孕妇循环总三碘甲状腺原氨酸与子痫前期后续风险之间的关联。
Association between maternal circulating total triiodothyronine and subsequent risk of preeclampsia.
作者信息
Wu Jiang-Nan, Pérez-López Faustino R, Rodríguez Ignacio, Yao Li, Mao Lu-Yi
机构信息
Obstetrics and Gynecology Hospital, Fudan University, 566 Fangxie Road, Shanghai, 200011, China.
Aragón Health Research Institute, 50009, Zaragoza, Spain.
出版信息
Eur J Med Res. 2025 Sep 4;30(1):842. doi: 10.1186/s40001-025-03118-w.
INTRODUCTION
To clarify the uncertain association between maternal total triiodothyronine (TT3) levels and preeclampsia risk.
METHODS
In a hospital-based cohort of pregnant women with universal thyroid testing, we assessed the association between TT3 and preeclampsia using directed acyclic graphs (DAG) to control confounders.
RESULTS
Maternal TT3 levels were associated with preeclampsia risk, with an adjusted odd ratio (OR) of 2.32 (95% confidence interval (CI) 2.02-2.68) in women with the highest TT3 quartile comparing to those in the lowest quartile. A J-shaped association was identified for early onset preeclampsia, with particularly strong association when thyroid-stimulating hormone exceeded 2.5 μIU/mL (OR, 17.22, 95% CI 4.52-65.60). Gestational age > 18 weeks at measurement significantly modified the effect of TT3 on preeclampsia risk, with an interaction OR of 3.22 (95% CI 1.56-6.62).
CONCLUSION
Increased maternal TT3 levels were associated with preeclampsia. TT3 may contribute to preeclampsia pathogenesis and serve as a clinical biomarker, especially for early onset cases with thyroid dysfunction.
引言
为阐明孕妇总三碘甲状腺原氨酸（TT3）水平与子痫前期风险之间不确定的关联。
方法
在一个对所有孕妇进行甲状腺检测的医院队列中，我们使用有向无环图（DAG）来控制混杂因素，评估TT3与子痫前期之间的关联。
结果
孕妇TT3水平与子痫前期风险相关，TT3四分位数最高的女性与最低四分位数的女性相比，校正后的比值比（OR）为2.32（95%置信区间[CI] 2.02 - 2.68）。早发型子痫前期呈现J形关联，当促甲状腺激素超过2.5 μIU/mL时关联尤为强烈（OR，17.22，95% CI 4.52 - 65.60）。测量时孕周>18周显著改变了TT3对子痫前期风险的影响，交互作用OR为3.22（95% CI 1.56 - 6.62）。
结论
孕妇TT3水平升高与子痫前期相关。TT3可能参与子痫前期的发病机制，并可作为一种临床生物标志物，尤其是对于伴有甲状腺功能障碍的早发型病例。
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