Royal Victoria Hospital (Regional Centre for Endocrinology and Diabetes), Belfast, Antrim, UK.
Royal Jubilee Maternity Hospital, Royal Victoria Hospital, Belfast, Antrim, UK.
Eur J Clin Nutr. 2022 Nov;76(11):1542-1547. doi: 10.1038/s41430-022-01144-z. Epub 2022 May 5.
Iodine deficiency has re-emerged among pregnant cohorts in the UK. Thyroglobulin (Tg) is a protein produced uniquely by the thyroid gland which appears to mount a U-shaped response to extremes of iodine status. Tg has been suggested as an alternative marker for chronic iodine deficiency but the value of Tg in pregnancy has not been fully elucidated. A recent non-European study suggested a median Tg ≤10 µg/L with <3% of values >44 µg/L was indicative of sufficiency in the second trimester of pregnancy.
We measured serum Tg levels in each trimester in 241 pregnant women living in Northern Ireland, a population with mild iodine deficiency at all stages of pregnancy as defined by urinary iodine concentration (UIC) and iodine: creatinine ratio (ICR). Women with Tg antibodies (6% in 1st trimester) were excluded.
The median UIC in this cohort was in the deficient range at 73, 94 and 117 µg/L in sequential trimesters (adequacy ≥ 150 µg/L). Corresponding median Tg levels were 19, 16 and 16 µg/L respectively. Median Tg for all samples was 17 μg/L (IQR 11-31) suggestive of iodine deficiency. Tg was >44 μg/L in 14.3%, 9.4% and 12.4% of women in sequential trimesters respectively. Women with either UIC/ICR below the cut-offs 150 µg/L and 150 µg/g creatinine had higher Tg concentrations in 1st and 2nd trimester (p < 0.01; p < 0.001) but not in 3rd trimester.
This study adds to the evolving evidence that Tg measurement is of value in reflecting iodine status in pregnancy.
在英国，孕妇群体中碘缺乏问题再次出现。甲状腺球蛋白（Tg）是甲状腺特有的一种蛋白质，其含量似乎对碘营养状态的极端情况呈 U 型反应。Tg 已被提议作为慢性碘缺乏的替代标志物，但 Tg 在妊娠中的价值尚未完全阐明。最近一项非欧洲研究表明，中位数 Tg≤10μg/L，且 <3%的 Tg 值>44μg/L，提示妊娠中期碘充足。
我们测量了 241 名居住在北爱尔兰的孕妇在每个孕期的血清 Tg 水平，这些孕妇在整个孕期的碘营养状态均处于碘缺乏状态，根据尿碘浓度（UIC）和碘：肌酐比值（ICR）来定义。排除 Tg 抗体阳性的女性（1 孕期占 6%）。
该队列的中位数 UIC 在孕期分别为 73、94 和 117μg/L（充足范围≥150μg/L），相应的中位数 Tg 水平分别为 19、16 和 16μg/L。所有样本的中位数 Tg 为 17μg/L（11-31），提示碘缺乏。1 孕期、2 孕期和 3 孕期分别有 14.3%、9.4%和 12.4%的女性 Tg 值>44μg/L。UIC/ICR 低于 150μg/L 和 150μg/g 肌酐的切点的女性，其 1 孕期和 2 孕期的 Tg 浓度较高（p<0.01；p<0.001），但在 3 孕期则没有。
本研究进一步证实，Tg 测量在反映妊娠期间碘营养状况方面具有价值。
