Heikkinen Anna-Leena, Päkkilä Fanni, Hartikainen Anna-Liisa, Vääräsmäki Marja, Männistö Tuija, Suvanto Eila
Department of Obstetrics and Gynecology, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, 90029 OYS, Finland.
Medical Research Center Oulu, Oulu University Hospital and University of Oulu, 90014 Oulu, Finland.
J Clin Endocrinol Metab. 2017 Nov 1;102(11):4184-4190. doi: 10.1210/jc.2017-01137.
The objective of this study was to determine the effects of maternal thyroid dysfunction or antibodies during pregnancy on the cardiometabolic risk factors in children.
DESIGN, SETTING, AND PARTICIPANTS: This prospective population-based cohort study, Northern Finland Birth Cohort 1986, included all pregnancies within a year in the area. Maternal serum samples were collected before the 20th week of gestation and analyzed for thyrotropin, free T4, thyroid-peroxidase antibodies (TPO-Abs), and thyroglobulin antibodies (Tg-Abs). Cardiometabolic risk factors in children at the age of 16 years were evaluated via blood sampling and clinical examination. Data were available for 3229 to 4176 mother-child pairs.
Waist circumference, blood pressure, lipids and lipoproteins, and insulin resistance were measured. Odds ratios (ORs) with 95% confidence intervals (CIs) of cardiometabolic risk factors in children with and without mothers with thyroid dysfunction or antibodies were calculated with logistic regression and adjusted for covariates.
Children of TPO-Ab-positive mothers had higher odds of metabolic syndrome (OR, 2.57; 95%, CI 1.26 to 5.25) and waist circumference indicative of metabolic syndrome (OR, 1.69; 95% CI, 1.14 to 2.50). They were also more likely to be overweight or obese (OR, 1.56; 95% CI, 1.04 to 2.34). Maternal thyroid dysfunction or Tg-Ab positivity did not associate with cardiometabolic risk factors in children.
Metabolic syndrome, greater waist circumference, and higher body mass index were more prevalent in children of TPO-Ab-positive mothers, indicating an adverse cardiovascular health profile.
本研究的目的是确定孕期母亲甲状腺功能障碍或抗体对儿童心脏代谢危险因素的影响。
设计、地点与参与者：这项基于人群的前瞻性队列研究——1986年芬兰北部出生队列，纳入了该地区一年内的所有妊娠。在妊娠20周前采集母亲血清样本，分析促甲状腺激素、游离T4、甲状腺过氧化物酶抗体（TPO-Ab）和甲状腺球蛋白抗体（Tg-Ab）。通过采血和临床检查评估16岁儿童的心脏代谢危险因素。有3229至4176对母婴的数据可供使用。
测量腰围、血压、血脂和脂蛋白以及胰岛素抵抗。采用逻辑回归计算有或没有甲状腺功能障碍或抗体母亲的儿童心脏代谢危险因素的比值比（OR）及其95%置信区间（CI），并对协变量进行调整。
TPO-Ab阳性母亲的孩子患代谢综合征的几率更高（OR，2.57；95%CI，1.26至5.25），且腰围提示代谢综合征（OR，1.69；95%CI，1.14至2.50）。他们也更有可能超重或肥胖（OR，1.56；95%CI，1.04至2.34）。母亲甲状腺功能障碍或Tg-Ab阳性与儿童心脏代谢危险因素无关。
TPO-Ab阳性母亲的孩子中代谢综合征、更大的腰围和更高的体重指数更为普遍，表明心血管健康状况不佳。
