Hofstee Pierre, James-McAlpine Janelle, McKeating Daniel R, Vanderlelie Jessica J, Cuffe James S M, Perkins Anthony V
School of Medical Science, Griffith University Gold Coast Campus, Southport, Queensland, Australia.
School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia.
J Endocrinol. 2021 Jan;248(1):45-57. doi: 10.1530/JOE-20-0319.
Thyroid disorders are the most common endocrine disorders affecting women commencing pregnancy. Thyroid hormone metabolism is strongly influenced by selenium status; however, the relationship between serum selenium concentrations and thyroid hormones in euthyroid pregnant women is unknown. This study investigated the relationship between maternal selenium and thyroid hormone status during pregnancy by utilizing data from a retrospective, cross-sectional study (Maternal Outcomes and Nutrition Tool or MONT study) with cohorts from two tertiary care hospitals in South East Queensland, Australia. Pregnant women (n = 206) were recruited at 26-30 weeks gestation and serum selenium concentrations were assessed using inductively coupled plasma mass spectrometry. Thyroid function parameters were measured in serum samples from women with the lowest serum selenium concentrations (51.2 ± 1.2 µg/L), women with mean concentrations representative of the entire cohort (78.8 ± 0.4 µg/L) and women with optimal serum selenium concentrations (106.9 ± 2.3 µg/L). Women with low serum selenium concentrations demonstrated reduced fT3 levels (P < 0.05) and increased TPOAb (P < 0.01). Serum selenium was positively correlated with fT3 (P < 0.05) and negatively correlated with TPOAb (P < 0.001). Serum fT4 and thyroid-stimulating hormone (TSH) were not different between all groups, though the fT4/TSH ratio was increased in the low selenium cohort (P < 0.05). Incidence of pregnancy disorders, most notably gestational diabetes mellitus, was increased within the low serum selenium cohort (P < 0.01). These results suggest selenium status in pregnant women of South East Queensland may not be adequate, with possible implications for atypical thyroid function and undesirable pregnancy outcomes.
甲状腺疾病是影响妊娠女性的最常见内分泌疾病。甲状腺激素代谢受硒状态的强烈影响；然而，甲状腺功能正常的孕妇血清硒浓度与甲状腺激素之间的关系尚不清楚。本研究利用澳大利亚昆士兰州东南部两家三级护理医院队列的一项回顾性横断面研究（孕产妇结局与营养工具或MONT研究）的数据，调查了孕期母体硒与甲状腺激素状态之间的关系。在妊娠26 - 30周时招募孕妇（n = 206），并使用电感耦合等离子体质谱法评估血清硒浓度。对血清硒浓度最低的女性（51.2 ± 1.2 µg/L）、代表整个队列平均浓度的女性（78.8 ± 0.4 µg/L）以及血清硒浓度最佳的女性（106.9 ± 2.3 µg/L）的血清样本进行甲状腺功能参数测量。血清硒浓度低的女性表现出fT3水平降低（P < 0.05）和TPOAb升高（P < 0.01）。血清硒与fT3呈正相关（P < 0.05），与TPOAb呈负相关（P < 0.001）。所有组之间血清fT4和促甲状腺激素（TSH）无差异，尽管低硒队列中的fT4/TSH比值升高（P < 0.05）。低血清硒队列中妊娠疾病的发生率增加，最显著的是妊娠期糖尿病（P < 0.01）。这些结果表明，昆士兰州东南部孕妇的硒状态可能不足，这可能对非典型甲状腺功能和不良妊娠结局产生影响。
