Narrow intra-individual variation of maternal thyroid function in pregnancy based on a longitudinal study on 132 women
Narrow intra-individual variation of maternal thyroid function in pregnancy based on a longitudinal study on 132 women
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DOI：
10.1530/eje-09-0579
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发表时间：
2009-12-01
影响因子：
5.8
通讯作者：
Main, Katharina M.
中科院分区：
文献类型：
--
作者：
Boas, Malene;Forman, Juhe Lyng;Main, Katharina M.
背景：母体生理的适应性改变会导致整个妊娠期间甲状腺激素水平的变化，因此准确的生化评估高度依赖于特定于妊娠的参考间隔和预期的个体内变化。本研究的目的是评估正常妊娠期间甲状腺激素的个体内变异和纵向变化过程以及影响甲状腺功能正常参考范围的因素。为此目的，应用纵向统计模型。设计：在132名孕妇队列中，采集连续血样并在整个孕期进行超声检查。结果：甲状腺激素水平的个体内变异小于个体间变异(个性指数0.38~0.71)。孕妇身高与游离T-4(FT4)呈正相关(b=0.003，P=0.031)，与孕前体重指数(BMI)与T-3、游离T-3呈正相关(b=0.017；0.001和b=0.007；P<；0.001)。吸烟与T-4、FT4呈正相关，但受胎龄的影响。给出了自身抗体阴性受试者甲状腺功能变量的孕期特定参考区间。结论：与非妊娠成人的数据一致，妊娠期间甲状腺激素的个体内变异也小于个体间变异。在评价妊娠期甲状腺功能时，应考虑个体甲状腺激素的纵向变化，而不是绝对值。本文提出了预测孕妇甲状腺功能的纵向模型。
Background: Adaptive alterations in maternal physiology cause changes in thyroid hormone levels throughout pregnancy, and precise biochemical evaluation is thus highly dependent on gestation-specific reference intervals and expected intra-individual variationObjective. The aim of the study was the assessment of the intra-individual variation as well as the longitudinal course of thyroid hormones during normal pregnancy and factors that influence the normal reference range for thyroid function For this purpose, a longitudinal statistical model was appliedDesign: In a cohort of 132 pregnant women, serial blood samples were obtained and ultrasound scans were performed throughout pregnancy.Methods: Serum levels of TSH, free and total thyroxine (T-4), free and total trnodothyronine (T-3) as well as autoantibodies against thyroid peroxidase and thyroglobulin were measured in 979 serum samplesResults: Intra-individual variations of thyroid hormone concentrations were smaller than inter-individual variations (Individuality index range 0.38-0.71). Maternal height was positively associated with free T-4 (FT4) (b=0.003, P=0.031) and pre-pregnancy body mass index with T-3 and free T-3 (b=0.017; < 0.001 and b=0.007; P < 0.001). Smoking was positively associated with T-4 and FT4, but It was modulated by gestational age. Gestation-specific reference intervals for thyroid function variables from autoantibody-negative participants are presentedConclusions: In accordance with the data from nonpregnant adults, intra-individual variations of thyroid hormones were smaller than inter-individual variations also during pregnancy. In the evaluation of thyroid function in pregnancy, the individual longitudinal course of thyroid hormones rather than absolute values should be considered We present a longitudinal model for the prediction of maternal thyroid function tests in pregnant women.