Полный текст:


В обзоре обсуждается проблема циркадианной и индивидуальной динамики уровня ТТГ и тиреоидных гормонов и её клиническое значение. Кроме того, в этом контексте обсуждается проблема референсного диапазона для уровня ТТГ.

Список литературы

1. Фадеев В.В. Нормативы уровня ТТГ: нужны ли изменения? // Клиническая тиреоидология. 2004. № 3. С. 5-9.

2. Фадеев В.В. Верхний референсный уровень ТТГ -достаточно ли аргументов для его изменения: Отклик на статью Л. Н. Самсоновой и Э. П. Касаткиной “Нормативы уровня ТТГ: современное состояние проблемы” // Пробл. эндокринол. 2008. № 1. С. 46-50.

3. Adriaanse R., Brabant G., Endert E., Wiersinga W.M. Pulsatile thyrotropin secretion in patients with Cushing’s syndrome // Metabolism. 1994. V. 43(6). P. 782-786.

4. Adriianse R., Brabant G., Prank K. et al. Circadian changes in pulsatile TSH release in primary hypothyroidism // Clin. Endocrinol. (Oxf). 1992. V. 37. P. 504-510.

5. Adriaanse R., Romijn J.A., Endert E., Wiersinga W.M. The nocturnal TSH surge is absent in overt but present in mild primary hypothyroidism and equivocal in central hypothyroidism // Acta Endocrinol. (Copenh). 1992. Р. 126206-126212.

6. Asvold B., Vatten L., Nilsen T., Bjoro T. The association between TSH within the reference range and serum lipid concentrations in a population-based study. The HUNT Study // Eur. J. Endocrinol. 2007. V. 156. P. 181-186.

7. Azukizawa M., Mori S., Ohta H. et al. Effect of a single dose of glucocorticoid on the diurnal variations of TSH, thyroxine, 3,5,3’-triiodothyronine,,3’5’-triiodothyronine and cortisol in normal men // Endocrinol. Jpn. 1979. V. 26. P. 719-723.

8. Azukizawa M., Pekary A.E., Hershman J.M., Parker D.C. Plasma thyrotropin, thyroxine, and triiodothyronine relationships in man // J. Clin. Endocrinol. Metab. 1976. V. 43. P. 533-542.

9. Baloch Z., Carayon P., Conte-Devolx B. et al. Guidelines Committee, National Academy of Clinical Biochemistry. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease // Thyroid. 2003. V. 13. P. 3-126.

10. Bartalena L., Martino E. et al. Relationship between nocturnal serum thyrotropin peak and metabolic control in diabetic patients // J. Clin. Endocrinol. Metab. 1993. V. 76 (4). P. 983-987.

11. Bartalena L., Martino E., Falcone M. et al. Evaluation of the nocturnal serum thyrotropin (TSH) surge, as assessed by TSH ultrasensitive assay, in patients receiving long term L-thyroxine suppression therapy and in patients with various thyroid disorders // J. Clin. Endocrinol. Metab. 1987. V. 65(6). P. 1265-1271.

12. Bartalena L., Placidi G.F., Martino E. et al. Nocturnal serum thyrotropin (TSH) surge and the TSH response to TSH-releasing hormone: dissociated behavior in untreated depressives // J. Clin. Endocrinol. Metab. 1990. V. 71(3). P. 650-655.

13. Bolk N., Visser T.J., Kalsbeek A. et al. Effects of evening vs morning thyroxine ingestion on serum thyroid hormone profiles in hypothyroid patients // Clin. Endocrinol. 2007. V. 66. P. 43-48.

14. Boscato L.M., Stuart M.C. Heterophilic antibodies: a problem for all immunoassays // Clin. Chem. 1988. V. 34. P. 27-33.

15. Brabant G., Beck-Peccoz P., Jarzab B. et al. Is there a need to redefine the upper normal limit of TSH? // Eur. J. Endocrinol. 2006. V.154. P. 633-637.

16. Brabant A., Brabant G., Schuermeyer T. et al. The role of glucocorticoids in the regulation of thyrotropin // Acta Endocrinol. 1989. V. 121. P. 95-100.

17. Brabant G., Prank K., Hoang-Vu. C. et al. Hypothalamic regulation of pulsatile thyrotopin secretion // J. Clin. Endocrinol. Metab. 1991. V. 72. P. 145-150.

18. Brabant G., Prank K., Ranft U. et al. Physiological regulation of circadian and pulsatile thyrotropin secretion in normal man and woman // J. Clin. Endocrinol. Metab. 1990. V. 70. P. 403-409.

19. Browning M.C. Analytical goals for quantities used to assess thyrometabolic status // Ann. Clin. Biochem. 1989. V. 26. P. 1-12.

20. Browning M.C., Ford R.P., Callaghan S.J. et al. Intra- and interindividual biological variation of five analytes used in assessing thyroid function: implications for necessary standards of performance and the interpretation of results // Clin. Chem. 1986. V. 32. P. 962.

21. Canaris G.J., Manowitz N.R., Mayor G., Ridgway E.C. The Colorado thyroid disease prevalence study // Arch. Intern. Med. 2000. V. 160(4). P. 526-534.

22. Caron P.J., Nieman L.K., Rose S.R., Nisula B.C. Deficient nocturnal surge of thyrotropin in central hypothyroidism // J. Clin. Endocrinol. Metab. 1986. V. 62. P. 960-964.

23. Coiro V., Volpi R., Marchesi C. et al. Influence of residual C-peptide secretion on nocturnal serum TSH peak in well-controlled diabetic patients // Clin. Endocrinol. (Oxf). 1997. V. 47(3). P. 305-310.

24. Covinsky M., Laterza O., Pfeifer J.D. et al. Lamda antibody to Esherichia coli produces false-positive results in multiple immunometric assays // Clin. Chem. 2000. V. 46. P. 1157-1161.

25. Custro N., Scafldi V., Notarbartolo A. Pituitary resistance to thyroid hormone action with preserved circadian rhythm of thyrotropin in a postmenopausal woman // J. Endocrinol. Invest. 1992. V. 15(2). P. 121-126.

26. Darzy K.H., Shalet S.M. Circadian and stimulated thyrotropin secretion in cranially irradiated adult cancer survivors // J Clin Endocrinol Metab. 2005. V. 90. P. 6490-6497.

27. DeGroot L.J. Dangerous dogmas in medicine: the nonthyroidal illness syndrome // J. Clin. Endocrinol. Metab. 1999. V. 84. P. 151-164.

28. DeGroot L.J., Mayor G. Admission screening by thyroid function tests in an acute general care teaching hospital // Am. J. Med. 1992. V. 93. P. 558-564.

29. Diez J.J., Iglesias P., Burman K.D. Spontaneous Normalization of Thyrotropin Concentrations in Patients with Subclinical Hypothyroidism // J. Clin Endocrinol. Metab. 2005. V. 90(7). P. 4124-4127.

30. Evans P.J., Weeks I., Jones M.K. et al. The circadian variation of thyrotrophin in patients with primary thyroidal disease // Clin. Endocrinol. (Oxf). 1986. V. 24(4). P. 343-348.

31. Fatourechi V., Klee G.G., Grebe S.K. et al. Effects of Reducing the Upper Limit of Normal TSH Values // JAMA. 2003. V 290(24). P. 3195-3196.

32. Fisher D.A. Physiological variations in thyroid hormones: physiological and pathophysiological considerations // Clin. C’hemistiy. 1996. V. 42. P. 135-139.

33. Feldt-Rasmussen U., Petersen P.H., Blaabjerg O. et al. Long-term variability in serum thyroglobulin and thyroid related hormones in healthy subjects // Acta Endocrinol. (Copenh). 1980. V. 95. P. 328-334.

34. Fliers E., Guldenaar S.E., Wiersinga W.M., Swaab D.F. Decreased hypothalamic thyrotropin-releasing hormone gene expression in patients with nonthyroidal illness // J. Clin. Endocrinol. Metab. 1997. V. 82(12). P. 4032-4036.

35. Fraser C.G., Petersen P.H., Ricos C. et al. Proposed quality specifications for the imprecision and inaccuracy of analytical systems for clinical chemistry // Eur. J. Clin. Chem. Biochem. 1992. V. 30. P. 311.

36. Geffner D.L., Hershman J.M. Beta-adrenergic blockade for the treatment of hyperthyroidism // Am. J. Med. 1992. V. 93. P. 61-68.

37. Gharib H., Tuttle R.M., Baskin H.J. et al. American Association of Clinical Endocrinologists/American Thyroid Association/ Endocrine Society. Subclinical thyroid dysfunction: a joint statement on management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and the Endocrine Society // Endocr. Pract. 2004. V. 10(6). P. 497-501.

38. Glinoer D. The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology // Endocrinol. Rev. 1997. V. 18. P. 404-433.

39. Glinoer D. The systematic screening and management of hypothyroididsm and hyperthyroidism during pregnancy // Trends Endocrinol. Metab. 1998. V. 9. N 10. P. 403-411. [RTF bookmark start: BM43][RTF bookmark end: BM43]

40. Glinoer D., De Nayer P., Bourdoux P. et al. Regulation of maternal thyroid function during pregnancy // J. Clin. Endocrinol. Metab. 1990. V. 71. P. 276.

41. Gursoy A., Ozduman Cin M., Kamel N., Gullu S. Which thyroid-stimulating hormone level should be sought in hypothyroid patients under L-thyroxine replacement therapy? // Int. J. Clin. Pract. 2006. V. 60. P. 655-659.

42. Hamblin P.S., Dyer S.A., Mohr VS. et al. Relationship between thyrotropin and thyroxine changes during recovery from severe hypothyroxinemia of critical illness // J. Clin. Endocrinol. Metab. 1986. V. 62. P. 717-722.

43. Hangaard J., Andersen M., Grodum E. et al. The Effects of Endogenous Opioids and Cortisol on Thyrotropin and Prolactin Secretion in Patients with Addison’s Disease // J. Clin. Endocrinol. Metab. 1999. V. 84(5). P. 1595-1601.

44. Hansen P.S., Brix T.H., Iachine I. Genetic and environmental interrelations between measurements of thyroid function in a healthy Danish twin population // Am. J. Physiol. Endocrinol. Metab. 2007. V. 292. E765-E770.

45. Hansen P.S., Brix T.H., Sorensen T.I.A. et al. Major Genetic Influence on the Regulation of the Pituitary-Thyroid Axis: A Study of Healthy Danish Twins // J. Clin. Endocrinol. Metab. 2004. V. 89. P. 1181-1187.

46. Harel G., Shamoun D.S., Kane J.P. et al. Prolonged effects of tumor necrosis factor-alpha on anterior pituitary hormone release // Peptides. 1995. V. 16(4). P. 641-645.

47. Harris P.E. The management of thyroid cancer in adults: a review of new guidelines // Clin. Med. 2002. V. 2(2). P. 144-146.

48. Hennemann G., Docter R., Visser T.J. et al. Thyroxine plus low-dose, slow-release triiodothyronine replacement in hypothyroidism: proof of principle // Thyroid. 2004. V. 14. P. 271-275.

49. Hennessey J.V. Levothyroxine dosage and the limitations of current bioequivalence standards // Nat. Clin. Pract. Endocrinol. Metab. 2006. V. 2(9). P. 474-475.

50. Hollowell J.G., Staehling N.W., Flanders W.D. et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III) // J. Clin. Endocrinol. Metab. 2002. V. 87. P. 489-499.

51. Huber G., Staub J., Meier C. et al. Prospective Study of the Spontaneous Course of Subclinical Hypothyroidism: Prognostic Value of Thyrotropin, Thyroid Reserve and Thyroid Antibodies. // J. Clin. Endocrinol. Metabolism. V. 87(7). P. 3221-3226.

52. Hugues J.N., Burger A.G., Pekary A.E., Hershman J.M. Rapid adaptations of serum thyrotrophin, triiodothyronine and reverse triiodothyronine levels to short-term starvation and refeeding // Acta Endocrinol (Copenh). 1984. V.105(2). P.194-199.

53. Jensen E.A., Petersen P.H., Blaabjerg O., Hegedus L. Consequences of National Academy of Clinical Biochemistry (NACB) proposal for serum Thyrothropin (TSH) reference intervals // Abstract Book of 32nd Ann. Meet. Eur. Thyroid Assoc. 2007. P. 44.

54. Jordan V., Grebe S.K., Cooke R.R. et al. Acidic isoforms of chorionic gonadotrophin in European and Samoan women are associated with hyperemesis gravidarum and may be thyrotrophic // Clin. Endocrinol. 1999. V. 50. P. 619-627.

55. Kailajarvi M., Takala T., Gronroos P. et al. Reminders of drug effects on laboratory test results // Clin. Chem. 2000. V. 46. P. 1395-1400.

56. Kaptein E.M., Spencer C.A., Kamiel M.B. et al. Prolonged dopamine administration and thyroid hormone economy in normal and critically ill subjects // J. Clin. Endocrinol. Metab. 1980. V. 51. P. 387-393.

57. Karmisholt J., Andersen S., Laurberg P. Variation in thyroid function tests in patients with stable untreated subclinical hypothyroidism // Thyroid. 2008. V. 18(3). P. 303-308.

58. Karmisholt J., Andersen S., Laurberg P. Interval between tests and T4 estimation method influence outcome of monitoring of sub-clinical hypothyroidism // J. Clin. Endocrin. Metab. 2008. V. 93. P. 1634-1640.

59. Kricka L.J. Human anti-animal antibody interference in immunological assays // Clin. Chem. 1999. V. 45. P. 942-956.

60. Kusalic M., Engelsmann F. Effect of lithium maintenance therapy on thyroid and parathyroid function // J. Psych. Neurosci. 1999. V. 24. P. 227-233.

61. Laurberg P. Persistent problems with the specificity of immunometric TSH assays // Thyroid. 1993. V. 3. P. 279-283.

62. Lazarus J.H. The effects of lithium therapy on thyroid and thyrotropin-releasing hormone // Thyroid. 1998. V. 8. P. 909-913.

63. Lekakis J., Papamichael C., Alevizaki M. et al. Flow-mediated, endothelium-dependent vasodilation is impaired in subjects with hypothyroidism, borderline hypothyroidism, and high-normal serum thyrotropin (TSH) values // Thyroid. 1997. V. 7(3). P. 411-414.

64. Liewendahl K., Tikanoja S., Mahonen H. et al. Concentrations of iodothyronines in serum of patients with chronic renal failure and other nonthyroidal illnesses: role of free fatty acids // Clin. Chem. 1987. V. 33. P. 1382-1386.

65. Lucke C., Hehrmann R. et al. Studies on circadian variations of plasma TSH, thyroxine and triiodothyronine in man // Acta Endocrinol. 1977. V. 86. P. 81-88.

66. Maes M., Mommen K., Hendrickx D. et al. Components of biological variation, including seasonality, in blood concentrations of TSH, TT3, FT4, PRL, cortisol and testosterone in healthy volunteers // Clin. Endocrinol. (Oxf). 1997. V. 46(5). P. 587-598.

67. Mariotti S., Franceschi C., Cossarizza A., Pinchera A. The aging thyroid // Endocr. Rev. 1995. V. 16. P. 686-715.

68. Martel J., Despres N., Ahnadi C.E. et al. Comparative multicentre study of a panel of thyroid tests using different automated immunoassay platforms and specimens at high risk of antibody interference // Clin. Chem. Lab. Med. 2000. V. 38. P. 785-793.

69. Martino E., Bartalena L., Bogazzi F. et al. The effects of Amiodarone on the Thyroid // Endoc. Rev. 2001. V. 22. P. 240-254.

70. Mazzoccoli G., Giuliani A., Carughi S. et al. The hypothalamic-pituitary-thyroid axis and melatonin in humans: possible interactions in the control of body temperature // Neuro Endocrinol. Lett. 2004. V. 25(5). P. 368-372.

71. McDermott M.T., Haugen B.R., Lezotte D.C. et al. Management practices among primary care physicians and thyroid specialists in the care of hypothyroid patients // Thyroid. 2001. V.11. P. 757-764.

72. Mendel C.M., Frost P.H., Kunitake S.T. et al. Mechanism of the heparin-induced increase in the concentration of free thyroxine in plasma // J. Clin. Endocrinol. Metab. 1987. V. 65. P. 1259-1265.

73. Meurisse M., Gollogly M.M., Degauque C. et al. Iatrogenic thyrotoxicosis: causal circumstances, pathophysiology, and principles of treatment- review of the literature // World J. Surg. 2000. V. 24. P. 1377-1385.

74. Meyerovitch J., Rotman-Pikielny P., Sherf M. et al. Serum Thyrotrompin Measurements in the Community Five-Year Follow-up in a Large Network of Primary Care Physicians // Arch. Intern. Med. 2007. V. 167(14). P. 1533-1538.

75. Nelson J.C., Weiss R.M. The effects of serum dilution on free thyroxine (T4) concentration in the low T4 syndrome of nonthyroidal illness // J. Clin. Endocrinol. Metab. 1985. V. 61. P. 239-46.

76. Nissim M., Giorda G., Ballabio M. et al. Maternal thyroid function in early and late pregnancy // Horm. Res. 1991. V. 36. P. 196-202.

77. Nohr S.B., Jorgensen A., Pedersen K.M. et al. Postpartum thyroid dysfunction in pregnant TPOAb-positive women living in an area with mild to moderate iodine deficiency- is iodine supplementation safe? // J. Clin. Endocrinol. Metab. 2000. V. 85. P. 3191-3198.

78. Norden A.G.M., Jackson R.A., Norden L.E. et al. Misleading results for immunoassays of serum free thyroxine in the presence of rheumatoid factor // Clin. Chem. 1997. V. 43. P. 957-962.

79. Pallas D., Koutras D.A., Adamopoulos P. et al. Increased mean serum thyrotropin in apparently euthyroid hypercholesterolemic patients: does it mean occult hypothyroidism? // J. Endocrinol. Invest. 1991. V. 14(9). P. 743-746.

80. Panesar N.S., Li C.Y., Rogers M.S. Reference intervals for thyroid hormones in pregnant Chinese women // Ann. Clin. Biochem. 2001. V. 38. P. 329-332.

81. Pekonen F., Alfthan H., Stenman U.H., Ylikorkala O. Human chorionic gonadotropin (hCG) and thyroid function in early human pregnancy: circadian variation and evidence for intrinsic thyrotropic activity of hCG // J. Clin. Endocrinol. Metab. 1988. V. 66. P. 853-856.

82. Persani L., Terzolo M., Asteria C. et al. Circadian variations of thyrotropin bioactivity in normal subjects and patients with primary hypothyroidism // J. Clin. Endocrinol. Metab. 1995. V. 80. P. 2722-2728.

83. Peteranderl C., Antonijevic I.A., Steiger A. et al. Nocturnal secretion of TSH and ACTH in male patients with depression and healthy controls // J. Psychiatr. Res. 2002. V. 36(3). P. 189-96.

84. Piketty M.L., D’Herbomez M., Le Guillouzic D. et al. Clinical comparision of three labeled-antibody immunoassays of free triiodothyronine // Clin. Chem. 1996. V. 42. P. 933-941.

85. Rao M.L., Gross G., Strebel B. et al. Circadian rhythm of tryptophan, serotonin, melatonin, and pituitary hormones in schizophrenia // Biol. Psychiatry. 1994. V. 35(3). P. 151-163.

86. Ritter D., Stott R., Grant N., Nahm M.H. Endogenous antibodies that interfere with Thyroxine fluorescence polarization assay but not with radioimmunoassay or EMIT // Clin. Chem. 1993. V. 39. P. 508-11.

87. Romijn J.A., Adriaanse R., Brabant G. Pulsatile secretion of thyrotropin during fasting: a decrease of thyrotropin pulse amplitude // J. Clin. Endocrinol. Metab. 1990. V. 70. P. 1631-1636.

88. Rose S.R. Cranial irradiation and central hypothyroidism. // TRENDS Endocrinol. Metab. 2001. V. 12. N 3. P. 97-104.

89. Rose S.R. et al. Diagnosis of hidden central hypothyroidism in survivors of childhood cancer // J. Clin. Endocrinol. Metab. 1999. V. 84. P. 4472-4479.

90. Rose S.R. Isolated central hypothyroidism in short stature // Pediatr. Res. 1995. V. 38. P. 967-973.

91. Russell W., Harrison R.F., Smith N. et al. Free triiodothyronine has a distinct circadian rhythm that is delayed but parallels thyrotropin levels // J. Clin. Endocrin. Metab. 2008. V. 93(6). P. 2300-2306.

92. Samuels M.H., McDaniel P.A. Thyrotropin levels during hydrocortisone infusions that mimic fasting-induced cortisol elevations: a clinical research center study // J. Clin. Endocrinol. Metab. 1997. V. 82. P. 3700-3704.

93. Sapin R., Schliener J.L., Kaltenbach G. et al. Determination of free triiodothyronine by six different methods in patients with non-thyroidal illness and in patients treated with amiodarone // Ann. Clin. Biochem. 1995. V. 32. P. 314-324.

94. Saravanan P., Siddique H. et al. Twenty-four hour hormone profiles of TSH, Free T3 and free T4 in hypothyroid patients on combined T3/T4 therapy. // Exp. Clin. Endocrinol. Diabetes. 2007. V. 115(4). P. 261-267.

95. Scobbo R.R., VonDohlen T.W., Hassan M., Islam S. Serum TSH variability in normal individuals: the influence of time of sample collection // W. V. Med. J. 2004. V. 100(4). P. 138-42.

96. Spencer C.A., Takeuchi M., Kazarosyan M. Current status and performance goals for serum thyrotropin (TSH) assays // Clin. Chem. 1996. V. 42. P. 141-145.

97. Stockigt J.R. Guidelines for diagnosis and monitoring of thyroid disease: nonthyroidal illness // Clin. Chem. 1996. V. 42. P. 188.

98. Surks M., Goswami G., Daniels G. The Thyrotropin Reference Range Should Remain Unchanged // J. Clin. Endocrinol. Metab. 2005. V. 90(9). P. 5489-5496.

99. Surks M., Sievert R. Drugs and thyroid function. // NEJM. 1995. V. 333. P. 1688-1694.

100. Talbot J.A., Lambert A., Anobile C.J. et al. The nature of human chorionic gonadotropin glycoforms in gestational thyrotoxicosis // Clin. Endocrinol. 2001. V. 55. P. 33-39.

101. Walsh J.P., Ward L.C., Burke V. et al. Small changes in thyroxine dosage do not produce measurable changes in hypothyroid symptoms, well-being, or quality of life: results of a double-blind, randomized clinical trial // J. Clin. Endocrinol. Metab. 2006. V. 91(7). P. 2624-2630.

102. Wartofsky L. and Dickey R.A. The Evidence for a Narrower Thyrotropin Reference Range Is Compelling // J. Clin. Endocrinol. Metab. 2005. V. 90. P. 5483-5488.

103. Wassen F., Moerings E., Van Toor H. et al. Effects of Interleukin-IP on Thyrotropin Secretion and Thyroid Hormone Uptake in Cultured Rat Anterior Pituitary Cells // Endocrinol. 1996. V. 137(5). P. 1591-1598.

104. Weeke J., Dybkjaer L., Granlie K et al. A longitudinal study of serum TSH and total and free iodothyronines during normal pregnancy // Acta Endocrinol. 1982. V. 101. P. 531-537.

105. Weeke J., Gundersen H.J. Circadian and 30 minutes variations in serum TSH and thyroid hormones in normal subjects // Acta Endocrinol. 1978. V. 89. P. 659-672.

106. Weeke J., Laurberg P. Diural TSH variations in hypothyroidism // J. Clin. Endocrinol. Metab. 1996. V. 43. P. 32-37.

107. Weibel L., Brandenberger G., Goichot B., Spiegel K., Ehrhart J., Follenius M. The circadian thyrotropin rhythym is delayed in regular night workers // Neurosci Lett. 1995. V. 187. P. 83-86.

108. Vanderpump M.P., Tunbridge W.M., French J.M. et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey // Clin. Endocrinol. 1995. V. 43. N 1. P. 55-68.

109. Zimmermann R.C., Krahn L.E., Klee G.G. et al. Prolonged inhibition of presynaptic catecholamine synthesis with alpha-methylpara-tyrosine attenuates the circadian rhythm of human TSH secretion // J. Soc. Gynecol. Investig. 2001. V. 8(3). Р. 174-178.

Для цитирования:

Sviridonova M.A., Fadeyev V.V. ЗНАЧЕНИЕ ВАРИАБЕЛЬНОСТИ УРОВНЯ ТТГ В КЛИНИЧЕСКОЙ ПРАКТИКЕ. Клиническая и экспериментальная тиреоидология. 2008;4(4):16-24.

For citation:

., . Clinical Significace of Thyrotropin Variability. Clinical and experimental thyroidology. 2008;4(4):16-24. (In Russ.)

Просмотров: 21

Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.

ISSN 1995-5472 (Print)
ISSN 2310-3787 (Online)