The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China.
Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.
Asia Pac J Clin Nutr. 2020;29(1):27-34. doi: 10.6133/apjcn.202003_29(1).0004.
Thyroglobulin (Tg) is considered a sensitive indicator of iodine status for children and adults, but its usefulness for pregnant women is unknown. The aim of this study was attempting to explore the relationship between Tg and iodine status and the association between elevated Tg and thyroid diseases.
A total of 2163 pregnant women were recruited in this study. The ratio of urine iodine concentration and urine creatinine concentration (UI/Cr) was measured in spot urine samples. Serum thyroid hormones and thyroglobulin were measured. Thyroid nodules and thyroid volume were diagnosed by ultrasound.
The geometric mean of serum Tg was significantly higher in the UI/Cr <100 μg/g group (10.94 [2.47] μg/L) and the UI/Cr >500 μg/g group (11.48 [2.35] μg/L) than in the 150-249 μg/g group (9.64 [2.32] μg/L). The generalized linear model analysis showed that Serum log(10) Tg concentration was much higher in the UI/Cr <100 μg/g group (β=0.052, p=0.026) than in the 150-249 μg/g group. Multivariate logistic regression models demonstrated that elevated Tg may be a risk factor for both goiter (OR=8.30) and thyroid nodules (OR=2.73).
Pregnant women with UI/Cr <100 μg/g have a higher Tg, and those with elevated Tg concentrations have a higher risk of thyroid nodules and goiter. Tg can be a functional biomarker of iodine deficient, thyroid nodules and goiter.
甲状腺球蛋白（Tg）被认为是儿童和成人碘状态的敏感指标，但它在孕妇中的应用尚不清楚。本研究旨在探讨 Tg 与碘状态的关系，以及 Tg 升高与甲状腺疾病的关系。
本研究共纳入 2163 名孕妇。采用随机尿样测量尿碘浓度与尿肌酐浓度的比值（UI/Cr）。检测血清甲状腺激素和甲状腺球蛋白。采用超声诊断甲状腺结节和甲状腺体积。
UI/Cr<100μg/g 组（10.94[2.47]μg/L）和 UI/Cr>500μg/g 组（11.48[2.35]μg/L）的血清 Tg 几何均数明显高于 150-249μg/g 组（9.64[2.32]μg/L）。广义线性模型分析显示，UI/Cr<100μg/g 组血清 log(10)Tg 浓度明显高于 150-249μg/g 组（β=0.052，p=0.026）。多因素 logistic 回归模型表明，Tg 升高可能是甲状腺肿（OR=8.30）和甲状腺结节（OR=2.73）的危险因素。
UI/Cr<100μg/g 的孕妇 Tg 较高，且 Tg 浓度升高者甲状腺结节和甲状腺肿的风险更高。Tg 可能是碘缺乏、甲状腺结节和甲状腺肿的功能性生物标志物。
