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在碘缺乏地区,孕妇体内的锌、铜、镁和铷等元素与营养和碘缺乏有关吗?

Are the elements zinc, copper, magnesium, and rubidium related to nutrition and iodine deficiency in pregnant Bulgarian women from iodine deficient region?

机构信息

Department of Physiology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria.

Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria.

出版信息

Cent Eur J Public Health. 2024 Mar;32(1):31-38. doi: 10.21101/cejph.a7796.

Abstract

OBJECTIVE

Trace elements are essential for the biochemistry of the cell. Their reference values have been found to differ considerably in pregnant women stratified by age, place of residence, anthropometric status, and length of pregnancy. In optimal amounts, these elements reduce the risk of pregnancy complications. Subclinical hypothyroidism in pregnancy is associated with adverse maternal and neonatal outcomes. The aim of the study was to determine the effects of zinc (Zn), copper (Cu), magnesium (Mg), and rubidium (Rb) on pregnant women in an iodine deficiency region and find the relationship with the thyroid status and nutrition.

METHODS

We evaluated the iodine status of 61 healthy pregnant women from an iodine deficient region in Bulgaria. Thyroid stimulating hormone (TSH) and thyroxin free (FT4) levels were measured using ELISA.

RESULTS

We found elevated levels of copper that differed the most between the first and second trimesters; Cu and TSH were found to be positively correlated (р < 0.05). Lower Cu levels were found in pregnant women consuming pulses more than 2-3 times a week (р = 0.033). The women consuming fish more than 2-3 times a week had higher levels of Rb. We found a pronounced iodine deficiency in more than half of the examined women in the first to third trimesters, without any effect of pregnancy on the ioduria (р=0.834). All second and third trimester cases were associated with severe ioduria (< 150 µg/L).

CONCLUSION

The high Cu levels were associated with subclinical hypothyroidism (SCH) and less pulse consumption during pregnancy in an iodine deficiency endemic area. SCH was found in 24% of the pregnant women in such an area while in 13% of them SCH had progressed to overt hypothyroidism.

摘要

目的

微量元素对细胞的生物化学至关重要。已发现其参考值在按年龄、居住地、人体测量状况和妊娠时间分层的孕妇中差异很大。在最佳数量下,这些元素可以降低妊娠并发症的风险。妊娠亚临床甲状腺功能减退症与不良的母婴和新生儿结局有关。本研究旨在确定在碘缺乏地区对孕妇的锌(Zn)、铜(Cu)、镁(Mg)和铷(Rb)的影响,并发现其与甲状腺功能和营养的关系。

方法

我们评估了来自保加利亚碘缺乏地区的 61 名健康孕妇的碘状况。使用 ELISA 测量甲状腺刺激激素(TSH)和游离甲状腺素(FT4)水平。

结果

我们发现铜的水平升高,在第一和第二孕期之间差异最大;Cu 和 TSH 呈正相关(p<0.05)。每周食用豆类超过 2-3 次的孕妇Cu 水平较低(p=0.033)。每周食用鱼类超过 2-3 次的孕妇 Rb 水平较高。我们发现,在第一至第三孕期,超过一半的受检妇女存在明显的碘缺乏,而妊娠对尿碘(p=0.834)没有影响。所有第二和第三孕期的病例都与严重的尿碘不足(<150μg/L)有关。

结论

在碘缺乏流行地区,高铜水平与亚临床甲状腺功能减退症(SCH)和妊娠期间豆类摄入减少有关。在这样的地区,24%的孕妇患有 SCH,其中 13%的孕妇已经发展为显性甲状腺功能减退症。

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