Mahajan S D, Aalinkeel R, Singh S, Shah P, Gupta N, Kochupillai N
Department of Endocrinology & Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Horm Metab Res. 2005 Oct;37(10):633-40. doi: 10.1055/s-2005-870533.
Data on the effect of maternal malnutrition and/or anemia on thyroid hormone regulation in human fetuses are scarce, and would be of great importance in examining the relevance of Barker's hypothesis, which proposes adaptation of fetuses to undernutrition leading to permanent metabolic and endocrine changes that form the basis of adult diseases. To examine the quantitative variations in thyroid hormone profile of neonates born to malnourished and/or anemic mothers, we quantitated the T3, T4, rT3 and TSH levels in cord blood of neonates and maternal blood of their corresponding mothers that are malnourished and/or anemic. Further, we classified neonates born to each of these groups of mothers into Small for Gestational Age (SGA) or Appropriate for Gestational Age (AGA) based on the intrauterine growth curve for our population, and examined the thyroid hormone profile in these neonates. Our results show that firstly, the effects of malnutrition or anemia on thyroid hormone profile are distinct, secondly, significantly higher levels of cord blood T4 and correspondingly lower levels of T3 and rT3 are observed in the neonates born to anemic and malnourished mothers and thirdly, decreases in cord blood T3 levels were observed in Small for Gestational Age neonates born to anemic mothers. These observations lead us to speculate that alterations in the pituitary-thyroid function result in beneficial adaptations to the hostile intrauterine environment in malnutrition related growth retardation and anemia.
关于母体营养不良和/或贫血对人类胎儿甲状腺激素调节影响的数据很少，而这对于检验巴克假说的相关性非常重要，该假说提出胎儿会适应营养不良，从而导致永久性的代谢和内分泌变化，这些变化构成了成人疾病的基础。为了研究营养不良和/或贫血母亲所生新生儿甲状腺激素水平的定量变化，我们对营养不良和/或贫血母亲及其相应新生儿脐带血中的T3、T4、反T3和促甲状腺激素（TSH）水平进行了定量分析。此外，我们根据本群体的宫内生长曲线，将这些母亲所生的新生儿分为小于胎龄儿（SGA）或适于胎龄儿（AGA），并检测了这些新生儿的甲状腺激素水平。我们的结果表明，首先，营养不良或贫血对甲状腺激素水平的影响是不同的；其次，贫血和营养不良母亲所生新生儿的脐带血T4水平显著升高，相应地T3和反T3水平降低；第三，贫血母亲所生小于胎龄儿的脐带血T3水平降低。这些观察结果使我们推测，垂体-甲状腺功能的改变会导致在与营养不良相关的生长发育迟缓及贫血中对恶劣宫内环境产生有益的适应性变化。
