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高氯酸盐和硫氰酸盐暴露对英格兰西南部孕妇甲状腺功能的影响:一项队列研究。

Effect of perchlorate and thiocyanate exposure on thyroid function of pregnant women from South-West England: a cohort study.

作者信息

Knight Bridget A, Shields Beverley M, He Xuemei, Pearce Elizabeth N, Braverman Lewis E, Sturley Rachel, Vaidya Bijay

机构信息

1NIHR Exeter Clinical Research Facility, Royal Devon & Exeter Hospital, University of Exeter Medical School, University of Exeter, Exeter, EX2 5DW UK.

2Research & Development Department, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK.

出版信息

Thyroid Res. 2018 Jul 6;11:9. doi: 10.1186/s13044-018-0053-x. eCollection 2018.

Abstract

BACKGROUND

Iodine is important for thyroid hormone synthesis, and iodine deficiency in pregnancy may impair fetal neurological development. As perchlorate and thiocyanate inhibit sodium-iodide symporter reducing the transport of iodine from circulation into the thyroid follicular cells, environmental exposure to these substances in pregnancy may impair maternal thyroid hormone synthesis. We aimed to explore the impact of perchlorate and thiocyanate exposure on thyroid status in a cohort of pregnant mothers from South West England.

METHODS

Urine samples were obtained from 308 women participating in a study of breech presentation in late pregnancy. They had no known thyroid disease and a singleton pregnancy at 36-38 weeks gestation. Samples were analysed for urinary concentrations of iodine (UIC), perchlorate (UPC) and thiocyanate (UTC). Blood samples were taken for free T4 (FT4), thyrotropin (TSH) and thyroid peroxidase antibodies (TPO-Ab). Baseline data included age, parity, smoking status, ethnicity and BMI at booking. Following delivery, data on offspring's sex, gestational age at birth and birthweight were collected.

RESULTS

Participants had a mean (SD) age 31 (5) years, median (IQR) BMI 24.4 (22.0, 28.3) kg/m, 42% were primiparous, 10% were smokers, and 96% were Caucasian. Median UIC was 88 μg/l, and 174/308 (57%) women had UIC < 100 μg/l. Log transformed UPC negatively correlated with FT4, but not with TSH, in the whole cohort ( = - 0.12,  = 0.03) and in the subgroup of women with UIC < 100 μg/l ( = - 0.15,  = 0.04). Regression analysis with the potential confounders (TPO-Ab status, UIC and UTC) identified UPC to be negatively associated with FT4 ( = 0.01). There was no correlation between UTC and FT4 or TSH. Maternal UPC or UTC was not associated with offspring birthweight.

CONCLUSION

Environmental perchlorate exposure is negatively associated with circulating FT4 levels in third trimester pregnant women. This may have an adverse impact on neurocognitive development of the fetus.

摘要

背景

碘对甲状腺激素合成至关重要,孕期碘缺乏可能损害胎儿神经发育。由于高氯酸盐和硫氰酸盐会抑制钠-碘同向转运体,减少碘从循环进入甲状腺滤泡细胞的转运,孕期环境暴露于这些物质可能损害母体甲状腺激素合成。我们旨在探讨高氯酸盐和硫氰酸盐暴露对英格兰西南部一组孕妇甲状腺状态的影响。

方法

从308名参与晚期妊娠臀位研究的女性中获取尿液样本。她们无已知甲状腺疾病,妊娠36 - 38周时为单胎妊娠。分析样本中尿碘浓度(UIC)、高氯酸盐(UPC)和硫氰酸盐(UTC)。采集血样检测游离T4(FT4)、促甲状腺激素(TSH)和甲状腺过氧化物酶抗体(TPO - Ab)。基线数据包括登记时的年龄、产次、吸烟状况、种族和体重指数。分娩后,收集关于后代性别、出生时孕周和出生体重的数据。

结果

参与者的平均(标准差)年龄为31(5)岁,体重指数中位数(四分位间距)为24.4(22.0,28.3)kg/m²,42%为初产妇,10%为吸烟者,96%为白种人。尿碘浓度中位数为88μg/l,174/308(57%)名女性的尿碘浓度<100μg/l。在整个队列中(r = - 0.12,P = 0.03)以及尿碘浓度<100μg/l的女性亚组中(r = - 0.15,P = 0.04),对数转换后的高氯酸盐与游离T4呈负相关,但与促甲状腺激素无关。对潜在混杂因素(TPO - Ab状态、尿碘浓度和硫氰酸盐)进行回归分析发现,高氯酸盐与游离T4呈负相关(P = 0.01)。硫氰酸盐与游离T4或促甲状腺激素之间无相关性。母体高氯酸盐或硫氰酸盐与后代出生体重无关。

结论

孕期环境暴露于高氯酸盐与孕晚期孕妇循环游离T4水平呈负相关。这可能对胎儿的神经认知发育产生不利影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7025/6035476/37c289215a1b/13044_2018_53_Fig1_HTML.jpg

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