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苏丹孕妇孕早期铁缺乏和甲状腺功能障碍的横断面研究。

Iron deficiency and thyroid dysfunction among sudanese women in first trimester of pregnancy: a cross-sectional study.

机构信息

Faculty of Medicine, Kordofan University, Elobeid, Sudan.

Faculty of Medicine, El Imam El Mahdi University, Kosti, Sudan.

出版信息

BMC Endocr Disord. 2023 Oct 13;23(1):223. doi: 10.1186/s12902-023-01487-z.

Abstract

BACKGROUND

Pregnant women are more susceptible to iron deficiency (ID), and it can lead to several maternal and perinatal adverse effects. There are some published data on the effect of ID on thyroid function, but none of the studies were conducted in sub-Saharan African countries including Sudan. This study was conducted to investigate association between ID (ferritin < 15 µg/L) and thyroid functions [thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4)] among Sudanese women in the first trimester of pregnancy.

METHOD

A cross-sectional study was conducted in Saad Abuelela Maternity Hospital, Sudan. Obstetric/sociodemographic characteristics were gathered through questionnaires. Hemoglobin, serum ferritin, TSH, FT3, and FT4 were measured in all pregnant women. Continuous variables were compared with either independent sample t-test if they were normally distributed, or with Mann-Whitney U- test if they were not-normally distributed. Spearman correlations were performed between the continuous variables.

RESULTS

In total, 127 pregnant women with mean [standard deviation (SD)] age of 27.0 (5.5) years and gestational age of 10.5 (3.0) weeks, respectively, were enrolled in this study. Forty-seven (37.0%) of these 127 women had ID. While the median [interquartile range (IQR)] of the parity, TSH, and FT3 were not different between women with ID and women without ID, the median (IQR) of FT4 was significantly lower in women with ID compared with women without ID [1.020 (0.910‒1.120) vs. 1.095 (0.990‒1.217) pmol, P = 0.014]. Serum ferritin was inversely correlated with FT3, (r = -0.225, P = 0.011). There was no significant correlation between serum ferritin, TSH, and FT4.

CONCLUSIONS

Iron deficiency was common during the first trimester of pregnancy and was associated with thyroid dysfunctions. Therefore, ID should be evaluated to avoid thyroid dysfunction.

摘要

背景

孕妇更容易缺铁(ID),这可能导致母婴和围产期的不良后果。有一些关于 ID 对甲状腺功能影响的已发表数据,但没有一项研究是在包括苏丹在内的撒哈拉以南非洲国家进行的。本研究旨在调查苏丹孕妇在妊娠早期 ID(铁蛋白<15μg/L)与甲状腺功能[促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)]之间的关联。

方法

本研究是在苏丹的 Saad Abuelela 妇产医院进行的一项横断面研究。通过问卷收集产科/社会人口学特征。对所有孕妇进行血红蛋白、血清铁蛋白、TSH、FT3 和 FT4 检测。连续变量如果呈正态分布,则采用独立样本 t 检验进行比较,如果呈非正态分布,则采用 Mann-Whitney U 检验进行比较。对连续变量进行 Spearman 相关性分析。

结果

本研究共纳入 127 名孕妇,平均[标准差(SD)]年龄为 27.0(5.5)岁,孕龄为 10.5(3.0)周。这些孕妇中,47 人(37.0%)患有 ID。虽然 ID 组和非 ID 组的产次、TSH 和 FT3 的中位数(IQR)无差异,但 ID 组的 FT4 中位数(IQR)明显低于非 ID 组[1.020(0.910-1.120)比 1.095(0.990-1.217)pmol,P=0.014]。血清铁蛋白与 FT3 呈负相关(r=-0.225,P=0.011)。血清铁蛋白与 TSH 和 FT4 无显著相关性。

结论

妊娠早期缺铁很常见,与甲状腺功能障碍有关。因此,应评估 ID 以避免甲状腺功能障碍。

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本文引用的文献

1
Trace elements and the thyroid.微量元素与甲状腺。
Front Endocrinol (Lausanne). 2022 Oct 24;13:904889. doi: 10.3389/fendo.2022.904889. eCollection 2022.
2
The association between iron status and thyroid hormone levels during pregnancy.孕期铁状态与甲状腺激素水平的关系。
J Trace Elem Med Biol. 2022 Dec;74:127047. doi: 10.1016/j.jtemb.2022.127047. Epub 2022 Jul 22.

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