摘要
目的探讨妊娠中期碘营养状况及各种指标在甲状腺功能正常时对同型半胱氨酸(homocysteine,HCY)含量的影响。方法选取甲状腺功能正常的妊娠中期妇女(孕13~27周)481例为研究对象,测定尿碘浓度(UIC)、甲状腺自身抗体、HCY及生化指标。比较不同碘营养状况的HCY含量,并分析与HCY相关的因素。结果研究对象碘缺乏、碘足量、碘超足量、碘过量的比例分别为57.0%(n=274)、29.7%(n=143)、10.8%(n=52)和2.5%(n=12),中位数尿碘浓度为134.1μg/L。碘过量组与碘足量组的HCY水平差异有统计学意义(1.83μmol/L比2.46μmol/L,P=0.036)。Spearman相关分析显示,HCY与碘过量、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、甲状腺球蛋白抗体、空腹血糖呈负相关(r=-0.101,P=0.026;r=-0.099,P=0.03;r=-0.192,P<0.01;r=-0.099,P=0.03),与甲状腺过氧化物酶抗体呈正相关(r=0.177,P<0.01)。多元线性回归分析表明,HCY与碘过量(β=-1.505,P=0.043)、FT3(β=-0.661,P=0.008)呈独立负相关。结论碘缺乏在妊娠中期甲状腺功能正常妇女中比例高达57%,适度的碘过量、FT3水平升高有益于HCY浓度降低进而降低妊娠妇女血管并发症的发生风险。
Objective To investigate the effect of iodine nutrition status and sorts of indexes on homocysteine(HCY)in the second trimester of pregnancy under conditions with normal thyroid function.Methods 481 second-trimester pregnant(13th to 27th week of pregnancy)women with normal thyroid function were selected for the study.Urinary iodine concentration(UIC),thyroid auto-antibody,HCY and biochemical indexes were measured.The HCY levels were compared among subjects with different iodine nutritional status,and factors related to HCY level were analyzed.Results Patients were stratified into iodine deficiency,iodine adequate,iodine more than adequate and iodine excess groups and the proportion were 57.0%(n=274),29.7%(n=143),10.8%(n=52)and 2.5%(n=12),respectively.The overall median UIC was 134.1μg/L.There was significant difference in HCY levels between iodine excess group and iodine adequate group(1.83μmol/L vs.2.46μmol/L,P=0.036).Spearman correlation analysis showed that HCY was negatively correlated with iodine excess,free triiodothyronine(FT3),thyroglobulin antibody,and fasting blood glucose(r=-0.101,P=0.026;r=-0.099,P=0.03;r=-0.192,P<0.01;r=-0.099,P=0.03),and was positively correlated with TPOAb(r=0.177,P<0.01).Multiple linear regression analysis showed that HCY was independently negatively correlated with iodine excess(β=-1.505,P=0.043)and FT3(β=-0.661,P=0.008).Conclusion Up to 57%women in the second trimester of pregnancy are with iodine deficiency and normal thyroid function.Moderate iodine excess and elevated FT3 levels are beneficial to the decrease of HCY levels and thus reduce the risk of vascular complications in pregnant women.
作者
林娇娇
蔡星璇
朱昭昭
周竟雄
Lin Jiaojiao;Cai Xingxuan;Zhu Zhaozhao;Zhou Jingxiong(Department of Endocrinology,the Second Hospital Affiliated to Fujian Medical University,Quanzhou 362000,China;Fenyang Hospital of Shanxi Medical University,Fenyang 032200,China)
出处
《中华临床营养杂志》
CAS
CSCD
2021年第1期30-34,共5页
Chinese Journal of Clinical Nutrition
关键词
妊娠
碘营养
甲状腺功能
同型半胱氨酸
Pregnancy
Iodine nutrition
Thyroid function
Homocysteine
