Department of Endocrinology, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China.
Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Front Endocrinol (Lausanne). 2023 Jul 4;14:1184747. doi: 10.3389/fendo.2023.1184747. eCollection 2023.
To assess the iodine status and its associations with thyroid function in pregnant women of Shanghai.
In this cross-sectional study, a total of 562 pregnant women were enrolled from January to December 2021. Both serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyroid peroxidase antibody (TPOAB), thyroglobulin antibody (TGAB), and urinary iodine concentration (UIC) were detected. Participants were divided into four groups based on their UIC values. Correlation analysis was used to investigate the association between UIC and thyroid function-associated parameters.
The median UIC of the pregnant women studied was 158.25µg/L (interquartile range [IQR] 90.15, 245.65µg/L). Among all the subjects, 45.55% had iodine deficiency according to the World Health Organization (WHO) criteria, and 15.65% had thyroid autoimmunity. FT3, FT4, TSH, TPOAB and TGAB levels were not different among different UIC groups (P > 0.05). UIC and TSH were negatively correlated (r=-0.127, p=0.043) in UIC<150 µg/L group. In the group with UIC 250- 499 µg/L, UIC was positively correlated with total T4 (TT4), total T3 (TT3) and TPOAB (r= 0.228, p=0.022, r=0.208, p= 0.039, r=0.190, p=0.042, respectively). A negative correlation between UIC and TPOAB values was observed in TPOAB-positive (+) pregnant women (r=-0.384, p=0.012). The prevalence of isolated hypothyroxinemia in UIC<150 µg/L group was significantly higher than that of other groups(p=0.033). The relationship between the prevalence of thyroid diseases and UIC embodied a U-shaped curve.
Pregnant women on Chongming Island of Shanghai were iodine sufficient during the second trimester, but iodine deficiency was still prevalent. Both low and high gestational iodine status was related to thyroid function and autoimmunity. Optimal iodine nutrition status during gestation was important.
评估上海孕妇的碘营养状况及其与甲状腺功能的关系。
本横断面研究于 2021 年 1 月至 12 月期间纳入了 562 名孕妇。检测血清促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、甲状腺过氧化物酶抗体（TPOAB）、甲状腺球蛋白抗体（TGAB）和尿碘浓度（UIC）。根据 UIC 值将参与者分为四组。采用相关分析探讨 UIC 与甲状腺功能相关参数之间的关系。
研究孕妇的中位 UIC 为 158.25µg/L（四分位距 [IQR] 90.15，245.65µg/L）。根据世界卫生组织（WHO）标准，所有受试者中 45.55%存在碘缺乏，15.65%存在甲状腺自身免疫。不同 UIC 组间 FT3、FT4、TSH、TPOAB 和 TGAB 水平无差异（P>0.05）。在 UIC<150µg/L 组中，UIC 与 TSH 呈负相关（r=-0.127，p=0.043）。在 UIC 250-499µg/L 组中，UIC 与 TT4、TT3 和 TPOAB 呈正相关（r=0.228，p=0.022，r=0.208，p=0.039，r=0.190，p=0.042）。在 TPOAB 阳性的孕妇中，UIC 与 TPOAB 值呈负相关（r=-0.384，p=0.012）。UIC<150µg/L 组中孤立性低甲状腺素血症的患病率明显高于其他组（p=0.033）。甲状腺疾病的患病率与 UIC 之间呈 U 形曲线关系。
上海崇明岛孕妇妊娠中期碘营养状况充足，但仍普遍存在碘缺乏。妊娠期低碘和高碘状态均与甲状腺功能和自身免疫有关。妊娠期间保持最佳碘营养状态很重要。
