妊娠≤12周孕妇血清25-OH-VD水平与甲状腺功能减退症相关性

Correlation between serum 25-OH-VD level and hypothyroidism in women with≤12 gestational weeks

目的:探究妊娠≤12周孕妇血清25-羟维生素D(25-OH-VD)水平与甲状腺功能减退症关系。方法:选取2015年8月—2018年8月在本院产前检查的妊娠早期孕妇90例,测定血清25-OH-VD、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPOAb)、血清促甲状腺激素(TSH)及三碘甲状腺原氨酸(FT3)水平。分析孕妇维生素D与甲状腺功能指标水平间相关性及其影响。结果:90例孕妇血清25-OH-VD水平(16.7±4.3)μg/L(5.16~43.86μg/L),维生素D缺乏、不足以及充足孕妇分别占66.7%、23.3%、10.0%;不同维生素D水平孕妇血清FT4、TSH、FT3水平无差异(P>0.05),而TPOAb水平逐渐下降(P<0.05);不同维生素D水平孕妇甲状腺功能正常与减退比例无差异,临床甲状腺减退症、亚临床甲状腺减退症以及低T4血症发生也未见差异(均P>0.05);孕妇血清25-OH-VD与FT4、TSH、FT3水平不相关(P>0.05),与TPOAb水平呈负相关(P<0.05);多元logistic回归分析,FT4、TSH、FT3水平未影响孕妇维生素D水平(P>0.05),而TPOAb水平上升会增加孕妇维生素D缺乏风险(P<0.05)。结论:早期妊娠孕妇存在维生素D水平缺乏状况,孕妇血清25-OH-VD与患甲状腺功能减退症无相关性,但TPOAb水平上升会增加孕妇维生素D缺乏风险。

Objective:To investigate relationship between serum 25-hydroxyvitamin D(25-OH-VD)level and hypothyroidism of pregnant women with≤12 gestational weeks.Methods:90 early pregnancy women who underwent prenatal examination were enrolled in this study from August 2015 to August 2018.The levels of serum 25-OH-VD,free thyroxine(FT4),thyroid peroxidase antibody(TPOAb),thyroid stimulating hormone(TSH),and triiodothyronine(FT3)of these women were measured.The correlation between vitamin D level and thyroid function indexes of these women,and the influence of vitamin D level on their thyroid function were analyzed.Results:The serum 25-OH-VD level of these 90 women was 16.74±4.27μg/L(5.16 to 43.86μg/L).The proportion of women with vitamin D deficiency,with vitamin D insufficient,and with vitamin D adequation had accounted for 66.7%,23.3%and 10.0%,respectively.There were no significant differences in serum FT4,TSH or FT3 levels among the women with vitamin D deficiency,with vitamin D insufficient,and with vitamin D adequation(P>0.05).TPOAb level of the women with vitamin D deficiency,insufficient and adequation was decreased gradually(P<0.05).There was no significant difference in proportion of the women with normal thyroid function or hypothyroidism among the women with different vitamin D levels(P>0.05).There was no significant difference in proportion of the women with hypothyroidism,subclinical hypothyroidism or low T4 among the women with different vitamin D levels(all P>0.05).Serum 25-OH-VD level of the women was not correlated with their levels of FT4,TSH or FT3(P>0.05),which was negatively correlated with the TPOAb level(P<0.05).Multivariate Logistic regression analysis showed that the levels of FT4,TSH and FT3 of the women had not affect their vitamin D level(P>0.05),but the increased TPOAb level of pregnant women had improved their risk of vitamin D deficiency(P<0.05).Conclusion:There is vitamin D deficiency in some early pregnant women.There is no correlation between serum 25-OH-VD level of pregnant women and their hypothyroidism,however,the increased TPOAb level will increase the risk of vitamin D deficiency of pregnant women.