血清IL-17A、IL-6与妊娠期亚临床甲状腺功能减退症及妊娠结局的关系

The relationship between serum IL-17A,IL-6 and subclinical hypothyroidism during pregnancy and pregnancy outcome

目的分析血清白介素(IL)-17A、IL-6与妊娠期发生亚临床甲状腺功能减退症(SCH)及妊娠结局的关系。方法选择2020年1月—2021年12月贵州中医药大学第二附属医院产科收治妊娠期SCH孕妇107例(SCH组)和正常妊娠孕妇109例(对照组),SCH组再根据妊娠结局分为妊娠结局不良亚组21例和妊娠结局正常亚组86例。检测2组及不同妊娠结局孕妇血清IL-17A、IL-6水平。Pearson分析血清IL-17A、IL-6与促甲状腺激素(TSH)的相关性,Logistic回归分析影响妊娠期间发生SCH的影响因素,ROC曲线分析血清IL-17A、IL-6诊断妊娠期发生SCH的效能。结果SCH组血清IL-17A、IL-6、TSH水平显著高于对照组(t/P=23.320/<0.001、27.803/<0.001、15.954/<0.001),妊娠结局不良亚组血清IL-17A、IL-6水平高于妊娠结局正常亚组(t/P=4.008/<0.001、7.551/<0.001)。血清IL-17A、IL-6与TSH均呈正相关(r/P=0.493/<0.001、0.369/<0.001),IL-17A与IL-6之间亦呈正相关(r/P=0.556/<0.001)。妊娠期碘摄入偏少及血清IL-17A、IL-6高是妊娠期发生SCH的危险因素[OR(95%CI)=2.354(1.625~3.409)、1.900(1.394~2.590)、1.654(1.259~2.172)]。血清IL-17A、IL-6及二者联合诊断妊娠期SCH的曲线下面积为0.604、0.671、0.803,联合检测高于单项指标诊断(Z=5.683、3.912,P均<0.001)。结论妊娠期SCH患者血清IL-17A、IL-6水平均升高,且与妊娠期间SCH的发生及妊娠结局不良有关,可作为妊娠期SCH诊断的辅助指标。

Objective To analyze the relationship between interleukin(IL)-17A and IL-6 with subclinical hypothyroidism(SCH)during pregnancy and pregnancy outcome.Methods From January 2020 to December 2021,107 pregnant women with SCH during pregnancy(SCH group)and 109 pregnant women with normal pregnancy(control group)were admitted to the Obstetrics Department of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine.The SCH group was divided into pregnancy outcomes according to pregnancy outcomes.There were 21 subgroups with poor outcomes and 86 subgroups with normal pregnancy outcomes.Serum levels of IL-17A and IL-6 in pregnant women with different pregnancy outcomes were detected.Pearson analyzed the correlation between serum IL-17A,IL-6 and thyroid-stimulating hormone(TSH),Logistic regression analyzed the influencing factors of SCH during pregnancy,and ROC curve analyzed the efficacy of serum IL-17A and IL-6 in diagnosing SCH during pregnancy.Results The serum levels of IL-17A,IL-6 and TSH in the SCH group were higher than those in the control group(t/P=23.320/<0.001,27.803/<0.001,15.954/<0.001),and the serum IL-17A and IL-6 levels in the subgroup with poor pregnancy outcome were higher than those in the subgroup with normal pregnancy outcome.group(t/P=4.008/<0.001,7.551/<0.001).Serum IL-17A and IL-6 were positively correlated with TSH(r/P=0.493/<0.001,0.369/<0.001),and there was also a positive correlation between IL-17A and IL-6(r/P=0.556/<0.001).Low iodine intake during pregnancy and high serum IL-17A and IL-6 are risk factors for SCH during pregnancy[OR(95%CI)=2.354(1.625-3.409),1.900(1.394-2.590),1.654(1.259-2.172)].The areas under the curve of serum IL-17A,IL-6 and their combination in the diagnosis of SCH during pregnancy were 0.604,0.671,and 0.803,and the combined detection was higher than the single index diagnosis(Z=5.683,3.912,all P<0.001).Conclusion Serum IL-17A and IL-6 levels were elevated in pregnant SCH patients,and they were associated with the occurrence of SCH during pregnancy and poor pregnancy outcomes,and could be used as auxiliary indicators for the diagnosis of SCH during pregnancy.