Fu Jinyan, Yang Anqiang, Zhao Jun, Zhu Yunlong, Gu Ying, Xu Yaohui, Chen Daozhen
Department of Obstetrics, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China.
Department of Pathology, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China.
J Trace Elem Med Biol. 2017 Sep;43:148-152. doi: 10.1016/j.jtemb.2017.01.004. Epub 2017 Jan 22.
Our objective was to evaluate the relationship between iron level and thyroid function during the first trimester of pregnancy in Eastern China. This was a hospital-based, cross-sectional observational study. A total of 1764 pregnant women were enrolled during their first trimester of gestation in Wuxi city. Serum ferritin (SF), hemoglobin (Hb), urinary iodine concentrations (UIC), thyroid-stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) were measured and evaluated in pregnant women. The median of TSH,FT4 and FT3 were 1.53mIU/L,10.43pmol/L and 4.50pmol/L respectively. The median UIC was 200μg/L and the median Hb was 126g/L. Of all the women, 1.76% of the subjects had iron deficiency anaemia (IDA) (SF<20μg/L and Hb<105g/L), and 39.06% of the population had iron deficiency (ID) (SF<15μg/L). Compared with SF>100μg/L group, the FT4 level was significantly lower in SF<20μg/L group (P=0.031) and in SF 20-100μg/L group (P=0.048). The TSH value of SF>20μg/L group was significantly higher than that in SF 20-100μg/L group (P=0.038) and SF>100μg/L group(P=0.034). There was an inverse linear relationship between TSH and FT4 after log transformation (r=0.245,P=0.000). Moreover, spearman's correlation analysis showed that UIC were correlated with SF and FT3 (all P<0.001) and iodine status more than adequate was associated with reduced serum ferritin concentration and FT3 levels. Thus, it is recommended that iron deficiency and iron deficiency anaemia shoud be evaluated and treated to combat thyroid dysfunction during the first trimester of pregnancy, Meanwhile, an increased attention should be paid on iodine nutritional status among this pregnant women simultaneous iron deficiency and thyroid dysfunction.
我们的目的是评估中国东部地区妊娠早期铁水平与甲状腺功能之间的关系。这是一项基于医院的横断面观察性研究。无锡市共有1764名孕妇在妊娠早期入组。对孕妇进行血清铁蛋白（SF）、血红蛋白（Hb）、尿碘浓度（UIC）、促甲状腺激素（TSH）、游离甲状腺素（FT4）和游离三碘甲状腺原氨酸（FT3）的检测和评估。TSH、FT4和FT3的中位数分别为1.53mIU/L、10.43pmol/L和4.50pmol/L。UIC的中位数为200μg/L，Hb的中位数为126g/L。在所有女性中，1.76%的受试者患有缺铁性贫血（IDA）（SF<20μg/L且Hb<105g/L），39.06%的人群患有缺铁（ID）（SF<15μg/L）。与SF>100μg/L组相比，SF<20μg/L组（P=0.031）和SF 20-100μg/L组（P=0.048）的FT4水平显著降低。SF>20μg/L组的TSH值显著高于SF 20-100μg/L组（P=0.038）和SF>100μg/L组（P=0.034）。对数转换后TSH与FT4之间存在负线性关系（r=0.245，P=0.000）。此外，Spearman相关性分析表明，UIC与SF和FT3相关（所有P<0.001），碘状态充足与血清铁蛋白浓度和FT3水平降低有关。因此，建议在妊娠早期评估和治疗缺铁和缺铁性贫血以对抗甲状腺功能障碍，同时，应更加关注同时存在缺铁和甲状腺功能障碍的孕妇的碘营养状况。
