Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China.
Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine, Boston, USA.
Biol Trace Elem Res. 2019 Jul;190(1):52-59. doi: 10.1007/s12011-018-1530-8. Epub 2018 Oct 2.
Pregnant women are more vulnerable to iodine deficiency and iodine excess. The study aimed to assess the changes in iodine nutrition and thyroid function of pregnant women exposed to different iodine sources resulting in various iodine intakes during pregnancy. From 2016 to 2017, 2004 healthy pregnant women aged 20-35 years from Shandong and Tianjin, China, were enrolled. Urinary iodine concentration (UIC), drinking water iodine content (WIC), thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroid hormone (FT4), thyroglobulin (Tg), serum thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured. Pregnant women in both Shandong and Tianjin were iodine sufficient, but the median UIC in pregnant women was significantly higher in Shandong (244 μg/L) than that in Tianjin (159 μg/L). No differences were found in UIC over the course of gestation in Shandong. In Tianjin, the UIC decreased during 13-24 weeks and stabilized thereafter. Compared with Tianjin, TSH levels were higher and FT3 and FT4 levels were lower in Shandong. Both FT3 and FT4 significantly decreased during pregnancy in Shandong and Tianjin. TSH and Tg increased over the course of gestation in both Shandong and Tianjin. The iodine status of pregnant women in Tianjin and Shandong were sufficient, but different changing patterns in UIC and thyroid function during pregnancy were presented. More attention should be focused on iodine nutrition of pregnant women, even in iodine-sufficient areas.
孕妇更容易受到碘缺乏和碘过量的影响。本研究旨在评估暴露于不同碘源的孕妇在怀孕期间因不同碘摄入量而导致的碘营养和甲状腺功能变化。2016 年至 2017 年,共纳入来自中国山东和天津的 2004 名 20-35 岁健康孕妇。检测尿碘浓度(UIC)、饮用水碘含量(WIC)、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、甲状腺球蛋白(Tg)、血清甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TgAb)。山东和天津的孕妇均为碘充足,但山东孕妇的 UIC 中位数(244μg/L)明显高于天津(159μg/L)。山东孕妇在整个孕期的 UIC 无差异。天津孕妇的 UIC 在 13-24 周时下降,之后稳定。与天津相比,山东孕妇的 TSH 水平较高,FT3 和 FT4 水平较低。山东孕妇的 FT3 和 FT4 在整个孕期均显著降低,天津孕妇的 FT3 和 FT4 也呈降低趋势。山东和天津孕妇的 TSH 和 Tg 在整个孕期均升高。天津和山东孕妇的碘营养状况充足,但在孕期 UIC 和甲状腺功能的变化模式不同。即使在碘充足地区,也应更加关注孕妇的碘营养。