妊娠期间 24 小时尿肌酐排泄及其在 24 小时尿碘排泄的适当估计中的应用。
24 h urinary creatinine excretion during pregnancy and its application in appropriate estimation of 24 h urinary iodine excretion.
机构信息
Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, National Health and Family Planning Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology (23618504), Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin, 150086 Heilongjiang, China; The Fourth Affiliated Hospital of Harbin Medical University, Department of Obstetrics and Gynecology, Harbin, 150001 Heilongjiang, China.
The Fourth Affiliated Hospital of Harbin Medical University, Department of Obstetrics and Gynecology, Harbin, 150001 Heilongjiang, China.
出版信息
J Trace Elem Med Biol. 2021 Jul;66:126751. doi: 10.1016/j.jtemb.2021.126751. Epub 2021 Mar 26.
BACKGROUND
Urinary creatinine can be used to adjust urinary iodine to evaluate iodine nutritional status during pregnancy. However, the reference intervals and impact factors of urinary creatinine are unknown.
METHODS
24 h urine creatinine concentration (24 hUCr) and spot UCr at four different time periods of the day of pregnant women from Part 1 (n = 743) were measured. Linear regression analysis was performed to identify the impact factors of 24 h urinary creatinine excretion (24 hUCrE) and obtain the estimated 24 h urinary creatinine excretion (24 hUCrE). Then measured urinary iodine concentration (UIC) of 24 h and at fasting of pregnant women from Part 2 (n = 325), used spot urinary iodine to creatinine concentration ratio (UIC/UCr) and 24 hUCrE to calculate the estimated 24 h urinary iodine excretion (24 hUIE), finally checked the consistency and correlation of 24 hUIE and 24 h urinary iodine excretion (24 hUIE).
RESULTS
In Part 1, the median 24 hUCrE was 1.24(IQR0.98-1.76)g, and the reference interval was 0.61-2.93 g. The median 24 hUCr was 0.76 (IQR0.57-1.01)g/L, and the reference interval was 0.36-1.88 g/L. Multiple linear regression results showed that pregnancy weight was an influencing factor to 24 hUCrE after adjusting by gestational weeks, age, pre-pregnancy BMI, and percentage of body fat (F = 45.029, p＜0.001). In Part 2, there was no statistically significant difference between 24 hUIE and 24 hUIE (Z =-0.767, p = 0.443). Using 24hUIE as the gold standard, the relative average difference in 24hUIE was 4.2 %, the relative average differences for UIC and UIC/UCr were 32.4 % and 37.2 %. The reference interval of 24 hUIE and 24 hUIE were 88.43-585.90 μg and 50.97-700.39 μg, respectively.
CONCLUSIONS
The reference intervals of 24 hUCrE, spot UCr, 24 hUIE, and 24 hUIE during pregnancy were established. 24 hUCrE has important application value in iodine nutrition evaluation to gain more lead time for pregnant women with iodine nutrition-related diseases.
背景
尿肌酐可用于校正尿碘，以评估妊娠期间的碘营养状况。然而，尿肌酐的参考区间和影响因素尚不清楚。
方法
分别对第 1 部分（n = 743）中孕妇的 24 小时尿肌酐浓度（24 hUCr）和 4 个不同时间点的晨尿肌酐进行测量，对 24 小时尿肌酐排泄量（24 hUCrE）的影响因素进行线性回归分析，并获得估计的 24 小时尿肌酐排泄量（24 hUCrE）。然后对第 2 部分（n = 325）中孕妇的 24 小时尿碘浓度（UIC）和空腹时的尿碘肌酐浓度比（UIC/UCr）进行测量，用估计的 24 小时尿肌酐排泄量（24 hUCrE）计算估计的 24 小时尿碘排泄量（24 hUIE），最后检查 24 hUIE 和 24 小时尿碘排泄量（24 hUIE）的一致性和相关性。
结果
在第 1 部分中，24 hUCrE 的中位数为 1.24（IQR0.98-1.76）g，参考区间为 0.61-2.93 g。24 hUCr 的中位数为 0.76（IQR0.57-1.01）g/L，参考区间为 0.36-1.88 g/L。多元线性回归结果显示，妊娠体重是调整孕周、年龄、孕前 BMI 和体脂百分比后影响 24 hUCrE 的因素（F = 45.029，p＜0.001）。在第 2 部分中，24 hUIE 与 24 hUIE 之间无统计学差异（Z =-0.767，p = 0.443）。以 24 hUIE 为金标准，24 hUIE 的相对平均差异为 4.2%，UIC 和 UIC/UCr 的相对平均差异分别为 32.4%和 37.2%。24 hUIE 和 24 hUIE 的参考区间分别为 88.43-585.90 μg 和 50.97-700.39 μg。
结论
建立了妊娠期间 24 hUCrE、晨尿肌酐、24 hUIE 和 24 hUIE 的参考区间。24 hUCrE 在评估碘营养状况方面具有重要的应用价值，可以为孕妇的碘营养相关疾病争取更多的治疗时间。
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