{"id":180,"title":"Bidirectional association between thyroid autoimmunity/thyroglobulin antibody and diminished ovarian reserve: a systematic review and meta-analysis of observational studies","title_zh":"甲状腺自身免疫/甲状腺球蛋白抗体与卵巢储备功能下降的双向关联：观察性研究的系统评价与荟萃分析","url":"https://pubmed.ncbi.nlm.nih.gov/42978857","doi":"10.3389/frph.2026.1958811","pmid":"42978857","journal":"Front Reprod Health","kind":"paper","lang":"en","published_at":"2026-10-20T00:00:00+00:00","fetched_at":"2026-11-08T03:43:57+00:00","authors":["Yang S","Wang J","Wang H","Ma Y"],"primary_topic":"repro-endo","topics":[{"slug":"repro-endo","score":7.0,"hits":["amh","anti-müllerian","diminished ovarian reserve","dor"]},{"slug":"oocyte","score":5.0,"hits":["ovarian","ovarian reserve"]},{"slug":"repro-immunology","score":4.0,"hits":["autoimmunity"]},{"slug":"ethics-policy","score":1.0,"hits":["guidelines"]}],"topic_score":7.0,"preference_score":0.0,"preference_labels":[],"llm_score":71.0,"final_score":71.0,"score_dims":{"novelty":62,"rigor":72,"impact":65,"relevance":88,"translation":70},"recommend_reason":"首次以双向设计系统整合TgAb（而非仅TPOAb）与卵巢储备的关联证据，注册规范、样本量尚可，为生殖内分泌门诊的自身免疫筛查提供了量化依据；但纳入研究均为观察性、反向分析异质性极高，因果推断仍受限。","keywords":["甲状腺自身免疫","甲状腺球蛋白抗体","卵巢储备功能下降","抗苗勒管激素","荟萃分析"],"selected":1,"story_id":364,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-gametes","source_name":"PubMed · 配子与性腺","source_tier":1,"mention_count":2,"has_interpretation":false,"journal_key":null,"journal_tier":"standard","journal_if":null,"is_mock":false,"summary_zh":"该研究系统检索2014年1月至2025年1月中英文数据库，纳入13项观察性研究（共4286例），采用双向验证设计评估甲状腺自身免疫（TAI）及甲状腺球蛋白抗体（TgAb）与卵巢储备的关系。正向分析显示，TAI阳性女性血清AMH显著低于对照（SMD=-0.20，95%CI -0.34~-0.06，I²=0%）；反向分析显示，卵巢储备功能下降（DOR）女性TgAb水平更高（SMD=0.93，I²=94%，异质性大需谨慎），TgAb阳性率亦显著升高（OR=1.65，95%CI 1.29~2.11，I²=32%）。研究已PROSPERO注册，结论提示两者存在双向关联，支持在育龄女性卵巢功能评估中筛查TgAb。","summary":"BACKGROUND: Evidence suggests that thyroid autoimmunity (TAI) may be associated with ovarian dysfunction; however, most studies have focused primarily on thyroid peroxidase antibodies (TPOAb), while evidence regarding thyroglobulin antibodies (TgAb) remains limited and inconsistent. This study aimed to evaluate the association between TAI/TgAb and ovarian reserve. METHODS: A systematic literature search was conducted in PubMed, Embase, Web of Science, CNKI databases for Chinese- and English-language articles published from January 2014 to January 2025. A bidirectional validation design was employed: (1) forward analysis, quantifying between-group differences in serum anti-Müllerian hormone (AMH) levels between TAI-positive women and healthy controls using standardized mean differences (SMD); and (2) reverse analysis, quantifying differences in TgAb levels (SMD for continuous variables) and TgAb positivity rates (odds ratios OR for dichotomous variables) between women with diminished ovarian reserve (DOR) and healthy controls. This study was prospectively registered with PROSPERO (CRD420251207428) and conducted in accordance with the PRISMA 2020 guidelines. The reverse analysis denotes a reverse-direction cross-sectional comparison in which the grouping and outcome variables are exchanged; it does not imply temporal or causal reversal. RESULTS: Thirteen studies (total n = 4,286) were included. Forward analysis (4 studies, n = 870) demonstrated significantly lower serum AMH levels in TAI-positive women compared with controls (SMD=-0.20, 95% CI [-0.34, -0.06], P = 0.005, I2 = 0%). Reverse analysis of continuous variables (5 studies, n = 1,496) revealed significantly elevated TgAb levels in women with DOR compared with controls (SMD=0.93, 95% CI [0.36, 1.50], P = 0.001, I2 = 94%); however, this estimate should be interpreted with caution given the substantial heterogeneity. Reverse analysis of dichotomous variables (7 studies, n = 2,568) confirmed that women with DOR had significantly higher odds of TgAb positivity compared with controls (OR=1.65, 95% CI [1.29, 2.11], P < 0.0001, I2 = 32%). CONCLUSIONS: A significant bidirectional association exists between diminished ovarian reserve and TgAb/TAI positivity. TAI may impair ovarian reserve, while women with ovarian insufficiency exhibit a higher burden of thyroglobulin autoantibodies. These findings highlight the clinical importance of TgAb screening in the evaluation of ovarian function among reproductive-age women. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251207428, identifier CRD420251207428.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}