Serum iodine concentration in pregnant women and its association with urinary iodine concentration and thyroid function
Serum iodine concentration in pregnant women and its association with urinary iodine concentration and thyroid function
复制标题
孕妇血清碘浓度及其与尿碘浓度和甲状腺功能的关系
DOI：
10.1111/cen.13945
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发表时间：
2019-05-01
影响因子：
3.2
通讯作者：
Zhang, Wanqi
中科院分区：
文献类型：
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作者：
Pan, Ziyun;Cui, Tingkai;Zhang, Wanqi
目的探讨孕妇血清碘浓度（SIC）与尿碘浓度（UIC）及甲状腺功能的关系，为高碘地区孕妇SIC提供参考值。方法选择2016年3月至2017年5月在天津市塘沽区妇产医院产科就诊的孕妇。采集空腹静脉血和点尿样本。测定血清游离三碘甲状腺原氨酸（FT 3）、游离甲状腺素（FT 4）、促甲状腺激素（TSH）、甲状腺球蛋白（Tg）、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TgAb）、尿IC和SIC。结果1099例受试者纳入本研究。UIC中位数为156 μ g/L。SIC中位数为108 μ g/L，SIC的95%参考区间为65.6-164.7 μ g/L。SIC与UIC（r = 0.12，P < 0.001）、FT 3（r = 0.23，P < 0.001）、FT 4（r = 0.50，P < 0.001）呈正相关，与TSH呈负相关（r =-0.14，P < 0.001）。SIC < 79.9 μ g/L的孕妇发生低甲状腺素血症的风险高于SIC较高的孕妇（OR = 2.44，95%CI：1.31-4.75）。SIC > 138.5 μ g/L者比SIC低者更易患甲状腺毒症（OR = 13.52，95% CI：4.21-43.36）。结论孕妇血清碘水平与UIC及甲状腺功能有关。低SIC与碘缺乏和低甲状腺素血症的风险增加有关，而高SIC与过量和甲状腺毒症有关。
Objective This study aims to evaluate the association of serum iodine concentration (SIC) with urinary iodine concentration (UIC) and thyroid function in pregnant women, as well as to provide the reference range of SIC of pregnant women in iodine-sufficiency area. Methods Pregnant women were enrolled in the Department of Obstetrics, Tanggu Maternity Hospital, Tianjin from March 2016 to May 2017. Fasting venous blood and spot urine samples were collected. Serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), thyroglobulin (Tg), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), UIC and SIC were measured. Results One thousand and ninety-nine participants were included in this study. The median UIC was 156 mu g/L. The median SIC was 108 mu g/L, and the 95% reference interval for SIC was 65.6-164.7 mu g/L. SIC was positively correlated with UIC (r = 0.12, P < 0.001), FT3 (r = 0.23, P < 0.001), and FT4 (r = 0.50, P < 0.001) and was inversely correlated with TSH (r = -0.14, P < 0.001). Pregnant women with a SIC < 79.9 mu g/L had a higher risk of hypothyroxinemia compared to those with higher SIC (OR = 2.44, 95% CI: 1.31-4.75). Those having SIC > 138.5 mu g/L were more likely to have thyrotoxicosis than those with lower SIC values (OR = 13.52, 95% CI: 4.21-43.36). Conclusions Serum iodine level is associated with UIC and thyroid function in pregnant women. Low SIC was associated with increased risk for iodine deficiency and hypothyroxinemia, while high SIC was related to excess and thyrotoxicosis.