Li Shuxiang, Gao Xin, Wei Yancai, Zhu Gengchao, Yang Chen
Department of Nuclear Medicine, Suzhou Hospital Affiliated to Nanjing Medical University.
J Nutr Sci Vitaminol (Tokyo). 2016;62(6):397-401. doi: 10.3177/jnsv.62.397.
Previous studies have identified an association between iron deficiency and thyroid function. We aimed to determine if there is a relationship between iron deficiency and thyroid function during the first trimester of pregnancy. Two thousand five hundred eighty-one pregnant women who presented for the first prenatal care were enrolled and divided into three groups, the mild iron deficiency (MID) group, iron deficiency anemia (IDA) group and normal control (NC) group, according to serum ferritin and hemoglobin levels. The former two groups can be merged into one iron deficiency (ID) group. Thyroid function parameters were compared among the three groups, including free thyroxine (FT4), thyroid stimulating hormone (TSH), total thyroxine (TT4) and thyroid peroxidase antibodies (TPOAb). Moreover, the rates of thyroid dysfunction were also compared. Our results show that pregnant women in the MID and IDA groups have higher TSH and lower FT4 status than those in the NC group (p<0.01), and the difference between the IDA group and MID group is significant (p<0.05). TPOAb in the IDA group is higher than in the MID group and NC group. Meanwhile, the rate of hypothyroidism or subclinical hypothyroidism in the IDA group was significantly higher than in the MID group and NC group (p<0.01). And the positive rate of TPOAb is also higher in the IDA group than MID group and NC group (p<0.05). Iron deficiency is related to thyroid function and could lead to hypothyroidism during early pregnancy, which could be explained by thyroid autoimmunity.
既往研究已证实缺铁与甲状腺功能之间存在关联。我们旨在确定妊娠早期缺铁与甲状腺功能之间是否存在关系。招募了2581名前来进行首次产前检查的孕妇,并根据血清铁蛋白和血红蛋白水平将其分为三组,即轻度缺铁(MID)组、缺铁性贫血(IDA)组和正常对照组(NC)组。前两组可合并为一个缺铁(ID)组。比较了三组之间的甲状腺功能参数,包括游离甲状腺素(FT4)、促甲状腺激素(TSH)、总甲状腺素(TT4)和甲状腺过氧化物酶抗体(TPOAb)。此外,还比较了甲状腺功能障碍的发生率。我们的结果显示,MID组和IDA组孕妇的TSH水平高于NC组,FT4水平低于NC组(p<0.01),IDA组与MID组之间的差异具有统计学意义(p<0.05)。IDA组的TPOAb高于MID组和NC组。同时,IDA组甲状腺功能减退或亚临床甲状腺功能减退的发生率显著高于MID组和NC组(p<0.01)。并且IDA组TPOAb的阳性率也高于MID组和NC组(p<0.05)。缺铁与甲状腺功能相关,且可能导致妊娠早期甲状腺功能减退,这可能由甲状腺自身免疫来解释。