Yadav Alka, Katyal Ranjan, Mittal Shilpa, Kumar Saha Tapan
Biochemistry, Al-Falah School of Medical Science and Research Centre, Faridabad, IND.
Biochemistry, Noida International Institute of Medical Sciences, Noida, IND.
Cureus. 2023 Apr 18;15(4):e37748. doi: 10.7759/cureus.37748. eCollection 2023 Apr.
Introduction Pregnancy leads to changes in hormonal levels and lipid profile. Thyroid hormones play a crucial role in embryonic growth and fetal development. Untreated thyroid disease during pregnancy can lead to a high risk of complications. Aim The aim of the study is to examine the correlation between thyroid stimulating hormone (TSH) and lipid profile in pregnant women with hypothyroidism. Materials and methods This cross-sectional case-control study was conducted at the Biochemistry Department, Alfalah School of Medical Science & Research Centre, Dhauj, Faridabad, Haryana, India. The study consisted of 500 patients (250 cases and 250 controls) who fulfilled the inclusion and exclusion criteria. Of the 250 cases recruited, 23 cases were in the 2nd trimester and 209 cases were in the 3rd trimester. Blood samples were collected from the participants to assess their lipid profile and TSH levels. Results The study showed a statistically significant difference between the mean TSH levels of hypothyroid pregnant females in the 2nd trimester (3.85 ± 0.59) and the 3rd trimester (4.71 ± 0.54). There was a significant positive correlation observed between TSH and Total Cholesterol, Triglycerides, and LDL-C in both the 2nd and 3rd trimesters. In the second trimester, there was a significant positive correlation observed between TSH & TC (r = 0.6634, p<0.0005), TSH & TG (r= 0.7346, p=0.00006), TSH & LDL (r= 0.5322, p= 0.008). In the third trimester, there was a significant positive correlation observed between TSH & TC (r = 0.8929, p<0.00001), TSH & TG (r= 0.430, p<0.00001), TSH & LDL (r= 0.168, p= 0.015). However, no significant correlation was found between TSH levels and HDL-C in either trimester. The correlation coefficient and p-value for TSH & HDL were r = 0.2083, p=0.340 in the second trimester, and r = 0.0189, p=0.2384 in the third trimester. Conclusion A significant increase in TSH levels in hypothyroid pregnant women was observed in the 3rd trimester compared to the second trimester. Moreover, a significant positive correlation was found between TSH and lipid profile (total cholesterol, triglycerides, and LDL) in both trimesters, but not with HDL. These findings highlight the importance of monitoring thyroid hormone levels in the later stages of pregnancy to avoid potential maternal & fetal complications.
引言
怀孕会导致激素水平和血脂状况发生变化。甲状腺激素在胚胎生长和胎儿发育中起着至关重要的作用。孕期未经治疗的甲状腺疾病会导致并发症的高风险。
目的
本研究的目的是检查甲状腺功能减退孕妇的促甲状腺激素（TSH）与血脂状况之间的相关性。
材料和方法
这项横断面病例对照研究在印度哈里亚纳邦法里达巴德市道杰的阿尔法拉赫医学科学与研究中心生物化学系进行。该研究包括500名符合纳入和排除标准的患者（250例病例和250例对照）。在招募的250例病例中，23例处于孕中期，209例处于孕晚期。从参与者身上采集血样以评估他们的血脂状况和TSH水平。
结果
研究表明，孕中期（3.85±0.59）和孕晚期（4.71±0.54）甲状腺功能减退孕妇的平均TSH水平之间存在统计学上的显著差异。在孕中期和孕晚期，TSH与总胆固醇、甘油三酯和低密度脂蛋白胆固醇之间均观察到显著的正相关。在孕中期，TSH与总胆固醇（r = 0.6634，p<0.0005）、TSH与甘油三酯（r = 0.7346，p = 0.00006）、TSH与低密度脂蛋白（r = 0.5322，p = 0.008）之间均观察到显著的正相关。在孕晚期，TSH与总胆固醇（r = 0.8929，p<0.00001）、TSH与甘油三酯（r = 0.430，p<0.00001）、TSH与低密度脂蛋白（r = 0.168，p = 0.015）之间均观察到显著的正相关。然而，在两个孕期中均未发现TSH水平与高密度脂蛋白胆固醇之间存在显著相关性。孕中期TSH与高密度脂蛋白的相关系数和p值分别为r = 0.2083，p = 0.340，孕晚期为r = 0.0189，p = 0.2384。
结论
与孕中期相比，孕晚期甲状腺功能减退孕妇的TSH水平显著升高。此外，在两个孕期中均发现TSH与血脂状况（总胆固醇、甘油三酯和低密度脂蛋白）之间存在显著的正相关，但与高密度脂蛋白无关。这些发现突出了在妊娠后期监测甲状腺激素水平以避免潜在的母婴并发症的重要性。
