Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, 510080, People's Republic of China.
Department of Clinical Nutrition, The Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510235, People's Republic of China.
Biol Trace Elem Res. 2024 Jun;202(6):2457-2465. doi: 10.1007/s12011-023-03859-x. Epub 2023 Sep 15.
The study aims to establish trimester-specific reference ranges for serum iodine (SI) in Chinese pregnant women and explore its associations with maternal and infantile thyroid function. Apparently healthy pregnant women were enrolled during their first antenatal visit. Fasting venous and spot urine samples were collected for determining serum and urinary iodine (UI) levels by a validated inductively coupled plasma mass spectrometry. Serum free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin (TSH), and neonatal TSH levels were tested by electro-chemiluminescent assay. The reference ranges of SI were established by percentile method and reported as 2.5-97.5%. ROC analysis was applied to compare the discriminative ability of SI, UI, and UI to urinary creatine ratio (UI /UCr) in early pregnancy for various thyroid conditions. The trimester-specific reference ranges of SI for Chinese pregnant women were 60.91-114.53 μg/L for the first trimester (T1, n = 1029), 54.57-103.42 μg/L for the second trimester (T2, n = 379), and 52.03-110.40 μg/L for the third trimester (T3, n = 455). Maternal SI at T1 but not UI and UI/UCr was significantly correlated with FT3 (r = 0.393, P < 0.001), FT4 (r = 0.637, P < 0.001), and TSH (r = -0.299, P<0.001). Maternal SI change% from T1 to T2 (but not SI change% from T1 to T3) had marginal correlation with neonatal TSH (r=-0.106, P=0.046). ROC analysis showed that maternal SI at T1 had better predictability for several thyroid conditions than UIC and UI/UCr.
本研究旨在建立中国孕妇血清碘（SI）的孕期特异性参考范围，并探讨其与母婴甲状腺功能的关系。显然健康的孕妇在首次产前检查时入组。采集空腹静脉血和随机尿样，采用经验证的电感耦合等离子体质谱法测定血清和尿碘（UI）水平。用电化学发光法检测血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺素（TSH）和新生儿 TSH 水平。采用百分位数法建立 SI 的参考范围，报告值为 2.5-97.5%。应用 ROC 分析比较了 SI、UI 和 UI 与尿肌酐比值（UI/UCr）在早期妊娠对各种甲状腺疾病的鉴别能力。中国孕妇血清碘的孕期特异性参考范围分别为：早孕期（T1，n=1029）为 60.91-114.53μg/L，中孕期（T2，n=379）为 54.57-103.42μg/L，晚孕期（T3，n=455）为 52.03-110.40μg/L。T1 时的母体 SI 但不是 UI 和 UI/UCr 与 FT3（r=0.393，P<0.001）、FT4（r=0.637，P<0.001）和 TSH（r=-0.299，P<0.001）显著相关。从 T1 到 T2 的母体 SI 变化百分比（但不是从 T1 到 T3 的 SI 变化百分比）与新生儿 TSH 有边缘相关性（r=-0.106，P=0.046）。ROC 分析表明，T1 时的母体 SI 对几种甲状腺疾病的预测能力优于 UIC 和 UI/UCr。
