Department of Endocrinology, Peking University International Hospital, Beijing, 102206, China.
Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, China.
Biol Trace Elem Res. 2022 Jun;200(6):2620-2628. doi: 10.1007/s12011-021-02887-9. Epub 2021 Sep 27.
Iodine is an essential trace element for humans and the main raw material for thyroid hormone synthesis. However, the association between iodine nutritional status and adverse pregnancy outcomes in different regions remains controversial. This single-center cohort study was focused on the association between iodine nutritional status and adverse pregnancy outcomes in Beijing, China. We enrolled 726 pregnant women who were registered at the Peking University International Hospital between February 2017 and December 2019. To analyze the association between iodine nutritional status variations and adverse pregnancy outcomes, this study cohort included 390 (53.72%) participants with iodine deficiency, 206 (28.37%) with an adequate iodine level, 103 (14.19%) with a more than adequate iodine level, and 27 (3.72%) with iodine excess, according to the urinary iodine (UI) status of pregnant women. After adjusting for age, body mass index, parity, and history of spontaneous abortion, we identified iodine deficiency as a risk factor for anti-thyroid peroxidase antibody (TPOAb) positivity [odds ratio (OR), 3.646; 95% confidence interval (95% CI), 1.658-8.017], anti-thyroglobulin antibody (TGAb) positivity (OR, 3.109; 95% CI, 1.465-6.599), and thyroid autoimmunity (OR, 2.885; 95% CI, 1.539-5.407). There was a non-linear relationship between UI and the concentrations of TPOAb and TGAb (P < 0.05). Iodine deficiency during the first trimester is a risk factor for thyroid autoantibody positivity. The relationship between UI and the concentrations of TPOAb and TGAb follows a nearly U-shaped curve. Thus, physicians should critically consider the iodine nutritional status of pregnant women during the first trimester. Clinical Trials.gov Identifier: NCT02966405.
碘是人体必需的微量元素,也是甲状腺激素合成的主要原料。然而,不同地区碘营养状况与不良妊娠结局的关系仍存在争议。本单中心队列研究旨在探讨中国北京地区碘营养状况与不良妊娠结局的关系。我们纳入了 2017 年 2 月至 2019 年 12 月期间在北京大学国际医院登记的 726 名孕妇。为了分析碘营养状况变化与不良妊娠结局的关系,本研究队列根据孕妇尿碘(UI)状况,将 390 例(53.72%)碘缺乏、206 例(28.37%)碘适宜、103 例(14.19%)碘超适宜和 27 例(3.72%)碘过量的孕妇纳入研究。在校正年龄、体重指数、产次和自然流产史后,我们发现碘缺乏是抗甲状腺过氧化物酶抗体(TPOAb)阳性的危险因素[比值比(OR),3.646;95%置信区间(95%CI),1.658-8.017]、抗甲状腺球蛋白抗体(TGAb)阳性(OR,3.109;95%CI,1.465-6.599)和甲状腺自身免疫(OR,2.885;95%CI,1.539-5.407)。UI 与 TPOAb 和 TGAb 浓度之间存在非线性关系(P<0.05)。孕早期碘缺乏是甲状腺自身抗体阳性的危险因素。UI 与 TPOAb 和 TGAb 浓度之间的关系呈近 U 型曲线。因此,医生在孕早期应慎重考虑孕妇的碘营养状况。临床试验注册编号:NCT02966405。