyroid States
  • コウジョウセン シッカン ニンシン オヨビ センテンセイ チロキシン ケツゴウ

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Serum levels of thyroxine (T4) -binding globulin (TBG) were determined by a radioimmunoassay using cellulose-linked antibody to TBG. Values obtained in healthy young adults averaged 1.62±0.25 (SD) mg/100 ml, and no significant difference was detected between males and females. The TBG levels remained within the normal limit in hyperthyroidism while they were significantly increased in hypothyroidism. Interestingly enough, TBG levels were significantly elevated in chronic thyroidities with no overt hypothyroidism. In normal pregnancy, TBG was increased slightly in the first trimester, and markedly in the second and third trimesters. In one case of congenital TBG deficiency, no immunoreactive TBG was detected. It was demonstrated, further, that an inverse relationship (r=-0.7593) existed between the TBG level and serum triiodothyronine uptake index, and that a direct relation (r=+0.6557) was present between the TBG level and T4 in sera from normal subjects and pregnancy. Ratios of T4/TBG were markedly increased in hyperthyroidism, and decreased in hypothyroidism, showing no overlap with the normal subjects, whereas they were below the normal limit in half the cases in the second and third trimesters of pregnancy. The radioim-munoassay for TBG was useful in evaluating hypothyroid states, because it could differentiate the increase in T4 associated with elevated TBG from hyperthyroidism.

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