孕期铁状态与甲状腺激素水平的关系。

The association between iron status and thyroid hormone levels during pregnancy.

机构信息

School of Public Health, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.

Pingguo Maternal and Child Health Hospital, Baise, Guangxi, China.

出版信息

J Trace Elem Med Biol. 2022 Dec;74:127047. doi: 10.1016/j.jtemb.2022.127047. Epub 2022 Jul 22.

DOI:10.1016/j.jtemb.2022.127047

PMID:35930951

Abstract

BACKGROUND

Iron deficiency may be a risk factor for thyroid disorder; however, the relationship between iron deficiency and thyroid disorder as well as mechanism involved remain unclear.

METHODS

A hospital-based cross-sectional study was conducted to analyze the correlation between iron status and thyroid hormone levels in pregnant women. A total of 2218 pregnant women were recruited, and iron status and thyroid hormones were measured. Canonical correlation, Lasso regression, and Receiver operator characteristic (ROC) curve analysis were used to determine the association and related factors.

RESULTS

There were 219 cases with iron deficiency anemia (IDA), 168 cases with iron deficiency (ID), and 1831 subjects with normal iron status. Compared with normal group, free triiodothyronine (FT3) and free thyroxine (FT4) in ID group and IDA group had a significant decreasing trend (P < 0.05), with the lowest levels in IDA group. Thyroid stimulating hormone (TSH) was significantly increased in ID group and IDA group (P < 0.05). Moreover, the proportion of hypothyroidism in both ID group and IDA group was higher than the normal group, meanwhile the proportion of hyperthyroidism was lower in both groups (P < 0.05). Serum ferritin (SF) and hemoglobin (Hb) were positively correlated with FT3 and FT4 but negatively correlated with TSH. Correlation analysis indicated that iron status was associated with thyroid hormone levels (P < 0.05). Lasso regression analysis showed that SF, Hb and other variables could be included in the prediction model of FT4. The variables selected by Lasso model were used for ROC curve analysis, and the prediction accuracy was acceptable (AUC=0.778, P < 0.05).

CONCLUSION

Our study indicated that there is an association between iron status and thyroid hormone levels in pregnant women, and the level of FT4 may change with iron status. Our findings provide new ideas for regulating the thyroid hormone levels to prevent thyroid dysfunction during pregnancy.

摘要

背景

铁缺乏可能是甲状腺疾病的一个危险因素；然而，铁缺乏与甲状腺疾病之间的关系以及涉及的机制仍不清楚。

方法

进行了一项基于医院的横断面研究，以分析孕妇中铁状况与甲状腺激素水平之间的相关性。共招募了 2218 名孕妇，测量铁状况和甲状腺激素。使用典型相关分析、套索回归和接收者操作特征（ROC）曲线分析来确定关联和相关因素。

结果

有 219 例缺铁性贫血（IDA），168 例缺铁（ID），1831 例铁状态正常。与正常组相比，ID 组和 IDA 组的游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）均呈显著下降趋势（P<0.05），IDA 组水平最低。ID 组和 IDA 组的促甲状腺激素（TSH）显著升高（P<0.05）。此外，ID 组和 IDA 组的甲状腺功能减退症比例均高于正常组，而两组的甲状腺功能亢进症比例均较低（P<0.05）。血清铁蛋白（SF）和血红蛋白（Hb）与 FT3 和 FT4 呈正相关，与 TSH 呈负相关。相关性分析表明，铁状态与甲状腺激素水平相关（P<0.05）。套索回归分析显示，SF、Hb 和其他变量可被纳入 FT4 的预测模型。使用 Lasso 模型选择的变量进行 ROC 曲线分析，预测准确性可接受（AUC=0.778，P<0.05）。