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严重维生素 D 缺乏和碘营养状况对孕妇甲状腺疾病风险的交互影响。

The Interactive Effects of Severe Vitamin D Deficiency and Iodine Nutrition Status on the Risk of Thyroid Disorder in Pregnant Women.

机构信息

Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China.

出版信息

Nutrients. 2022 Oct 25;14(21):4484. doi: 10.3390/nu14214484.

Abstract

Thyroid dysfunction is associated with both vitamin D deficiency and iodine; however, it is unclear whether they interact. This study aimed to investigate whether and to what extent the interactions between vitamin D and iodine contribute to the risk of thyroid disorder. Participants ( = 4280) were chosen using multistage, stratified random sampling from Shanghai. Fasting blood was drawn for the 25(OH)D and thyroid parameter tests. Spot urine samples were gathered to test for urine iodine. To evaluate the interactive effects of vitamin D and iodine, crossover analysis was carried out. Pregnant women with a high urinary iodine concentration (UIC) and severe vitamin D deficiency had a significantly higher risk of thyrotropin receptor antibody (TrAb) positivity (odds ratio = 2.62, 95% confidence interval (CI): 1.32, 5.22) in the first trimester. Severe vitamin D deficiency and high UIC interacted positively for the risk of TrAb positivity (relative excess risk due to interaction = 1.910, 95%CI: 0.054, 3.766; attributable proportion = 0.700, 95%CI: 0.367, 1.03). Severe vitamin D deficiency combined with excess iodine could increase the risk of TrAb positivity in pregnant women in the first trimester.

摘要

甲状腺功能障碍与维生素 D 缺乏和碘有关;然而,它们是否相互作用尚不清楚。本研究旨在调查维生素 D 和碘之间的相互作用是否以及在何种程度上导致甲状腺疾病的风险增加。参与者(=4280)通过多阶段、分层随机抽样从上海选取。抽取空腹血进行 25(OH)D 和甲状腺参数检测。采集随机尿样检测尿碘。为了评估维生素 D 和碘的交互作用,进行了交叉分析。在孕早期,高尿碘浓度(UIC)和严重维生素 D 缺乏的孕妇促甲状腺素受体抗体(TRAb)阳性的风险显著增加(比值比=2.62,95%置信区间(CI):1.32,5.22)。严重维生素 D 缺乏和高 UIC 对 TRAb 阳性的风险呈正交互作用(交互归因超额风险=1.910,95%CI:0.054,3.766;归因比例=0.700,95%CI:0.367,1.03)。严重维生素 D 缺乏合并碘过量可增加孕早期孕妇 TRAb 阳性的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e1c/9654270/03ccd591f0b7/nutrients-14-04484-g001.jpg

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