Departments of Endocrinology, Chongqing General Hospital, Chongqing 401147, China.
Departments of Science & Education, Chongqing General Hospital, Chongqing 401147, China.
Contrast Media Mol Imaging. 2022 Jul 20;2022:9716224. doi: 10.1155/2022/9716224. eCollection 2022.
Hypothyroidism is a systemic hypometabolic syndrome caused by the thyroxine resistance or a reduction in its extent. It is an endocrinopathy secondary to gestational diabetes and occurs usually without significant symptoms. This study explored the effect of bisphenol A (BPA)-mediated retinol-binding protein 4 (RBP-4) on pregnancy outcomes in a nonobese pregnant female with subclinical hypothyroidism. Three hundred nonobese pregnant females who had that established pregnancy files and had regular obstetric examinations from January 2021 to March 2022 were enrolled and classified with 100 cases in each group as early pregnancy (6-12 weeks of gestation), second-trimester (13-24 weeks of gestation), and third-trimester groups (25-36 weeks of gestation). Thirty pregnant women with subclinical hypothyroidism were selected as subjects, and another thirty pregnant women with normal thyroid function were selected as the normal control group. Thyroid function (thyroid-stimulating hormone (TSH), free triiodothyronine (FT), free T (FT), and thyroid peroxidase antibody (TPO-Ab)) was measured by immunoelectrochemiluminescence. The level of BPA in urine was determined by solid-phase extraction high-performance liquid chromatography-tandem mass spectrometry. Serum RBP4 levels were determined by enzyme-linked immunosorbent assay. The level of TSH in the third-trimester group was higher than that in the first- and second-trimester groups, while the levels of FT, FT, and TPO-Ab were lower than those in the other two groups ( ). TSH in the second-trimester group was higher than that in the first-trimester group, while FT, FT, and TPO-Ab levels were lower than those in the first-trimester group ( ). The levels of BPA and RBP4 in gestational diabetes mellitus and hypertension were higher than those in the nongestational period, and the levels of BPA and RBP4 in gestational intrahepatic cholestasis and anemia were higher than those in the nongestational period, and the levels of BPA and RBP4 in preterm delivery were higher than those in nongestational period ( ). Also, the level of urinary BPA in the hypothyroidism group was higher than that in the normal control group ( ) and the level of serum RBP4 in the hypothyroidism group was higher than that in the normal control group ( ). According to multivariate logistic regression analysis, age ≥30 years and the ascending BPA and RBP4 were risk factors for subclinical hypothyroidism during pregnancy in the nonobese female. BPA and RBP-4 are closely related to the pregnancy outcome of nonobese subclinical hypothyroidism in the pregnant female. The degree of BPA and RBP-4 in adverse pregnancy outcomes is increased, which is the risk factor for nonobese subclinical hypothyroidism.
甲状腺功能减退症是一种由甲状腺素抵抗或其程度降低引起的全身性代谢低下综合征。它是妊娠期糖尿病继发的内分泌疾病，通常没有明显的症状。本研究探讨了双酚 A (BPA) 介导的视黄醇结合蛋白 4 (RBP-4) 对非肥胖亚临床甲状腺功能减退症孕妇妊娠结局的影响。纳入了 2021 年 1 月至 2022 年 3 月期间建立妊娠档案并进行常规产科检查的 300 名非肥胖孕妇，并将其分为早孕期（妊娠 6-12 周）、中孕期（妊娠 13-24 周）和晚孕期（妊娠 25-36 周）组，每组 100 例。选择 30 例亚临床甲状腺功能减退症孕妇作为研究对象，选择 30 例甲状腺功能正常的孕妇作为正常对照组。采用电化学发光免疫法检测甲状腺功能（促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT）、游离甲状腺素（FT）和甲状腺过氧化物酶抗体（TPO-Ab））。采用固相萃取高效液相色谱-串联质谱法测定尿液中 BPA 的水平。采用酶联免疫吸附法测定血清 RBP4 水平。晚孕期组 TSH 水平高于早孕期和中孕期组，FT、FT 和 TPO-Ab 水平低于其他两组（ ）。中孕期组 TSH 高于早孕期组，FT、FT 和 TPO-Ab 水平低于早孕期组（ ）。妊娠期糖尿病和高血压患者的 BPA 和 RBP4 水平高于非妊娠期，妊娠期肝内胆汁淤积症和贫血患者的 BPA 和 RBP4 水平高于非妊娠期，早产儿的 BPA 和 RBP4 水平高于非妊娠期（ ）。此外，甲状腺功能减退症组尿中 BPA 水平高于正常对照组（ ），甲状腺功能减退症组血清 RBP4 水平高于正常对照组（ ）。多因素 logistic 回归分析显示，年龄≥30 岁和 BPA、RBP4 水平升高是非肥胖女性妊娠期亚临床甲状腺功能减退的危险因素。BPA 和 RBP-4 与非肥胖孕妇亚临床甲状腺功能减退的妊娠结局密切相关。不良妊娠结局中 BPA 和 RBP-4 程度增加，是导致非肥胖亚临床甲状腺功能减退的危险因素。
