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孕期中期血清铁蛋白和甲状腺功能的评估。

Evaluation of serum ferritin and thyroid function in the second trimester of pregnancy.

作者信息

He Leqi, Shen Chunmei, Zhang Yanan, Chen Zaoping, Ding Heyuan, Liu Jun, Zha Bingbing

机构信息

Department of Clinical Laboratory Medicine, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China.

Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China.

出版信息

Endocr J. 2018 Jan 30;65(1):75-82. doi: 10.1507/endocrj.EJ17-0253. Epub 2017 Oct 13.

Abstract

Ferritin is a universal intracellular protein that acts as an iron carrier. Several studies have indicated that iron deficiency affects thyroid function in non-pregnant women. Our objective was to assess the relationship between serum ferritin levels and thyroid function in pregnant women during the second trimester. Pregnant women with sufficient iodine intake and normal antithyroid antibodies during the second trimester were recruited from the obstetric outpatient department of the Fifth People's Hospital of Fudan University. Serum ferritin (SF) levels, thyroid function, anti-thyroid antibodies and vitamin B12 were determined by electrochemiluminescence immunoassay kit. Maternal serum iron (Fe), unsaturated iron binding capacity (UIBC), hemoglobin (Hb), creatinine (Cr), fasting blood glucose (FBG), and alanine aminotransferase (ALT) were also evaluated. Stepwise regressions performed to evaluate the associations between SF and other maternal parameters. In the second trimester, 11.4% pregnant women had a SF concentration less than 12 μg/L, and 7.6% pregnant women were anemic. SF levels were negatively correlated with serum TSH levels (r = -0.219, p < 0.05), and positively correlated with FT4 levels (r = 0.203, p < 0.05). Linear regression analysis showed only SF, age, week of gestation were significant predictors of regression with TSH as the dependent variable (β: -0.007, -0.059, and 0.118 respectively; all p < 0.05). However consistent relation between the SF levels and FT4 was not observed in stepwise linear regression. Maternal iron status is a determinant of TSH concentrations during pregnancy in pregnant women during the second trimester.

摘要

铁蛋白是一种作为铁载体的普遍存在的细胞内蛋白质。多项研究表明,缺铁会影响非孕妇的甲状腺功能。我们的目的是评估妊娠中期孕妇血清铁蛋白水平与甲状腺功能之间的关系。从复旦大学附属第五人民医院产科门诊招募了妊娠中期碘摄入充足且抗甲状腺抗体正常的孕妇。采用电化学发光免疫分析试剂盒测定血清铁蛋白(SF)水平、甲状腺功能、抗甲状腺抗体和维生素B12。还评估了孕妇血清铁(Fe)、不饱和铁结合能力(UIBC)、血红蛋白(Hb)、肌酐(Cr)、空腹血糖(FBG)和丙氨酸转氨酶(ALT)。进行逐步回归以评估SF与其他母体参数之间的关联。在妊娠中期,11.4%的孕妇SF浓度低于12μg/L,7.6%的孕妇贫血。SF水平与血清促甲状腺激素(TSH)水平呈负相关(r = -0.219,p < 0.05),与游离甲状腺素(FT4)水平呈正相关(r = 0.203,p < 0.05)。线性回归分析显示,仅SF、年龄、孕周是TSH作为因变量的回归的显著预测因素(β分别为-0.007、-0.059和0.118;均p < 0.05)。然而,在逐步线性回归中未观察到SF水平与FT4之间的一致关系。孕妇的铁状态是妊娠中期孕妇孕期TSH浓度的一个决定因素。

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