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Yan K, Sun X, Fan C, Wang X, Yu H. Unveiling the Role of Gut Microbiota and Metabolites in Autoimmune Thyroid Diseases: Emerging Perspectives. Int J Mol Sci 2024; 25:10918. [PMID: 39456701 PMCID: PMC11507114 DOI: 10.3390/ijms252010918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 10/05/2024] [Accepted: 10/06/2024] [Indexed: 10/28/2024] Open
Abstract
Autoimmune thyroid diseases (AITDs) are among the most prevalent organ-specific autoimmune disorders, with thyroid hormones playing a pivotal role in the gastrointestinal system's structure and function. Emerging evidence suggests a link between AITDs and the gut microbiome, which is a diverse community of organisms that are essential for digestion, absorption, intestinal homeostasis, and immune defense. Recent studies using 16S rRNA and metagenomic sequencing of fecal samples from AITD patients have revealed a significant correlation between a gut microbiota imbalance and the severity of AITDs. Progress in animal models of autoimmune diseases has shown that intervention in the gut microbiota can significantly alter the disease severity. The gut microbiota influences T cell subgroup differentiation and modulates the pathological immune response to AITDs through mechanisms involving short-chain fatty acids (SCFAs), lipopolysaccharides (LPSs), and mucosal immunity. Conversely, thyroid hormones also influence gut function and microbiota composition. Thus, there is a bidirectional relationship between the thyroid and the gut ecosystem. This review explores the pathogenic mechanisms of the gut microbiota and its metabolites in AITDs, characterizes the gut microbiota in Graves' disease (GD) and Hashimoto's thyroiditis (HT), and examines the interactions between the gut microbiota, thyroid hormones, T cell differentiation, and trace elements. The review aims to enhance understanding of the gut microbiota-thyroid axis and proposes novel approaches to mitigate AITD severity through gut microbiota modulation.
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Affiliation(s)
- Kai Yan
- Department of Immunology, Special Key Laboratory of Ocular Diseases of Guizhou Province, Zunyi Medical University, Zunyi 563000, China; (K.Y.); (C.F.)
- School of Basic Medical Sciences, Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi Medical University, Zunyi 563000, China; (X.S.); (X.W.)
| | - Xin Sun
- School of Basic Medical Sciences, Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi Medical University, Zunyi 563000, China; (X.S.); (X.W.)
| | - Chenxi Fan
- Department of Immunology, Special Key Laboratory of Ocular Diseases of Guizhou Province, Zunyi Medical University, Zunyi 563000, China; (K.Y.); (C.F.)
- School of Basic Medical Sciences, Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi Medical University, Zunyi 563000, China; (X.S.); (X.W.)
| | - Xin Wang
- School of Basic Medical Sciences, Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi Medical University, Zunyi 563000, China; (X.S.); (X.W.)
| | - Hongsong Yu
- Department of Immunology, Special Key Laboratory of Ocular Diseases of Guizhou Province, Zunyi Medical University, Zunyi 563000, China; (K.Y.); (C.F.)
- School of Basic Medical Sciences, Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi Medical University, Zunyi 563000, China; (X.S.); (X.W.)
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Medenica S, Stojanovic V, Capece U, Mazzilli R, Markovic M, Zamponi V, Vojinovic T, Migliaccio S, Defeudis G, Cinti F. The interlink between thyroid autoimmunity and type 1 diabetes and the impact on male and female fertility. Hormones (Athens) 2024; 23:429-437. [PMID: 38748060 DOI: 10.1007/s42000-024-00563-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 04/18/2024] [Indexed: 09/28/2024]
Abstract
The aim of this review is to discuss the several interconnections between thyroid autoimmunity and type 1 diabetes in terms of epidemiology, immunoserology, genetic predisposition, and pathogenic mechanisms. We will also analyze the impact of these conditions on both male and female fertility. A literature search was carried out using the MEDLINE/PubMed, Scopus, Google Scholar, ResearchGate, and Clinical Trials Registry databases with a combination of keywords. It was found that the prevalence of thyroid autoantibodies in individuals with type 1 diabetes (T1DM) varied in different countries and ethnic groups from 7 to 35% in both sexes. There are several types of autoantibodies responsible for the immunoserological presentation of autoimmune thyroid diseases (AITDs) which can be either stimulating or inhibiting, which results in AITD being in the plus phase (thyrotoxicosis) or the minus phase (hypothyroidism). Different types of immune cells such as T cells, B cells, natural killer (NK) cells, antigen presenting cells (APCs), and other innate immune cells participate in the damage of the beta cells of the islets of Langerhans, which inevitably leads to T1D. Multiple genetic and environmental factors found in variable combinations are involved in the pathogenesis of AITD and T1D. In conclusion, although it is now well-known that both diabetes and thyroid diseases can affect fertility, only a few data are available on possible effects of autoimmune conditions. Recent findings nevertheless point to the importance of screening patients with immunologic infertility for AITDs and T1D, and vice versa.
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Affiliation(s)
- Sanja Medenica
- Department of Endocrinology, Internal Medicine Clinic, Clinical Center of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - Vukasin Stojanovic
- Emergency Medicine Center of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - Umberto Capece
- UOS Centro Malattie Endocrine e Metaboliche, UOC Endocrinologia e Diabetologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rossella Mazzilli
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant' Andrea Hospital, Rome, Italy
| | - Milica Markovic
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Virginia Zamponi
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant' Andrea Hospital, Rome, Italy
| | - Tanja Vojinovic
- Faculty of Medicine, University od Montenegro, Podgorica, Montenegro
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, University Foro Italico of Rome, Rome, 00135, Italy
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy
| | - Giuseppe Defeudis
- Department of Movement, Human and Health Sciences, University Foro Italico of Rome, Rome, 00135, Italy.
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy.
| | - Francesca Cinti
- UOS Centro Malattie Endocrine e Metaboliche, UOC Endocrinologia e Diabetologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
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Gu S, Mo Z, Chen Z, Li X, Jiang Y, Liu C, Guo F, Li Y, Mao G, Huang X, Wang X. Assessment of Individual and Mixed Effects of Six Minerals on Thyroid Hormones in Chinese Pregnant Women. Nutrients 2024; 16:450. [PMID: 38337734 PMCID: PMC10857285 DOI: 10.3390/nu16030450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/02/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
The biosynthesis of thyroid hormones is essential for brain and neurological development. It requires iodine as a key component but is also influenced by other nutrients. Evidence for the combined nutrient status in relation to thyroid hormones during pregnancy is limited. We aimed to investigate the joint associations of iodine, selenium, zinc, calcium, magnesium and iron with maternal thyroid functions in 489 pregnant women from Hangzhou, China. Serum levels of six essential minerals and thyroid function parameters were measured during the first antenatal visit. Linear regression, quantile g-computation and Bayesian kernel machine regression were used to explore the individual and joint relationships between the six minerals and thyroid hormones. Linear regression analyses revealed that calcium was positively associated with free triiodothyronine (FT3). Zinc was positively associated with free thyroxine (FT4). Iodine was negatively associated with thyroid-stimulating hormone (TSH) and positively associated with FT3 and FT4. The quantile g-computation and BKMR models indicated that the joint nutrient concentration was negatively associated with TSH and positively associated with FT3 and FT4. Among the six minerals, iodine contributed most to thyroid function. The findings suggested that maintaining the appropriate concentration of minerals, either as individuals or a mixture, is important for thyroid health during pregnancy.
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Affiliation(s)
- Simeng Gu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (S.G.); (Z.M.); (Z.C.); (X.L.); (Y.J.); (C.L.); (F.G.); (Y.L.); (G.M.); (X.H.)
| | - Zhe Mo
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (S.G.); (Z.M.); (Z.C.); (X.L.); (Y.J.); (C.L.); (F.G.); (Y.L.); (G.M.); (X.H.)
| | - Zhijian Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (S.G.); (Z.M.); (Z.C.); (X.L.); (Y.J.); (C.L.); (F.G.); (Y.L.); (G.M.); (X.H.)
| | - Xueqing Li
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (S.G.); (Z.M.); (Z.C.); (X.L.); (Y.J.); (C.L.); (F.G.); (Y.L.); (G.M.); (X.H.)
| | - Yujie Jiang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (S.G.); (Z.M.); (Z.C.); (X.L.); (Y.J.); (C.L.); (F.G.); (Y.L.); (G.M.); (X.H.)
- Health Science Center, Ningbo University, Ningbo 315211, China
| | - Chenyang Liu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (S.G.); (Z.M.); (Z.C.); (X.L.); (Y.J.); (C.L.); (F.G.); (Y.L.); (G.M.); (X.H.)
- School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Fanjia Guo
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (S.G.); (Z.M.); (Z.C.); (X.L.); (Y.J.); (C.L.); (F.G.); (Y.L.); (G.M.); (X.H.)
| | - Yahui Li
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (S.G.); (Z.M.); (Z.C.); (X.L.); (Y.J.); (C.L.); (F.G.); (Y.L.); (G.M.); (X.H.)
- School of Public Health, Hangzhou Medical College, Hangzhou 310053, China
| | - Guangming Mao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (S.G.); (Z.M.); (Z.C.); (X.L.); (Y.J.); (C.L.); (F.G.); (Y.L.); (G.M.); (X.H.)
| | - Xuemin Huang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (S.G.); (Z.M.); (Z.C.); (X.L.); (Y.J.); (C.L.); (F.G.); (Y.L.); (G.M.); (X.H.)
| | - Xiaofeng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (S.G.); (Z.M.); (Z.C.); (X.L.); (Y.J.); (C.L.); (F.G.); (Y.L.); (G.M.); (X.H.)
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Li X, Zhang Z, Cai W, Zhou X, Zhang Y, Wu C, Xu X, Wu H. Association Between Serum Ferritin Levels in Early Pregnancy and Thyroid Function and Pregnancy Outcomes in Chinese Population. Int J Womens Health 2023; 15:1951-1957. [PMID: 38106565 PMCID: PMC10723073 DOI: 10.2147/ijwh.s436651] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/22/2023] [Indexed: 12/19/2023] Open
Abstract
Background The relationship of iron deficiency and thyroid hormone has been researched a lot among pregnant or other healthy population. However, invisible iron deficiency, namely shortage of serum ferritin (sFer) level, has been barely investigated among Chinese pregnant women. This study aimed to explore the effects of sFer status on thyroid function and pregnancy outcomes in a population-based upper first-class hospital. Methods A total of 781 singleton pregnant women of gestation in Shanghai General Hospital took part in this retrospective cohort study. The participants were divided into four groups by quartiles of serum ferritin levels (Q1-4). Binary logistic regressions were used to examine the strength of association between the different traits and the serum ferritin (sFer) quartiles separately, where Q1 (lowest ferritin quartile) was taken as the base reference. One-way ANOVA was adopted to compare the averages of the different variables across sFer quartiles. Categorical measures were compared by Fisher exact test or chi-square test. Results As the sFer concentration rises, incidence of premature birth (15.8%vs 12.3% vs 9.20% vs 6.20% p = 0.016) as well as threatened miscarriage (14.8% vs 7.2% vs 8.70% vs 6.70% p = 0.021) presented a downward trend. Compared with the other sFer group, subjects of the low sFer group were older, more often to be found to have lower serum γT3 and FT4 levels in early pregnancy but not in middle pregnancy. Conclusion sFer concentration in the first trimester can affect thyroid function. The correction of invisible iron deficiency with inadequate sFer status prior to pregnancy or during early pregnancy is imperative, not only to prevent anemia, but also for maintaining optimum thyroid function and normal fetal development. For clinicians, sFer status of pregnant women should be attached great importance apart from attention to iron level.
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Affiliation(s)
- Xing Li
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Zhuyuan Zhang
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Wen Cai
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Xuexin Zhou
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Yan Zhang
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Cailiang Wu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Xianming Xu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Hao Wu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
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Garofalo V, Condorelli RA, Cannarella R, Aversa A, Calogero AE, La Vignera S. Relationship between Iron Deficiency and Thyroid Function: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:4790. [PMID: 38004184 PMCID: PMC10675576 DOI: 10.3390/nu15224790] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/05/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
Objective: Iron deficiency (ID) is the most prevalent nutritional deficiency worldwide. Low levels of serum ferritin (SF) could affect the thyroid gland and its functioning. The purpose of this systematic review and meta-analysis is to summarize the main currently available evidence and analyze data on the relationship between ID and thyroid function. Methods: This study included all articles evaluating the relationship between ID and thyroid function. Quality assessment was performed using Cambridge Quality Checklists. The search strategy included the following combination of Medical Subjects Headings terms and keywords: "iron deficiency", "thyroid function", "thyroid disease", "thyroid dysfunction", and "hypothyroidism". A meta-analysis was performed to evaluate whether thyroid stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) levels differed between patients with ID and healthy controls without ID. For statistical comparison between cases and controls, the mean difference (MD) was calculated, and a subgroup analysis of pregnant and non-pregnant women was performed. Cochran's Q testing and heterogeneity indices (I2) were used to assess statistical heterogeneity. Sensitivity analysis and publication bias analyses were also performed, both qualitatively and quantitatively. Finally, a meta-regression analysis was performed to evaluate the correlation between serum TSH or FT4 levels and SF in the study population. Results: Ten cross-sectional studies were identified and reviewed. Patients with ID showed TSH (MD: -0.24 mIU/L; 95% CI -0.41, -0.07; I2 = 100%, p = 0.005), FT4 (MD: -1.18 pmol/L; 95% CI -1.43, -0.94; I2 = 99%, p < 0.000001), and FT3 (MD: -0.22 pmol/L; 95% CI -0.32, -0.12; I2 = 99%, p < 0.00001) levels that were significantly lower. Subgroup analysis confirmed significantly lower TSH, FT4, and FT3 levels in pregnant women. Non-pregnant women showed significantly lower serum FT4 and FT3 levels but no difference in TSH values. Meta-regression analysis showed that serum TSH and FT4 levels were positively correlated with SF levels. Our systematic review of the literature found that ID significantly increases the prevalence of thyroid autoantibody (anti-thyroglobulin antibodies and anti-thyroid peroxidase antibodies) positivity both individually and collectively. Conclusion: Studies currently published in the literature indicate a possible relationship between ID, thyroid function, and autoimmunity, especially in some patient groups. Data analysis shows that thyroid hormone levels are lower in patients with ID and, in particular, in pregnant women. Further studies are needed to understand the role played by iron in thyroid metabolism.
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Affiliation(s)
- Vincenzo Garofalo
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
| | - Rosita A. Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
- Cleveland Clinic Foundation, Glickman Urological & Kidney Institute, Cleveland, OH 44195, USA
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy;
| | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
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Abbas W, Elmugabil A, Hamdan HZ, Rayis DA, Adam I. Iron deficiency and thyroid dysfunction among sudanese women in first trimester of pregnancy: a cross-sectional study. BMC Endocr Disord 2023; 23:223. [PMID: 37833658 PMCID: PMC10571453 DOI: 10.1186/s12902-023-01487-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 10/11/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Pregnant women are more susceptible to iron deficiency (ID), and it can lead to several maternal and perinatal adverse effects. There are some published data on the effect of ID on thyroid function, but none of the studies were conducted in sub-Saharan African countries including Sudan. This study was conducted to investigate association between ID (ferritin < 15 µg/L) and thyroid functions [thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4)] among Sudanese women in the first trimester of pregnancy. METHOD A cross-sectional study was conducted in Saad Abuelela Maternity Hospital, Sudan. Obstetric/sociodemographic characteristics were gathered through questionnaires. Hemoglobin, serum ferritin, TSH, FT3, and FT4 were measured in all pregnant women. Continuous variables were compared with either independent sample t-test if they were normally distributed, or with Mann-Whitney U- test if they were not-normally distributed. Spearman correlations were performed between the continuous variables. RESULTS In total, 127 pregnant women with mean [standard deviation (SD)] age of 27.0 (5.5) years and gestational age of 10.5 (3.0) weeks, respectively, were enrolled in this study. Forty-seven (37.0%) of these 127 women had ID. While the median [interquartile range (IQR)] of the parity, TSH, and FT3 were not different between women with ID and women without ID, the median (IQR) of FT4 was significantly lower in women with ID compared with women without ID [1.020 (0.910‒1.120) vs. 1.095 (0.990‒1.217) pmol, P = 0.014]. Serum ferritin was inversely correlated with FT3, (r = -0.225, P = 0.011). There was no significant correlation between serum ferritin, TSH, and FT4. CONCLUSIONS Iron deficiency was common during the first trimester of pregnancy and was associated with thyroid dysfunctions. Therefore, ID should be evaluated to avoid thyroid dysfunction.
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Affiliation(s)
- Wisal Abbas
- Faculty of Medicine, Kordofan University, Elobeid, Sudan
| | | | - Hamdan Z Hamdan
- Department of Basic Medical Sciences, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, 51911, Saudi Arabia
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Al-Neelain University, P.O. BOX 12702, Khartoum, Sudan
| | - Duria A Rayis
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
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Ovadia YS, Gefel D, Toledano Y, Rosen SR, Avrahami-Benyounes Y, Groisman L, Rorman E, Hen L, Fytlovich S, Katz LS, Anteby EY, Shenhav S. Does Iodine Intake Modify the Effect of Maternal Dysglycemia on Birth Weight in Mild-to-Moderate Iodine-Deficient Populations? A Mother-Newborn Prospective Cohort Study. Nutrients 2023; 15:2914. [PMID: 37447240 PMCID: PMC10343728 DOI: 10.3390/nu15132914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
It is unclear how maternal glycemic status and maternal iodine status influence birth weight among individuals with mild-to-moderate iodine deficiency (ID). We studied the association between birth weight and both maternal glucose levels and iodine intake among pregnant women with mild-to-moderate ID. Glucose values were assessed using a glucose challenge test (GCT) and non-fasting glucose levels that were determined before delivery; individuals' iodine statuses were assessed using an iodine food frequency questionnaire; and serum thyroglobulin (Tg) and urinary iodine concentrations (UIC) were used to assess each group's iodine status. Thyroid antibodies and free thyroxine (FT4) levels were measured. Obstetric and anthropometric data were also collected. Large-for-gestational age (LGA) status was predicted using a Cox proportional hazards model with multiple confounders. Tg > 13 g/L was independently associated with LGA (adjusted hazard ratio = 3.4, 95% CI: 1.4-10.2, p = 0.001). Estimated iodine intake correlated with FT4 among participants who reported consuming iodine-containing supplements (ICS) after adjusting for confounders (β = 0.4, 95% CI: 0.0002-0.0008, p = 0.001). Newborn weight percentiles were inversely correlated with maternal FT4 values (β = -0.2 95% CI:-0.08--56.49, p = 0.049). We conclude that in mild-to-moderate ID regions, insufficient maternal iodine status may increase LGA risk. Iodine status and ICS intake may modify the effect that maternal dysglycemia has on offspring weight.
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Affiliation(s)
- Yaniv S. Ovadia
- Obstetrics and Gynecology Department, Barzilai University Medical Center, Ashkelon 7830604, Israel; (L.H.); (E.Y.A.); (S.S.)
- Foreign Studies Department, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100001, Israel
| | - Dov Gefel
- School of Nutritional Science, Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100001, Israel; (D.G.); (S.R.R.)
| | - Yoel Toledano
- Endocrinology Clinic, Division of Maternal Fetal Medicine, Helen Schneider Women’s Hospital, Rabin Medical Center, Petah Tikva 4941492, Israel;
| | - Shani R. Rosen
- School of Nutritional Science, Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100001, Israel; (D.G.); (S.R.R.)
- Center for Healthcare Technology and Innovation Policy Research, Gertner Institute of Epidemiology & Health Policy Research, Sheba Medical Center, Ramat Gan 5262000, Israel
| | - Yael Avrahami-Benyounes
- Women’s Health Center, Maccabi Healthcare Services, Southern Region, Beersheba 8489312, Israel;
| | - Ludmila Groisman
- National Public Health Laboratory, Ministry of Health, Tel Aviv 6108401, Israel; (L.G.); (E.R.)
| | - Efrat Rorman
- National Public Health Laboratory, Ministry of Health, Tel Aviv 6108401, Israel; (L.G.); (E.R.)
| | - Lihi Hen
- Obstetrics and Gynecology Department, Barzilai University Medical Center, Ashkelon 7830604, Israel; (L.H.); (E.Y.A.); (S.S.)
| | - Shlomo Fytlovich
- Laboratory of Clinical Biochemistry, Barzilai University Medical Center, Ashkelon 7830604, Israel;
| | - Liora S. Katz
- Diabetes, Obesity and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Eyal Y. Anteby
- Obstetrics and Gynecology Department, Barzilai University Medical Center, Ashkelon 7830604, Israel; (L.H.); (E.Y.A.); (S.S.)
- Faculty of Health Sciences, Ben-Gurion University of Negev, Beersheba 8410501, Israel
| | - Simon Shenhav
- Obstetrics and Gynecology Department, Barzilai University Medical Center, Ashkelon 7830604, Israel; (L.H.); (E.Y.A.); (S.S.)
- Faculty of Health Sciences, Ben-Gurion University of Negev, Beersheba 8410501, Israel
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