孕妇年龄、BMI、尿碘/肌酐对甲状腺激素水平的影响  

Effect of maternal age, BMI,and urinary iodine/creatinine on thyroid hormone levels

作　　者：史梦琪 徐洪娜 李昕 刘想 SHI Meng-qi;XU Hong-na;LI Xin;LIU Xiang(Nantong City Center for Disease Control and Prevention,Nantong,Jiangsu 226000,China;Harbin City Center for Disease Control and Prevention;Institute of Iodine Deficiency Disorders(IDD),Chinese Center for Disease Control and Prevention,Harbin Medical University;Department of Ultrasound,Nantong First People's Hospital)

机构地区：[1]南通市疾病预防控制中心,江苏226000 [2]哈尔滨市疾病预防控制中心 [3]哈尔滨医科大学中国疾病预防控制中心地方病控制中心碘缺乏病防治研究所 [4]南通市第一人民医院超声科

出　　处：《预防医学论坛》2023年第1期62-65,共4页Preventive Medicine Tribune

摘　　要：目的 分析孕妇年龄、体质量指数(BMI)、尿碘/肌酐对甲状腺激素水平的影响。方法 选择充分补碘地区黑龙江省哈尔滨市(该地区连续三年盐碘覆盖率>95%,合格碘盐食用率>90%)的部分孕妇作为研究对象,分析问卷调查及实验室检测结果。用分光光度法检测尿碘及尿肌酐水平;采用西门子公司化学分析仪检测血清TSH、FT3及FT4水平。比较不同年龄、BMI、尿碘/肌酐孕妇的甲状腺激素水平变化。结果 共收集547名孕妇的年龄数据,508名孕妇的BMI数据,1 310名孕妇的尿液样本。年龄<30岁256名,30~35岁220名,>35岁71名;BMI<18.5 kg/m234名,18.5~23.9 kg/m2288名,24~27.9 kg/m2131名,≥28 kg/m255名;尿碘/肌酐中位数为142.00(102.92,209.98) g/g,将尿碘/肌酐按<50g/g、50~99g/g、100~149g/g、150~199g/g、200~249g/g、250~299g/g、≥300g/g分为7组。不同年龄FT4、TSH水平比较,差异有统计学意义(P<0.05),30~35岁孕妇TSH水平高于<30岁孕妇,35岁以上孕妇FT3、FT4水平低于<30岁孕妇,35岁以上孕妇FT4水平低于30~35岁孕妇;不同BMI的FT4、TSH水平比较,差异有统计学意义(P<0.05),BMI升高会伴随FT4水平下降,TSH水平升高;不同尿碘/肌酐FT3水平比较差异有统计学意义(P<0.05),尿碘肌酐水平<50 μg/g组FT3高于100~149 μg/g、200~249 μg/g、250~299 μg/g、≥300 μg/g组;尿碘肌酐水平50~99 μg/g组FT3高于≥300 μg/g组;尿碘肌酐水平100~149 μg/g组FT3低于150~199 μg/g组;尿碘肌酐水平150~199 μg/g组FT3浓度高于≥300 μg/g组。结论 孕妇年龄、BMI及尿碘/肌酐对甲状腺激素水平有一定影响。Objective To analyze of the effects of maternal age, BMI,and urinary iodine/creatinine on thyroid hormone levels. Methods Some pregnant women in Harbin city, Heilongjiang province, a region with adequate iodine supplementation(salt iodine coverage >95% and consumption rate of qualified iodized salt >90% for 3 consecutive years in the region) were selected as the study population, and the results of questionnaire surveys and laboratory tests were analyzed.The levels of urinary iodine and creatinine were detected by spectrophotometry.Serum TSH,FT3and FT4levels were measured using a Siemens chemistry analyzer.The thyroid hormone levels of different age, BMI,urinary iodine/creatinine were compared. Results Age data of 547 pregnant women, BMI data of 508 pregnant women and urine samples of 1 310 pregnant women were collected.There were 256 pregnant women aged <30 years, 220 pregnant women aged 30-35 years, and 71 pregnant women aged >35 years.There were 2 34 pregnant women with BMI<18.5 kg/m~2,288 with BMI between 18.5 and 23.9 kg/m~2,2131 with BMI between 24 and 27.9 kg/m~2,and 55 with BMI ≥ 28 kg/m~2.The median of urinary iodine-creatinine ratio was 142.00(102.92,209.98) g/g.The urinary iodine-creatinine ratio was divided into 7 groups according to <50 g/g, 50-99 g/g, 100-149 g/g, 150-199 g/g, 200-249 g/g, 250-299 g/g and ≥300 g/g.There were statistically significant differences in thyroid hormone levels of FT4and TSH among different age groups(P<0.05).The level of TSH in pregnant women ranging in age from 30-35 were higher than those less than 30 in age, while the levels of FT3and FT4in pregnant women more than 35 in age were lower than those less than 30 in age.There were statistically significant differences in thyroid hormone levels of FT4and TSH among different BMI groups(P<0.05).Increased BMI was coupled with an increase in TSH level and a decrease in FT4level.There were statistically significant differences in thyroid hormone level of FT3among different urinary iodine-creatinine ratio groups(P<0.05).The l

关 键 词：妊娠 碘 孕龄 体质量指数 尿碘/肌酐 甲状腺激素 

分 类 号：R563.1[医药卫生—呼吸系统]