Exploration of the optimal range of urinary iodine concentration in Chinese pregnant women in mildly iodine-deficient and -sufficient areas.
Exploration of the optimal range of urinary iodine concentration in Chinese pregnant women in mildly iodine-deficient and -sufficient areas.
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中国轻度缺碘和碘充足地区孕妇尿碘浓度最佳范围探讨
DOI：
10.1007/s00394-021-02693-y
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发表时间：
2021
影响因子：
5
通讯作者：
Zhang Wanqi
中科院分区：
文献类型：
--
作者：
Chen Yanting;Guo Wenxing;Pan Ziyun;Zhang Dingyan;Gao Min;Wu Wen;Wang Chongdan;Duan Yifan;Gu Xuyang;Pearce Elizabeth N;Lai Jianqiang;Zhang Wanqi
目的妊娠期尿碘浓度（UIC）的适宜范围存在一定的不确定性。本研究旨在探讨孕妇UIC和甲状腺功能之间的关联在碘充足和轻度缺碘areas.MethodsIt是一个横断面研究，其中1461名健康孕妇在其常规产前保健在天津和武强，中国收集其血液和尿液样本。武强为轻度缺碘地区，天津为碘充足地区。在常规产前检查中检测UIC、游离三碘甲状腺原氨酸（FT 3）、游离甲状腺激素（FT 4）、促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TgAb）、血清碘浓度（SIC），包括血清总碘浓度（tSIC）和非蛋白结合血清碘浓度（nbSIC）天津市为113，249 μg/L，武强市为111（63，167）μg/L。与天津市相比，武强市UIC、FT 3、TSH较低，FT 4、tSIC、nbSIC、TPOAb、TgAb阳性率及甲状腺功能异常率（TDR）较高（P< 0.001）。天津市孕妇妊娠期间FT 3、FT 4、tSIC和nbSIC随UIC的升高而升高，武强市孕妇妊娠期间仅FT 3和nbSIC升高（P< 0.05）。在天津，TDR随UIC升高而升高，在UIC ≥ 500 μg/L时达到峰值（P= 0.002）;在武强，TDR与UIC呈弱“U”型关系，在UIC 100 - 149 μ g/L时TDR最低。我们怀疑世卫组织推荐的最佳UIC标准对于轻度至中度碘缺乏国家的孕妇可能有点高。
PurposeThere is some uncertainty about the optimal ranges for urinary iodine concentration (UIC) during pregnancy. This study aimed to explore associations between maternal UIC and thyroid function in iodine sufficient and mildly iodine deficient areas.MethodsIt was a cross-sectional study in which 1461 healthy pregnant women were enrolled to collect their blood and urine samples during their routine antenatal care in Tianjin and Wuqiang, China. Wuqiang was a mildly iodine-deficient region, while Tianjin was iodine sufficient. UIC, free triiodothyronine (FT3), free thyroid hormone (FT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), serum iodine concentration (SIC) including total serum iodine concentration (tSIC) and non-protein bound serum iodine concentration (nbSIC) were assessed during the routine antenatal care visits.ResultsThe median UIC in pregnant women was 174 (113, 249) μg/L in Tianjin and 111 (63, 167) μg/L in Wuqiang, respectively. Compared with Tianjin, UIC, FT3 and TSH were lower, and FT4, tSIC, nbSIC, rates of TPOAb and TgAb positivity and the thyroid dysfunction rate (TDR) were higher in Wuqiang (P< 0.001). FT3, FT4, tSIC and nbSIC increased during pregnancy in Tianjin with increasing UIC, while only FT3 and nbSIC increased in Wuqiang (P< 0.05). In Tianjin, the TDR increased with UIC and peaked at UIC ≥ 500 μg/L (P= 0.002), while in Wuqiang, the TDR showed a weak “U-shaped” relationship with UIC and the rate was lowest with UIC 100–149 μg/L.ConclusionsIn iodine-deficient areas, there was a lower TDR in pregnant women with UIC 100–149 μg/L. We suspected that the optimal UIC criteria recommended by WHO may be a little high for pregnant women in mild-to-moderate iodine-deficient countries.