Chen Yanrong, Zhang Sijing, Hu Lingling, Dong Lun, Liu Qiuhong, Liu Yunting, Cheng Wei, Liu Dongfang, Yang Gangyi, Li Ke
Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Front Nutr. 2022 Oct 10;9:953745. doi: 10.3389/fnut.2022.953745. eCollection 2022.
To analyze the related factors of the postpartum thyroid function in women with overt hypothyroidism (OH)/subclinical hypothyroidism (SCH) and explore the effects of vitamin D categories.
Thyroid hormones, thyroid autoantibody, and serum 25OHD levels were continuously recorded from the first trimester of pregnancy (T1) to the 12th postpartum month. Logistic regression analysis and Cox regression analysis were used to screen the related factors of postpartum thyroid function, and the Latent Class Growth Model was performed to analyze the trajectory characteristics of serum 25OHD levels.
Totally, 252 pregnant women with OH/SCH were enrolled in the study. In the 12th month postpartum, 36.5% of the patients improved thyroid function, 37.3% continued hypothyroidism, and 26.2% developed thyroid dysfunction. Vitamin D sufficiency, positive TPOAb, and positive TgAb in T1 were independent prognostic factors of postpartum thyroid function. Vitamin D sufficiency in T1 was illustrated as an independent factor of the improved postpartum thyroid function, but the protective effect for the developed postpartum thyroid dysfunction was only confirmed in TPOAb-positive patients. Cox regression analysis further confirmed the effects of vitamin D categories. Notably, the high-level 25OHD trajectory during pregnancy and postpartum could predict improved postpartum thyroid function and decrease the risk of developed postpartum thyroid dysfunction.
Appropriate vitamin D nutrition during pregnancy and postpartum may be beneficial to postpartum thyroid function.
分析临床显性甲状腺功能减退症（OH）/亚临床甲状腺功能减退症（SCH）女性产后甲状腺功能的相关因素，并探讨维生素D类别所产生的影响。
连续记录从妊娠早期（T1）至产后第12个月的甲状腺激素、甲状腺自身抗体及血清25羟维生素D（25OHD）水平。采用Logistic回归分析和Cox回归分析筛选产后甲状腺功能的相关因素，并运用潜在类别增长模型分析血清25OHD水平的轨迹特征。
本研究共纳入252例OH/SCH孕妇。产后第12个月时，36.5%的患者甲状腺功能改善，37.3%持续甲状腺功能减退，26.2%出现甲状腺功能异常。T1期维生素D充足、甲状腺过氧化物酶抗体（TPOAb）阳性及甲状腺球蛋白抗体（TgAb）阳性是产后甲状腺功能的独立预后因素。T1期维生素D充足是产后甲状腺功能改善的独立因素，但仅在TPOAb阳性患者中证实其对产后发生甲状腺功能异常具有保护作用。Cox回归分析进一步证实了维生素D类别的影响。值得注意的是，孕期及产后25OHD高水平轨迹可预测产后甲状腺功能改善，并降低产后发生甲状腺功能异常的风险。
孕期及产后适当的维生素D营养状况可能有利于产后甲状腺功能。
