摘要
目的:观察南京地区妊娠中后期妇女尿碘浓度(urine iodine concentration,UIC)、尿肌酐(urinary creatnine,UCr)的变化,拟定尿碘/尿肌酐(urinary iodine concentration/urinary creatinine ratio,UIC/UCr)参考范围,探讨UIC/UCr与不同程度甲状腺激素减低的关系,及以UIC/UCr评估妊娠期妇女碘营养状态的可行性。方法:选取2018—2020年在南京医科大学第一附属医院就诊建卡的妊娠20~28周孕妇301例,检测促甲状腺素(thyriod stimulating hormone,TSH)、游离三碘甲状腺素(free triiodothy⁃roxine,FT3)、游离甲状腺素(free thyroxine,FT4)、抗甲状腺球蛋白抗体(anti⁃thyroglobulin antibody,TgAb)、抗甲状腺过氧化物酶抗体(anti⁃thyroid peroxidase antibody,TPOAb)、抗甲状腺素受体抗体(anti⁃thyroxine receptor antibody,TRAb)。留取晨尿测UIC、UCr,在137例甲功及抗体正常孕妇中确定UIC/UCr正常参考范围,并分析不同程度甲状腺功能减退孕妇的碘营养状况。结果:①正常妊娠中后期妇女UIC/UCr参考范围在106.14~269.75μg/g;②以UIC/UCr评估入组的孕妇,碘缺乏占22.59%,碘充足占48.17%,碘过量占29.24%;③FT4随着UIC/UCr的升高而降低,当UIC/UCr超足量时,TSH明显升高;④亚临床甲状腺功能减退症和单纯性低T4血症人群的碘超足量比例高于碘缺乏比例。结论:以UIC/UCr替代UIC评价孕期碘营养状态,碘缺乏比例明显降低,UIC/UCr与TSH、FT4相关;亚临床甲状腺功能减退症和单纯性低T4血症孕妇,应结合UIC/UCr值慎重补碘。
Objective:This study aims to investigate the variations of urinary iodine concentration(UIC)and urinary creatinine(UCr)in the second and third trimester of pregnancy in Nanjing establish the reference range of UIC/UCr,in order to explore the relationship between UIC/UCr and different degrees of hypothyroidism,and study the feasibility of using UIC/UCr to assess the iodine nutritional status in pregnant women.Methods:A total of 301 pregnant women at 20~28 weeks of gestation in the First Affiliated Hospital of Nanjing Medical University from 2018 to 2020 were recruited,and their thyroid stimulating hormone(TSH),free triiodothyroxine(FT3),free thyroxine(FT4),anti⁃thyroglobulin antibody(TgAb),anti⁃thyroperoxidase antibody(TPOAb),and anti⁃thyroxine receptor antibody(TRAb)were detected.UIC and UCr were measured in morning urine.The normal reference range for UIC/UCr was determined in 137 pregnant women with normal thyroid function and antibody.The iodine nutritional status of pregnant women with hypothyroidism of different degrees was analyzed.Results:①The UIC/UCr reference interval was 106.14~269.75μg/g in middle and late pregnancy.②According to our UIC/UCr reference interval,iodine deficiency accounted for 22.59%,iodine adequacy accounted for 48.17%,and iodine excess accounted for 29.24%.③FT4 decreased with the increase of UIC/UCr,and TSH increased significantly when UIC/UCr exceeded the limit.④The proportions of iodine excess in subclinical hypothyroidism and isolated hypothyroxinemia were higher than that of iodine deficiency.Conclusion:Using UIC/UCr instead of UIC to evaluate iodine nutritional status during pregnancy,the iodine deficiency proportion is significantly reduced.UIC/UCr is correlated with TSH and FT4.Iodine should be supplemented carefully according to the UIC/UCr value in subclinical hypothyroidism and isolated hypothyroxinemia.
作者
夏俊
俞琳
袁逸
王莉
唐艺
袁庆新
XIA Jun;YU Lin;YUAN Yi;WANG Li;TANG Yi;YUAN Qingxin(Department of Endocrinology,the Affiliated Jiangsu Shengze Hospital of Nanjing Medical University,Suzhou 215200;Department of Endocrinology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;Department of Endocrinology,the Affiliated Wuxi People’s Hospital of Nanjing Medical University,Wuxi 214000,China)
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2022年第10期1415-1420,1450,共7页
Journal of Nanjing Medical University(Natural Sciences)
基金
苏州市“科教兴卫”青年科技项目(KJXW2018074)。
关键词
妊娠期
尿碘
尿肌酐
尿碘/尿肌酐
甲状腺功能
pregnancy
urinary iodine concentration
urinary creatinine
urinary iodine concentration/urinary creatinine
thyroid function
