Liu Zhaomin, Chen Chaogang, Wang Cheng, Wang Yaqian, Li Minmin, Pan Wenjing
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou 510080, China.
Department of Clinical Nutrition, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510012, China.
Nutrients. 2025 May 9;17(10):1626. doi: 10.3390/nu17101626.
This study aimed to test the extra-thyroidal impacts of maternal serum iodine concentrations (SICs) on metabolic factors and subsequent pregnancy outcomes. Single pregnant women aged 18-49 years were recruited during their first prenatal visits. SICs at first trimester (T1) were tested by ICP-MS. Metabolic factors [body mass index (BMI), fat %, glucose, lipids, uric acid, and blood pressure] were measured, and composite indices [the triglyceride-glucose (TyG) index, TyG-BMI, and the Framingham steatosis index (FSI)] were estimated. Obstetric and birth outcomes were retrieved from the hospital information system, including gestational diabetes (GDM), gestational hypertension (GH), fetal distress, postpartum hemorrhage, premature rupture of membrane, small and large for gestational age (SGA and LGA), preterm birth, and low birth weight. Multivariable linear and logistic regression models were applied to explore the associations between maternal SIC, metabolic factors, and pregnancy outcomes. A total of 1456 mothers were included for analysis. Maternal LgSIC values at T1 were inversely associated with early gestational weight gain ( = -0.113, < 0.001) and BMI at T1 ( = -0.070, = 0.006), but they were positively associated with triglycerides ( = 0.142, < 0.001), the TyG index ( = 0.137, < 0.001), and uric acid ( = 0.060, = 0.018). However, upon further adjustment for thyroid hormones, the associations were attenuated. The joint effects of high SIC and metabolic conditions (hyperlipidemia, high FSI, and GH) suggested increased adverse pregnancy outcomes (increased postpartum bleeding, reduced birth length, and reduced delivery weeks). Our prospective data in the iodine replete region indicated that high SICs at T1 were associated with increased risk of metabolic conditions and adverse birth outcomes, with the associations being independent of thyroid hormones.
本研究旨在测试孕妇血清碘浓度（SICs）对代谢因素及后续妊娠结局的甲状腺外影响。年龄在18 - 49岁的单胎孕妇在首次产前检查时被招募。孕早期（T1）的SICs通过电感耦合等离子体质谱法（ICP - MS）检测。测量代谢因素[体重指数（BMI）、脂肪百分比、葡萄糖、脂质、尿酸和血压]，并估算复合指标[甘油三酯 - 葡萄糖（TyG）指数、TyG - BMI和弗雷明汉脂肪变性指数（FSI）]。从医院信息系统中获取产科和分娩结局，包括妊娠期糖尿病（GDM）、妊娠期高血压（GH）、胎儿窘迫、产后出血、胎膜早破、小于胎龄儿和大于胎龄儿（SGA和LGA）、早产和低出生体重。应用多变量线性和逻辑回归模型来探讨孕妇SIC、代谢因素和妊娠结局之间的关联。共有1456名母亲纳入分析。孕早期T1时孕妇的LgSIC值与孕早期体重增加（β = -0.113，P < 0.001）和T1时的BMI（β = -0.070，P = 0.006）呈负相关，但与甘油三酯（β = 0.142，P < 0.001）、TyG指数（β = 0.137，P < 0.001）和尿酸（β = 0.060，P = 0.018）呈正相关。然而，在进一步调整甲状腺激素后，这些关联减弱。高SIC与代谢状况（高脂血症、高FSI和GH）的联合作用提示不良妊娠结局增加（产后出血增加；出生身长降低和分娩孕周减少）。我们在碘充足地区的前瞻性数据表明孕早期T1时高SICs与代谢状况及不良出生结局风险增加相关，且这些关联独立于甲状腺激素。
