Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
Front Endocrinol (Lausanne). 2021 May 11;12:653680. doi: 10.3389/fendo.2021.653680. eCollection 2021.
The onset of puberty is influenced by thyroid function, and thyroid hormones (THs) fluctuate substantially during the period of pubertal development. However, it needs to be further clarified how THs change at specific puberty stages and how it influences pubertal development in girls. So far, longitudinal data from China are scarce.
A cohort study was conducted among girls during puberty in iodine-sufficient regions of East China between 2017 to 2019. Serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were determined for each participant. Thyroid homeostasis structure parameters (THSPs), including the ratio of FT4 to FT3 (FT4/FT3), Jostel's TSH index (TSHI), and thyroid feedback quantile-based index (TFQI), were calculated. Puberty category scores (PCS), calculated based on the Puberty Development Scale (PDS), was used to assess the stage of puberty. Girls were grouped into three categories according to PCS changes (△PCS) and six categories according puberty stage (BF: pre-pubertal at both baseline and follow-up; BF: pre-pubertal at baseline and late-pubertal at follow-up, respectively; BF: pre-pubertal at baseline and post-pubertal at follow-up, respectively; BF: late-pubertal at both baseline and follow-up; BF: late-pubertal at baseline and post-pubertal at follow-up, respectively; BF: post-pubertal at both baseline and follow-up). Multiple linear regression analyses were used to evaluate the associations of THs changes with pubertal progress.
The levels of serum TSH and FT3 decreased while serum FT4 increased during the study period (P<0.001). In multiple linear regression analyses, after adjustment for covariables, FT3 decreased by an additional 0.24 pmol/L (95% CI: -0.47 to -0.01) in the higher △PCS group than the lower △PCS group. Compared with the BF group, the BF group showed an additional decline in FT3 (β= -0.39 pmol/L, 95%CI: -0.73 to -0.04), the BF group showed a lower decline in TSH (β=0.50 mU/L, 95% CI: 0.21 to 0.80) and a lower decline in TSHI (β=0.24, 95%CI: 0.06 to 0.41), respectively. There was no association of △FT4 or △TFQI with △PCS or the puberty pattern.
Serum TSH and FT3 decreased while serum FT4 increased among girls during puberty. Both the initial stage and the velocity of pubertal development were related to thyroid hormone fluctuations.
青春期的启动受甲状腺功能的影响，甲状腺激素（THs）在青春期发育过程中会发生很大的波动。然而，仍需要进一步明确 THs 在特定青春期阶段如何变化，以及它如何影响女孩的青春期发育。到目前为止，中国的纵向数据还很缺乏。
在 2017 年至 2019 年期间，在中国东部碘充足地区进行了一项针对青春期女孩的队列研究。对每个参与者的血清促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）进行了测定。计算了甲状腺稳态结构参数（THSPs），包括 FT4/FT3 比值、Jostel 的 TSH 指数（TSHI）和基于甲状腺反馈定量的指数（TFQI）。根据青春期发育量表（PDS）计算的青春期类别评分（PCS）用于评估青春期阶段。根据 PCS 变化（△PCS）将女孩分为三组，根据青春期阶段（BF：基线和随访时均为青春期前；BF：基线时为青春期前，随访时为青春期晚期；BF：基线时为青春期前，随访时为青春期后；BF：基线和随访时均为青春期晚期；BF：基线时为青春期晚期，随访时为青春期后；BF：基线和随访时均为青春期后）将女孩分为六组。采用多元线性回归分析评估 THs 变化与青春期进展的关系。
研究期间，血清 TSH 和 FT3 水平降低，而血清 FT4 水平升高（P<0.001）。在多元线性回归分析中，在校正了协变量后，与低△PCS 组相比，高△PCS 组的 FT3 水平额外降低了 0.24 pmol/L（95%CI：-0.47 至-0.01）。与 BF 组相比，BF 组的 FT3 水平进一步降低（β=-0.39 pmol/L，95%CI：-0.73 至-0.04），TSH 水平进一步降低（β=0.50 mU/L，95%CI：0.21 至 0.80），TSHI 水平进一步降低（β=0.24，95%CI：0.06 至 0.41）。△FT4 或△TFQI 与△PCS 或青春期模式均无关联。
青春期女孩的血清 TSH 和 FT3 水平降低，而血清 FT4 水平升高。青春期的起始阶段和发育速度都与甲状腺激素的波动有关。
