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Bath SC. Thyroid function and iodine intake: global recommendations and relevant dietary trends. Nat Rev Endocrinol 2024; 20:474-486. [PMID: 38693274 DOI: 10.1038/s41574-024-00983-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 05/03/2024]
Abstract
Iodine is a micronutrient that is essential for thyroid hormone production. Adequate iodine intake is especially important during pregnancy and early life, when brain development is dependent on thyroid hormones. Iodine intake recommendations vary around the world, but most recommendations generally reflect the increased requirements during pregnancy and lactation, although adequate iodine intake before pregnancy is also important. Tremendous progress has been made in improving iodine intake across the world over the past 30 years, mainly through salt-iodization programmes. However, in countries without strong iodine fortification programmes, and with shifts in dietary patterns, a need has arisen for health organizations, governments and clinicians to ensure that adequate iodine is consumed by everyone in the population. For example, in countries in which adequate iodine intake depends on individual food choice, particularly of iodine-rich milk and dairy products, intake can be highly variable and is also vulnerable to changing dietary patterns. In this Review, iodine is considered in the wider context of the increasing prevalence of overweight and obesity, the dietary trends for salt restriction for cardiovascular health and the increasing uptake of plant-based diets.
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Affiliation(s)
- Sarah C Bath
- Department of Nutrition, Food and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
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Zheng X, Lai K, Liu C, Chen Y, Zhang X, Wu W, Luo M, Gu C. Association between maternal lipid profiles and vitamin D status in second trimester and risk of LGA or SGA: a retrospective study. Front Endocrinol (Lausanne) 2024; 15:1297373. [PMID: 39010896 PMCID: PMC11246877 DOI: 10.3389/fendo.2024.1297373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 06/18/2024] [Indexed: 07/17/2024] Open
Abstract
Background Accumulating evidence has linked dyslipidemia during pregnancy to the risk of delivering infants born either large for gestational age (LGA) or small for gestational age (SGA). However, the effects of the vitamin D status on these relationships require further investigation. This study investigated whether the relationship between lipid profiles and the risk of LGA or SGA was influenced by vitamin D levels during the second trimester. Methods Maternal lipid profile levels, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and vitamin D levels, were measured in a cohort of 6,499 pregnant women during the second trimester. Multivariate regression models and subgroup analyses were employed to evaluate the potential associations between maternal lipid profiles, vitamin D levels, and the risk of LGA or SGA. Results The prevalence of SGA infants was 9.8% (n=635), whereas that of LGA infants was 6.9% (n=447). Maternal TG levels were found to be positively associated with the risk of LGA (odds ratio [OR] = 1.41, 95% confidence interval [CI]:1.17-1.70), whereas a negative association was observed between maternal TG, TC, LDL-C levels, and risk of SGA. Additionally, mothers with higher HDL-C levels were less likely to give birth to an LGA infant (OR=0.58, 95% CI:0.39-0.85). Importantly, associations between TG, TC, LDL-c, and SGA as well as between TG and LGA were primarily observed among pregnant women with insufficient vitamin D levels. As for HDL-C, the risk of LGA was lower in mothers with sufficient vitamin D (OR = 0.42, 95% CI:0.18-0.98) compared to those with insufficient vitamin D (OR = 0.65, 95% CI:0.42-0.99). Conclusion Vitamin D status during the second trimester exerts a modifying effect on the association between lipid profiles and the risk of LGA and SGA infants.
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Affiliation(s)
| | | | | | | | | | | | | | - Chunming Gu
- Department of Clinical Laboratory, Guangdong Women and Children Hospital, Guangzhou, China
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Conejo-Bolaños LD, Mora AM, Hernández-Bonilla D, Cano JC, Menezes-Filho JA, Eskenazi B, Lindh CH, van Wendel de Joode B. Prenatal current-use pesticide exposure and children's neurodevelopment at one year of age in the Infants' Environmental Health (ISA) birth cohort, Costa Rica. ENVIRONMENTAL RESEARCH 2024; 249:118222. [PMID: 38272290 PMCID: PMC11065598 DOI: 10.1016/j.envres.2024.118222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/09/2024] [Accepted: 01/14/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Pesticide exposure may affect young children's neurodevelopment, but only few cohort studies have addressed possible effects of non-organophosphate pesticides. OBJECTIVE We evaluated associations between prenatal current-use pesticide exposure and neurodevelopmental outcomes among 1-year-old children from the Infants' Environmental Health (ISA) birth cohort. METHODS To determine prenatal pesticide exposure, we measured biomarkers of pyrimethanil, chlorpyrifos, synthetic pyrethroids, and 2,4-D in urine samples among 355 women, 1-3 times during pregnancy. One-year post-partum, we evaluated children's neurodevelopment with the Bayley Scales of Infant and Toddler Development 3rd edition (BSID-III). We assessed associations between exposures and neurodevelopmental outcomes (composite and z-scores) using single-chemical linear regression models adjusted for possible confounders (maternal education, parity, sex, gestational age at birth, child age, HOME-score, location of assessment, biomarkers of mancozeb), and studied effect-modification by sex. We evaluated non-linear associations of multiple pesticide exposures with Bayesian kernel machine regression (BKMR). RESULTS We found higher prenatal urinary 2,4-D concentrations were associated with lower language (βper ten-fold increase = -2.0, 95 % confidence interval (CI) = -3.5, -0.5) and motor (βper ten-fold increase = -2.2, 95 %CI = -4.2, -0.1) composite scores among all children. Also, higher chlorpyrifos exposure [measured as urinary 3,5,6-trichloro-2-pyridinol (TCPy)] was associated with lower cognitive composite scores (βper ten-fold increase = -1.9, 95 %CI = -4.7, 0.8), and lower motor composite scores among boys (βper ten-fold increase = -3.8, 95 % CI = -7.7, 0.1) but not girls (βper ten-fold increase = 2.3, 95 %CI = -1.6, 6.3, pINT = 0.11). Finally, higher pyrimethanil was associated with lower language abilities among girls, but not boys. Pyrethroid metabolite concentrations did not explain variability in BSID-III composite scores. Associations were similar for BSID-III z-scores, and we found no evidence for non-linear associations or mixture effects. DISCUSSION Prenatal exposure to common-use pesticides may affect children's neurodevelopment at 1-year of age, some effects may be sex-specific.
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Affiliation(s)
- L Diego Conejo-Bolaños
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica; Institute for Interdisciplinary Studies in Childhood and Adolescence (INEINA), Universidad Nacional, Heredia, Costa Rica
| | - Ana M Mora
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica; Center for Environmental Research and Community Health (CERCH), University of California at Berkeley, United States
| | | | - Juan Camilo Cano
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - José A Menezes-Filho
- Laboratory of Toxicology, College of Pharmacy, Federal University of Bahia, Av. Barão de Jeremoabo s/n Campus, Universitário de Ondina, 40170-115, Salvador, Bahia, Brazil
| | - Brenda Eskenazi
- Center for Environmental Research and Community Health (CERCH), University of California at Berkeley, United States
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Berna van Wendel de Joode
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica.
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Sánchez RM, Bermeo Losada JF, Marín Martínez JA. The research landscape concerning environmental factors in neurodevelopmental disorders: Endocrine disrupters and pesticides-A review. Front Neuroendocrinol 2024; 73:101132. [PMID: 38561126 DOI: 10.1016/j.yfrne.2024.101132] [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: 10/23/2023] [Revised: 03/08/2024] [Accepted: 03/29/2024] [Indexed: 04/04/2024]
Abstract
In recent years, environmental epidemiology and toxicology have seen a growing interest in the environmental factors that contribute to the increased prevalence of neurodevelopmental disorders, with the purpose of establishing appropriate prevention strategies. A literature review was performed, and 192 articles covering the topic of endocrine disruptors and neurodevelopmental disorders were found, focusing on polychlorinated biphenyls, polybrominated diphenyl ethers, bisphenol A, and pesticides. This study contributes to analyzing their effect on the molecular mechanism in maternal and infant thyroid function, essential for infant neurodevelopment, and whose alteration has been associated with various neurodevelopmental disorders. The results provide scientific evidence of the association that exists between the environmental neurotoxins and various neurodevelopmental disorders. In addition, other possible molecular mechanisms by which pesticides and endocrine disruptors may be associated with neurodevelopmental disorders are being discussed.
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Affiliation(s)
- Rebeca Mira Sánchez
- Universidad de Murcia, Spain; Instituto de Ciencias Medioambientales y Neurodesarrollo ICMYN, Murcia, Spain.
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Geng M, Ding P, Wang S, Wang B, Tong J, Gao H, Yan S, Liu K, Wu X, Zhu P, Cao Y, Huang K, Tao F. Prenatal antibiotics exposure and preschoolers' internalizing and externalizing problems: A biomonitoring-based prospective birth cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 919:170891. [PMID: 38346651 DOI: 10.1016/j.scitotenv.2024.170891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Biomonitoring-based epidemiological studies on prenatal antibiotic exposure and behavioral problems in preschoolers are lacking. The present study aimed to investigate the relationship between prenatal antibiotic exposure and internalizing and externalizing problems in preschoolers. METHODS Data from 2449 mother-child pairs were analyzed. Urine samples were repeatedly collected across three trimesters, and 43 antibiotics and 2 metabolites were measured, including preferred as veterinary antibiotics (PVAs), VAs, preferred as human antibiotics and human antibiotics. Preschoolers' internalizing and externalizing problems were evaluated by the Achenbach Child Behavior Checklist. Poisson regression models with generalized estimating equations were used to estimate risk ratios (RRs) and 95 % confidence intervals (CIs) for preschoolers' internalizing, externalizing and total problems across tertiles of antibiotic concentrations during three periods of pregnancy, and performed several subgroup analyses. RESULTS First-trimester urinary oxytetracycline (RR = 1.69, 95%CI: 1.20, 2.39, P-FDR = 0.011), tetracycline (RR = 1.91, 95%CI: 1.36, 2.68, P-FDR < 0.001), doxycycline (RR = 1.66, 95%CI: 1.28, 2.17, P-FDR < 0.001) and PVAs (RR = 1.79, 95%CI: 1.29, 2.48, P-FDR < 0.001) concentrations in the highest tertile were related to an elevated risk of internalizing problems compared with concentrations in the lowest tertile. First-trimester urinary doxycycline concentrations in the third tertile were also associated with an increased risk of externalizing problems compared with the first tertile (RR = 2.00, 95%CI: 1.28, 3.15, P-FDR = 0.042). Compared with concentrations in the lowest tertile, first-trimester urinary doxycycline (RR = 1.63, 95%CI: 1.19, 2.22, P-FDR = 0.028) and PVAs (RR = 1.67, 95%CI: 1.14, 2.43, P-FDR = 0.047) concentrations in the middle tertile were related to an increased risk of total problems. Furthermore, the type of main caregiver and children's outdoor activities time modified the relationships between specific prenatal antibiotic exposure and preschoolers' behavioral problems. CONCLUSIONS Exposure to specific antibiotics during the first trimester may be related to an increased risk of internalizing and externalizing problems in preschoolers.
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Affiliation(s)
- Menglong Geng
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Peng Ding
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Sheng Wang
- The Center for Scientific Research of Anhui Medical University, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Baolin Wang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Juan Tong
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Hui Gao
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Department of Pediatric, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230022, Anhui, China
| | - Shuangqin Yan
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; Ma'anshan Maternal and Child Healthcare (MCH) Center, Ma'anshan 243011, China
| | - Kaiyong Liu
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Xiaoyan Wu
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Peng Zhu
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yunxia Cao
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Kun Huang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Fangbiao Tao
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.
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Gao R, Lyu X, Yang Y, Fu J, Zhao C, Guan H, Ma X. Evaluating the progression to abnormal thyrotropin in euthyroid preconception women: a population-based study. Thyroid Res 2024; 17:5. [PMID: 38462616 PMCID: PMC10926655 DOI: 10.1186/s13044-024-00192-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/22/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Abnormal preconception thyrotropin levels were associated with fecundability and adverse fetomaternal outcomes, however, little is known regarding the natural change of serum thyrotropin in euthyroid preconception women. Thus, we performed a population-based study to evaluate the progression to abnormal thyrotropin in euthyroid preconception women. METHODS This retrospective cohort study used data from the National Free Prepregnancy Checkups Project (NFPCP) collected between 2010 and 2020. Female Han Chinese participants aged 20-49 years who had two repeated NFPCP participations with a time interval of 1.5-3.0 years, confirmed non-pregnant status within this duration, and normal thyrotropin levels during their first participation were included for the analysis of thyrotropin abnormalities during the second NFPCP examination. Data were analyzed between June 1 and October 1, 2023. RESULTS This study included 186,095 euthyroid women of reproductive age (mean ± SD, 26.72 ± 4.70 years) whose preconception thyrotropin levels were between 0.37 and 4.87 mIU/L. The median follow-up time was 2.13 (IQR, 1.85-2.54) years. A total of 8,497 (4.57%) women developed abnormal thyrotropin, including 4,118 (2.21%) subnormal thyrotropin and 4,379 (2.35%) supranormal thyrotropin. Compared with the reference group (thyrotropin 1.01-2.00 mIU/L), the lower baseline thyrotropin group had greater risk of developing subnormal thyrotropin, and the higher baseline thyrotropin group had greater risk of developing supranormal thyrotropin. Moreover, the restricted cubic spline analysis revealed a U-shaped dose-response association of baseline thyrotropin levels or thyrotropin multiples of the median (MOM) levels against risk of subnormal thyrotropin in the follow-up, and a J-shaped dose-response association against risk of supranormal thyrotropin levels in the follow-up. We further found that baseline thyrotropin outside of 1.43-1.93 mIU/L or baseline thyrotropin MOM outside 0.59-1.36 would hava a higher risk of developing of abnormal thyrotropin. CONCLUSIONS Both low and high baseline thyrotropin were associated with a significantly increased risk of developing abnormal thyrotropin outcomes. The optimal preconception baseline thyrotropin levels may be between 1.43 mIU/L and 1.93 mIU/L or baseline thyrotropin MoM between 0.59 and 1.36 to minimize progression toward abnormal thyrotropin after 1.5-3.0 years. These findings may help with counseling of preconception thyroid function monitoring.
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Affiliation(s)
- Rili Gao
- Department of Endocrinology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Xinyi Lyu
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Ying Yang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Jinrong Fu
- Department of Endocrinology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Chuanyu Zhao
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Haixia Guan
- Department of Endocrinology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
| | - Xu Ma
- National Research Institute for Family Planning, Beijing, China.
- National Human Genetic Resources Center, Beijing, China.
- Graduate School of Peking Union Medical College, Beijing, China.
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7
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Osinga JAJ, Derakhshan A, Feldt-Rasmussen U, Huang K, Vrijkotte TGM, Männistö T, Bassols J, López-Bermejo A, Aminorroaya A, Vafeiadi M, Broeren MAC, Palomaki GE, Ashoor G, Chen L, Lu X, Taylor PN, Tao FB, Brown SJ, Sitoris G, Chatzi L, Vaidya B, Popova PV, Vasukova EA, Kianpour M, Suvanto E, Grineva EN, Hattersley A, Pop VJM, Nelson SM, Walsh JP, Nicolaides KH, D’Alton ME, Poppe KG, Chaker L, Bliddal S, Korevaar TIM. TSH and FT4 Reference Interval Recommendations and Prevalence of Gestational Thyroid Dysfunction: Quantification of Current Diagnostic Approaches. J Clin Endocrinol Metab 2024; 109:868-878. [PMID: 37740543 PMCID: PMC10876390 DOI: 10.1210/clinem/dgad564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/14/2023] [Accepted: 09/21/2023] [Indexed: 09/24/2023]
Abstract
CONTEXT Guidelines recommend use of population- and trimester-specific thyroid-stimulating hormone (TSH) and free thyroxine (FT4) reference intervals (RIs) in pregnancy. Since these are often unavailable, clinicians frequently rely on alternative diagnostic strategies. We sought to quantify the diagnostic consequences of current recommendations. METHODS We included cohorts participating in the Consortium on Thyroid and Pregnancy. Different approaches were used to define RIs: a TSH fixed upper limit of 4.0 mU/L (fixed limit approach), a fixed subtraction from the upper limit for TSH of 0.5 mU/L (subtraction approach) and using nonpregnancy RIs. Outcome measures were sensitivity and false discovery rate (FDR) of women for whom levothyroxine treatment was indicated and those for whom treatment would be considered according to international guidelines. RESULTS The study population comprised 52 496 participants from 18 cohorts. Compared with the use of trimester-specific RIs, alternative approaches had a low sensitivity (0.63-0.82) and high FDR (0.11-0.35) to detect women with a treatment indication or consideration. Sensitivity and FDR to detect a treatment indication in the first trimester were similar between the fixed limit, subtraction, and nonpregnancy approach (0.77-0.11 vs 0.74-0.16 vs 0.60-0.11). The diagnostic performance to detect overt hypothyroidism, isolated hypothyroxinemia, and (sub)clinical hyperthyroidism mainly varied between FT4 RI approaches, while the diagnostic performance to detect subclinical hypothyroidism varied between the applied TSH RI approaches. CONCLUSION Alternative approaches to define RIs for TSH and FT4 in pregnancy result in considerable overdiagnosis and underdiagnosis compared with population- and trimester-specific RIs. Additional strategies need to be explored to optimize identification of thyroid dysfunction during pregnancy.
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Affiliation(s)
- Joris A J Osinga
- Department of Internal Medicine, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Arash Derakhshan
- Department of Internal Medicine, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and clinical Sciences, Copenhagen University, 1172 Copenhagen, Denmark
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, 230032 Anhui, China
| | - Tanja G M Vrijkotte
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Tuija Männistö
- Northern Finland Laboratory Center Nordlab and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, 90570 Oulu, Finland
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta Hospital, 17007 Girona, Spain
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta Hospital, 17007 Girona, Spain
- Departament de Ciències Mèdiques, Universitat de Girona, 17003 Girona, Spain
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, 81745-33871 Isfahan, Iran
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, 710 03 Crete, Greece
| | - Maarten A C Broeren
- Laboratory of Clinical Chemistry and Hematology, Máxima Medical Centre, 5504 DB Veldhoven, The Netherlands
| | - Glenn E Palomaki
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital and Alpert Medical School at Brown University, Providence, RI 02903, USA
| | - Ghalia Ashoor
- Harris Birthright Research Center for Fetal Medicine, King’s College Hospital, SE5 9RS London, UK
| | - Liangmiao Chen
- Department of Endocrinology and Rui’an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, 325035 Wenzhou, China
| | - Xuemian Lu
- Department of Endocrinology and Rui’an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, 325035 Wenzhou, China
| | - Peter N Taylor
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, CF10 3EU Cardiff, UK
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 230032 Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, 230032 Anhui, China
| | - Suzanne J Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, 6009 Nedlands, Perth, Australia
| | - Georgiana Sitoris
- Endocrine Unit, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), 1000 Brussels, Belgium
| | - Lida Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Bijay Vaidya
- Department of Endocrinology, Royal Devon and Exeter Hospital NHS Foundation Trust, University of Exeter Medical School, EX1 2LU Exeter, UK
| | - Polina V Popova
- Institute of Endocrinology, Almazov National Medical Research Centre, 197341 Saint Petersburg, Russia
- World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, 197341 Saint Petersburg, Russia
| | - Elena A Vasukova
- Institute of Endocrinology, Almazov National Medical Research Centre, 197341 Saint Petersburg, Russia
| | - Maryam Kianpour
- Departament de Ciències Mèdiques, Universitat de Girona, 17003 Girona, Spain
| | - Eila Suvanto
- Department of Obstetrics and Gynecology and Medical Research Center Oulu, University of Oulu, 90570 Oulu, Finland
| | - Elena N Grineva
- Institute of Endocrinology, Almazov National Medical Research Centre, 197341 Saint Petersburg, Russia
| | - Andrew Hattersley
- Molecular Medicine, University of Exeter Medical School, Royal Devon & Exeter Hospital, EX3 0AW Exeter, UK
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, 5000 LE Tilburg, The Netherlands
| | - Scott M Nelson
- School of Medicine, University of Glasgow, G12 8QQ Glasgow, UK
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, 6009 Nedlands, Perth, Australia
- Medical School, University of Western Australia, Crawley, WA 6009, Australia
| | - Kypros H Nicolaides
- Department of Women and Children’s Health, Faculty of Life Sciences and Medicine King’s College London, SE5 9RS London, UK
| | - Mary E D’Alton
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, NewYork, NY 10032, USA
| | - Kris G Poppe
- Endocrine Unit, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), 1000 Brussels, Belgium
| | - Layal Chaker
- Department of Internal Medicine, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Sofie Bliddal
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Tim I M Korevaar
- Department of Internal Medicine, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
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8
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Long J, Liang J, Liu T, Huang H, Chen J, Liao Q, Pang L, Yang K, Chen M, Chen Q, Huang X, Zhu Q, Zeng X, Huang D, Qiu X. Association between prenatal exposure to alkylphenols and intelligence quotient among preschool children: sex-specific effects. Environ Health 2024; 23:21. [PMID: 38365736 PMCID: PMC10870542 DOI: 10.1186/s12940-024-01047-5] [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: 09/25/2023] [Accepted: 01/05/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND While prenatal exposure to alkylphenols (APs) has been demonstrated to be associated with neurodevelopmental impairments in animals, the evidence from epidemiological studies remains limited and inconclusive. This study aimed to explore the link between AP exposure during pregnancy and the intelligence quotient (IQ) of preschool children. METHODS A total of 221 mother-child pairs from the Guangxi Zhuang Birth Cohort were recruited. Nonylphenol (NP), 4-tert-octylphenol (4-T-OP), 4-n-nonylphenol (4-N-NP), and 4-n-octylphenol were measured in maternal serum in early pregnancy. Childhood IQ was evaluated by the Fourth Edition of Wechsler Preschool and Primary Scale of the Intelligence at 3 to 6 years of age. The impact of APs on childhood IQ were evaluated by generalized linear models (GLMs), restricted cubic spline (RCS), and Bayesian kernel machine regression (BKMR). RESULTS In GLMs, prenatal exposure to NP and the second tertile of 4-T-OP exhibited an inverse association with full-scale IQ (FSIQ) (β = -2.38; 95% CI: -4.59, -0.16) and working memory index (WMI) (β = -5.24; 95% CI: -9.58, -0.89), respectively. Prenatal exposure to the third tertile of 4-N-NP showed a positive association with the fluid reasoning index (β = 4.95; 95% CI: 1.14, 8.77) in total children, as well as in girls when stratified by sex. A U-shaped relationship between maternal 4-T-OP and WMI was noted in total children and girls by RCS (all P nonlinear < 0.05). The combined effect primarily driven by NP, of maternal AP mixtures at concentrations above the 50th percentile exhibited an inverse trend on FSIQ in total children and girls in BKMR. CONCLUSIONS Prenatal exposure to various APs affects IQ in preschool children, and there may be nonmonotonic and sex-specific effects. Further investigation across the population is required to elucidate the potential neurotoxic effects of APs.
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Affiliation(s)
- Jinghua Long
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
- The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Jun Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Tao Liu
- Huaihua Center for Disease Control and Prevention, Huaihua, 418000, Hunan, China
| | - Huishen Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Jiehua Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Qian Liao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Lixiang Pang
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Kaiqi Yang
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Manlin Chen
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Qian Chen
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Xiaorong Huang
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Qihua Zhu
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Xiaoyun Zeng
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Dongping Huang
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China.
| | - Xiaoqiang Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China.
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9
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Kaplan ZB, Pearce EN, Lee SY, Shin HM, Schmidt RJ. Maternal Thyroid Dysfunction During Pregnancy as an Etiologic Factor in Autism Spectrum Disorder: Challenges and Opportunities for Research. Thyroid 2024; 34:144-157. [PMID: 38149625 PMCID: PMC10884547 DOI: 10.1089/thy.2023.0391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition with unknown etiology. Both genetic and environmental factors have been associated with ASD. Environmental exposures during the prenatal period may play an important role in ASD development. This narrative review critically examines the evidence for a relationship between maternal thyroid dysfunction during pregnancy and ASD in the child. Summary: Studies that assessed the associations of hypothyroidism, hyperthyroidism, hypothyroxinemia, thyroid hormone concentrations, or autoimmune thyroid disease with ASD outcomes were included. Most research focused on the relationship between hypothyroidism and ASD. Multiple population-based studies found that maternal hypothyroidism was associated with higher likelihood of an ASD diagnosis in offspring. Associations with other forms of maternal thyroid dysfunction were less consistent. Findings may have been affected by misclassification bias, survival bias, or publication bias. Studies using medical records may have misclassified subclinical thyroid dysfunction as euthyroidism. Two studies that assessed children at early ages may have misclassified those with ASD as typically developing. Most studies adjusted for maternal body mass index (BMI) and/or mental illness, but not interpregnancy interval or pesticide exposure, all factors associated with fetal survival and ASD. Most studies reported a combination of null and statistically significant findings, although publication bias is still possible. Conclusions: Overall, evidence supported a positive association between maternal thyroid dysfunction during pregnancy and ASD outcomes in the child, especially for hypothyroidism. Future studies could reduce misclassification bias by using laboratory measures instead of medical records to ascertain thyroid dysfunction and evaluating children for ASD at an age when it can be reliably detected. Survival bias could be further mitigated by adjusting models for more factors associated with fetal survival and ASD. Additional research is needed to comprehensively understand the roles of maternal levothyroxine treatment, iodine deficiency, or exposure to thyroid-disrupting compounds in the relationship between maternal thyroid dysfunction and child ASD outcomes.
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Affiliation(s)
- Zoe B Kaplan
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, California, USA
| | - Elizabeth N Pearce
- Department of Medicine, Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University Chobanian & Avesidian School of Medicine, Boston, Massachusetts, USA
| | - Sun Y Lee
- Department of Medicine, Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University Chobanian & Avesidian School of Medicine, Boston, Massachusetts, USA
| | - Hyeong-Moo Shin
- Department of Environmental Science, Baylor University, Waco, Texas, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, California, USA
- The MIND Institute, School of Medicine, University of California, Davis, Sacramento, California, USA
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10
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Zhao Z, Zhao H, Xiong Y, Zhou Q, Li X. Impact of levothyroxine therapy for maternal subclinical and overt hypothyroidism on early child neurodevelopment: A prospective cohort study. Clin Endocrinol (Oxf) 2024; 100:76-86. [PMID: 37859522 DOI: 10.1111/cen.14984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/08/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE Treatment indication of maternal subclinical hypothyroidism (SCH) is undetermined, despite the wide administration of levothyroxine for maternal overt hypothyroidism (OH). This study aimed to evaluate the therapeutic effect of levothyroxine for maternal SCH and OH in real-world practice, with a focus on early child neurodevelopment. DESIGN Prospective cohort study. PATIENTS AND MEASUREMENTS Pregnant women diagnosed with SCH at the first antenatal visit were enroled and compared to those diagnosed with OH. Thyroid follow-ups were conducted during pregnancy. Early child neurodevelopment was assessed using the Gesell Development Diagnosis Scale (GDDS) at 1, 3, 6, 12 and 24 months of age. RESULTS From January 2012 to December 2013, a total of 442 pregnant women were included in final analysis, among whom 194 and 248 were assigned to the SCH and OH groups, respectively. The percentage of levothyroxine therapy at the first antenatal visit was significantly lower in the SCH group than that in the OH group (91.24% vs. 97.58%, p < .01), with a similar treatment rate at delivery (99.4% vs. 100%, p > .05). Notably, GDDS scores were lower in the SCH group than those in the OH group at 6 months to 2 years of age, which was confirmed by subgroup analyses and sensitivity analyses. CONCLUSIONS Children born with maternal SCH demonstrated slightly lower neuropsychological scores at 6 months to 2 years of age compared to those with maternal OH in the clinical practice. The therapeutic effect of maternal SCH on the child neurodevelopment requires further exploration.
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Affiliation(s)
- Zhekun Zhao
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Huanqiang Zhao
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Department of Obstetrics, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, China
| | - Yu Xiong
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Qiongjie Zhou
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Xiaotian Li
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Department of Obstetrics, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, China
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11
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Li J, Tu F, Wan Y, Qian X, Mahai G, Wang A, Ma J, Yang Z, Xia W, Xu S, Zheng T, Li Y. Associations of Trimester-Specific Exposure to Perchlorate, Thiocyanate, and Nitrate with Childhood Neurodevelopment: A Birth Cohort Study in China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:20480-20493. [PMID: 38015815 DOI: 10.1021/acs.est.3c06013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Studies about the impacts of maternal exposure to perchlorate, thiocyanate, and nitrate on offspring neurodevelopment are scarce. Based on a birth cohort in China, 1,028 mothers provided urine samples at three trimesters for determination of the three target analytes, and their offspring neurodevelopment was evaluated at 2 years old. Associations of maternal exposure to the three chemicals with offspring neurodevelopment were estimated using three statistical methods. Trimester-specific analyses using generalized estimating equation models showed that double increment of thiocyanate and nitrate during the first trimester was associated with 1.56 (95% CI: -2.82, -0.30) and 1.22 (-2.40, -0.03) point decreases in the offspring mental development index (MDI), respectively. Weighted quantile sum (WQS) regression analyses showed that the mixture exposure at the first and second trimesters was negatively associated with the offspring MDI (β = -2.39, 95% CI: -3.85, -0.93; β = -1.75, 95% CI: -3.04, -0.47, respectively) and thiocyanate contributed the most to the association (65.0 and 91.6%, respectively). Bayesian kernel machine regression analyses suggested an inverted U-shape relationship of maternal urinary thiocyanate with the offspring MDI. These findings suggested that prenatal exposure to the three chemicals (at current levels), especially thiocyanate and nitrate, may impair neurodevelopment. Early pregnancy seems to be the sensitive window.
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Affiliation(s)
- Juxiao Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China
| | - Fengqin Tu
- Wuhan Institute for Food and Cosmetic Control, Key Laboratory of Edible Oil Quality and Safety for State Market Regulation, Wuhan 430040, China
| | - Yanjian Wan
- Center for Public Health Laboratory Service, Institute of Environmental Health, Wuhan Centers for Disease Control & Prevention, Wuhan, Hubei 430024, PR China
| | - Xi Qian
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China
| | - Gaga Mahai
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China
| | - Aizhen Wang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China
| | - Jiaolong Ma
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China
| | | | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island 02912, United States
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China
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12
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Oelkrug R, Harder L, Pedaran M, Hoffmann A, Kolms B, Inderhees J, Gachkar S, Resch J, Johann K, Jöhren O, Krause K, Mittag J. Maternal thyroid hormone receptor β activation in mice sparks brown fat thermogenesis in the offspring. Nat Commun 2023; 14:6742. [PMID: 37875497 PMCID: PMC10597992 DOI: 10.1038/s41467-023-42425-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
It is well established that maternal thyroid hormones play an important role for the developing fetus; however, the consequences of maternal hyperthyroidism for the offspring remain poorly understood. Here we show in mice that maternal 3,3',5-triiodothyronine (T3) treatment during pregnancy leads to improved glucose tolerance in the adult male offspring and hyperactivity of brown adipose tissue (BAT) thermogenesis in both sexes starting early after birth. The activated BAT provides advantages upon cold exposure, reducing the strain on other thermogenic organs like muscle. This maternal BAT programming requires intact maternal thyroid hormone receptor β (TRβ) signaling, as offspring of mothers lacking this receptor display the opposite phenotype. On the molecular level, we identify distinct T3 induced alterations in maternal serum metabolites, including choline, a key metabolite for healthy pregnancy. Taken together, our results connect maternal TRβ activation to the fetal programming of a thermoregulatory phenotype in the offspring.
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Affiliation(s)
- Rebecca Oelkrug
- Institute for Endocrinology & Diabetes - Molecular Endocrinology, Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Lisbeth Harder
- Institute for Endocrinology & Diabetes - Molecular Endocrinology, Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Mehdi Pedaran
- Institute for Endocrinology & Diabetes - Molecular Endocrinology, Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Anne Hoffmann
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Philipp-Rosenthal-Straße 27, 04103, Leipzig, Germany
| | - Beke Kolms
- Institute for Endocrinology & Diabetes - Molecular Endocrinology, Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Julica Inderhees
- Bioanalytic Core Facility - Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Sogol Gachkar
- Institute for Endocrinology & Diabetes - Molecular Endocrinology, Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Julia Resch
- Institute for Endocrinology & Diabetes - Molecular Endocrinology, Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Kornelia Johann
- Institute for Endocrinology & Diabetes - Molecular Endocrinology, Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Olaf Jöhren
- Bioanalytic Core Facility - Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Kerstin Krause
- Department of Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Jens Mittag
- Institute for Endocrinology & Diabetes - Molecular Endocrinology, Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
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13
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Björnholm L, Orell O, Kerkelä M, Honka U, Laasonen S, Riekki T, Surcel HM, Suvanto E, Veijola J. Maternal Thyroid Function During Pregnancy and Offspring White Matter Microstructure in Early Adulthood: A Prospective Birth Cohort Study. Thyroid 2023; 33:1245-1254. [PMID: 37498774 PMCID: PMC10611975 DOI: 10.1089/thy.2022.0699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Background: The fetus is fully dependent on maternal thyroid hormones until mid-gestation and suboptimal maternal thyroid function has been associated with alterations in the neurodevelopment of the offspring. We used maternal free thyroxine (fT4) and thyrotropin (TSH) levels in early gestation to study the association of maternal thyroid function during early pregnancy and offspring brain white matter (WM) integrity in early adulthood. Methods: Our study population consisted of a total of 292 mother-child pairs. Maternal fT4 and TSH were used as predictors and offspring multimodal imaging measures of fractional anisotropy, mean diffusivity, and magnetization transfer ratio (FA, MD, and MTR) as dependent variables. First, as Global analysis, all analyzed 14 WM tracts were studied simultaneously using linear-mixed effect models. Second, if a global effect was detected, a post hoc Tract-wise analysis was carried out using linear models individually in each WM tract. Study population was stratified by sex. Results: We found a positive association between maternal fT4 and offspring Global FA in males when adjusted for all maternal and offspring covariates (n = 114; β = 0.154; confidence interval = 0.045-0.263; p = 0.006). The finding was observed to be driven by multiple WM tracts, of which three projection fiber tracts and the forceps minor survived correcting for multiple comparisons in Tract-wise analysis. Conclusions: Maternal thyroid function in early pregnancy was observed to be associated with WM microstructure in male offspring in early adulthood. Our results suggest that maternal fT4 levels in early pregnancy may modulate axonal characteristics, with a long-term effect on offspring WM development.
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Affiliation(s)
- Lassi Björnholm
- Research Unit of Clinical Medicine, Department of Psychiatry, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Olavi Orell
- Research Unit of Clinical Medicine, Department of Psychiatry, University of Oulu, Oulu, Finland
| | - Martta Kerkelä
- Research Unit of Clinical Medicine, Department of Psychiatry, University of Oulu, Oulu, Finland
| | - Ulriika Honka
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Sini Laasonen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Tiina Riekki
- Research Unit of Clinical Medicine, Department of Psychiatry, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | | | - Eila Suvanto
- Department of Obstetrics and Gynecology, Oulu University Hospital and MRC Oulu University, Oulu, Finland
| | - Juha Veijola
- Research Unit of Clinical Medicine, Department of Psychiatry, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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14
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Spina V, Baldini E, Cardarelli S, Oliva C, Venarubea S, Faraoni F, Pastore G, Tittoni R, Musella A, Squarcella A, Lori E, Renzi E, Feroci R, Mastrodonato F, Ciferri F, Virili C, Centanni M, Fabiani C, Rago R, Schiavi MC, Palazzetti P, D'Armiento E, Cantisani V, Sorrenti S, Ulisse S. Iodized Salt May Not Be Sufficient to Guarantee an Adequate Iodine Intake in Pregnant Women. Nutrients 2023; 15:4182. [PMID: 37836466 PMCID: PMC10574232 DOI: 10.3390/nu15194182] [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: 09/01/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Adequate iodine intake is of crucial importance in pregnancy to meet the thyroid hormone needs of both mother and fetus. In the present study, undertaken as a part of the surveillance actions following the introduction in Italy of a national salt iodination program in 2005, the iodine intake was investigated in 123 pregnant women and 49 control women living in the same area of central Italy. All the participants were screened for urinary iodine concentration (UIC), serum level of thyrotropin, free-thyroxine, free-triiodothyronine, and thyroid volume. Moreover, they were provided with a questionnaire on the use of iodine-containing salt or supplements. Control women had a median UIC of 102 µg/L, consistent with an iodine sufficiency, while in pregnant women the median UIC value was 108 µg/L, lower than the endorsed UIC of 150 µg/L. In addition, pregnant women showed a significantly increased median thyroid volume compared to controls. Interestingly, the median UIC did not differ between pregnant women not using iodine-containing salt or supplements and those regularly consuming iodized salt alone, while pregnant women with a daily intake of iodine-containing supplements had an adequate median UIC (168 µg/L). In conclusion, the data reported here showed that pregnant women and their fetuses are still exposed to the detrimental effects of iodine deficiency and that the consumption of iodine-containing supplements should be recommended in pregnancy.
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Affiliation(s)
- Vincenzo Spina
- Mother and Infant Department Unit, ASL-Rieti, 02100 Rieti, Italy
| | - Enke Baldini
- Department of Surgery, "Sapienza" University of Rome, 00185 Rome, Italy
| | - Silvia Cardarelli
- Department of Surgery, "Sapienza" University of Rome, 00185 Rome, Italy
| | - Cosimo Oliva
- Obstetrics and Gynaecology Unit, "S. Camillo De Lellis" Hospital, 02100 Rieti, Italy
| | - Stefano Venarubea
- Clinical Pathology Laboratory Unit, "S. Camillo De Lellis" Hospital, 02100 Rieti, Italy
| | - Franca Faraoni
- Pediatrics and Neonatology Unit, "S. Camillo De Lellis" Hospital, 02100 Rieti, Italy
| | - Giovanni Pastore
- Obstetrics and Gynaecology Unit, "S. Camillo De Lellis" Hospital, 02100 Rieti, Italy
| | - Rachele Tittoni
- Obstetrics and Gynaecology Unit, "S. Camillo De Lellis" Hospital, 02100 Rieti, Italy
| | - Angela Musella
- Obstetrics and Gynaecology Unit, "S. Camillo De Lellis" Hospital, 02100 Rieti, Italy
| | - Antonia Squarcella
- Obstetrics and Gynaecology Unit, "S. Camillo De Lellis" Hospital, 02100 Rieti, Italy
| | - Eleonora Lori
- Department of Surgery, "Sapienza" University of Rome, 00185 Rome, Italy
| | - Elisabetta Renzi
- Mother and Infant Department Unit, ASL-Rieti, 02100 Rieti, Italy
| | - Roberta Feroci
- Mother and Infant Department Unit, ASL-Rieti, 02100 Rieti, Italy
| | | | - Fabiola Ciferri
- Mother and Infant Department Unit, ASL-Rieti, 02100 Rieti, Italy
| | - Camilla Virili
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, 04100 Latina, Italy
| | - Marco Centanni
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, 04100 Latina, Italy
| | - Cristina Fabiani
- Mother and Infant Department, "Sandro Pertini" Hospital, 00157 Rome, Italy
| | - Rocco Rago
- Mother and Infant Department, "Sandro Pertini" Hospital, 00157 Rome, Italy
| | | | | | - Eleonora D'Armiento
- Department of Internal Medicine and and Medical Specialties, "Sapienza" University of Rome, 00185 Rome, Italy
| | - Vito Cantisani
- Department of Radiological and Oncological Sciences and Pathological Anatomy, "Sapienza" University of Rome, 00185 Rome, Italy
- Teleradiology Complex Unit, ASL-Rieti, 02100 Rieti, Italy
| | | | - Salvatore Ulisse
- Department of Surgery, "Sapienza" University of Rome, 00185 Rome, Italy
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Zhao Z, Zhou Q, Zhao H, Xiong Y, Li X. Association between levothyroxine treatment for maternal subclinical hypothyroidism with negative TPOAb and early child neurodevelopment: A prospective real-world clinical trial. Acta Obstet Gynecol Scand 2023; 102:1183-1192. [PMID: 37443452 PMCID: PMC10407020 DOI: 10.1111/aogs.14602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 07/15/2023]
Abstract
INTRODUCTION Subclinical hypothyroidism (SCH) during pregnancy is reported to have detrimental impact on pregnancy and child development. However, its treatment indications require further investigation in different thyroid peroxidase antibody (TPOAb) status. MATERIAL AND METHODS This was a secondary analysis of a Chinese prospective cohort in a real-world setting. Pregnant women with gestational SCH were enrolled at the first antenatal visit and grouped by TPOAb positivity. Child neurodevelopment was assessed by the Gesell development diagnosis scale (GDDS) at one, three, six, 12, and 24 months of age. Subgroup analyses and sensitivity analyses were also conducted. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT01744743. RESULTS From January 2012 to December 2013, a total of 171 participants were enrolled, including 116 of SCH with TPOAb negative (SCH-TPOAb [-]) and 55 of SCH with TPOAb positive (SCH-TPOAb [+]). Compared to women in the SCH-TPOAb (+) group, those in the SCH-TPOAb (-) group had lower thyroid-stimulating hormone (TSH) levels at enrollment and 12-16+6 gestational weeks, and unexpectedly higher TSH levels at 30-34+6 gestational weeks and delivery, with a correspondingly lower levothyroxine dosage throughout pregnancy (all p < 0.05). Offspring in the SCH-TPOAb (-) group displayed lower GDDS scores at one year old than did their counterparts (adjusted p < 0.05), which was possibly related to the worse thyroid function control of maternal SCH-TPOAb (-). No statistically significant difference was found in the GDDS assessments of children at one, three, six, and 24 months of age. These results were also confirmed in subgroup analyses stratified by maternal thyroid characteristics at enrollment, namely TSH levels, free levothyroxine (T4 ) levels, and anti-thyroglobulin antibody (TgAb) status, as well as in sensitivity analyses excluding participants with no levothyroxine treatment at enrollment. CONCLUSIONS In the current clinical practice, infants born to mothers with SCH-TPOAb (-) displayed slightly lower neurodevelopmental scores at one year old than did those born to mothers with SCH-TPOAb (+) but this difference was not seen at two years.
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Affiliation(s)
- Zhekun Zhao
- Department of ObstetricsObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Qiongjie Zhou
- Department of ObstetricsObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Huanqiang Zhao
- Department of ObstetricsObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Yu Xiong
- Department of ObstetricsObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Xiaotian Li
- Department of ObstetricsObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
- Department of ObstetricsShenzhen Maternity and Child Healthcare HospitalShenzhenGuangdongChina
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16
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Moleti M, Alibrandi A, Di Mauro M, Paola G, Perdichizzi LG, Granese R, Giacobbe A, Scilipoti A, Ragonese M, Ercoli A, Benvenga S, Vermiglio F. Preconception Thyrotropin Levels and Thyroid Function at Early Gestation in Women With Hashimoto Thyroiditis. J Clin Endocrinol Metab 2023; 108:e464-e473. [PMID: 36620924 DOI: 10.1210/clinem/dgac748] [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: 09/21/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 01/10/2023]
Abstract
CONTEXT Preconception optimization of thyroid function in women with Hashimoto thyroiditis (HT) is highly recommended to prevent/reduce the risk of thyroid insufficiency at early gestation. OBJECTIVE This work aimed to evaluate the prevalence of first-trimester thyroid insufficiency in HT women with preconception thyrotropin (T0-TSH) values consistently less than or equal to 2.5 mIU/L with or without levothyroxine (LT4) treatment, and to calculate T0-TSH cutoffs that best preconceptionally identified HT women requiring first-trimester LT4 adjustment/prescription. METHODS Serum TSH was obtained at 4- to 6-week intervals from 260 HT pregnant women (122 on LT4 [Hypo-HT]; 138 euthyroid without LT4 [Eu-HT]), prospectively followed from preconception up to pregnancy term. Receiver operating characteristic (ROC) curves were plotted to identify T0-TSH cutoffs best predicting first-trimester TSH levels greater than 2.5 mIU/L (diagnostic criterion [DC] 1) and greater than 4.0 mIU/L (DC 2). RESULTS At first trimester, TSH was greater than 2.5 mIU/L in approximately 30% of both Hypo-HT and Eu-HT women, and greater than 4.0 mIU/L in 19.7% Hypo-HT and 10.1% Eu-HT women (P = .038). The optimal ROC-based T0-TSH cutoffs found were 1.24 mIU/L/1.74 mIU/L in Hypo-HT, and 1.73 mIU/L/2.07 mIU/L in Eu-HT women, for DC 1 and DC 2, respectively. T0-TSH values exceeding these cutoffs resulted in a statistically significantly increased risk of first-trimester thyroid insufficiency (odds ratio [OR] [95% CI)] 15.92 [5.06-50.15] and 16.68 [5.13-54.24] in Hypo-HT; 16.14 [6.47-40.30] and 17.36 [4.30-70.08] in Eu-HT women, for DC 1 and DC 2, respectively). CONCLUSION The preconception TSH cutoffs that guaranteed a first-trimester TSH less than 2.5 mU/L in hypothyroid- and euthyroid-HT women were, respectively, almost 50% (1.24 mU/L) and 30% (1.73 mU/L) lower than this gestational target, and 1.74 mU/L and 2.07 mU/L in hypothyroid- and euthyroid-HT women, respectively, for a gestational target of 4.0 mU/L.
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Affiliation(s)
- Mariacarla Moleti
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Messina, 98125 Messina, Italy
| | - Angela Alibrandi
- Dipartimento di Economia, Università degli Studi di Messina, 98125 Messina, Italy
| | - Maria Di Mauro
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Messina, 98125 Messina, Italy
| | - Giuseppe Paola
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Messina, 98125 Messina, Italy
| | - Laura Giovanna Perdichizzi
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Messina, 98125 Messina, Italy
| | - Roberta Granese
- Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali, Università degli Studi di Messina, 98125 Messina, Italy
| | - Annamaria Giacobbe
- Dipartimento Assistenziale Integrato Materno Infantile, Azienda Ospedaliera Universitaria Policlinico G. Martino, Messina, Italy
| | - Angela Scilipoti
- Dipartimento Assistenziale Integrato Materno Infantile, Azienda Ospedaliera Universitaria Policlinico G. Martino, Messina, Italy
| | - Marta Ragonese
- Dipartimento di Patologia Umana dell'adulto e dell'età Evolutiva Gaetano Barresi, Università degli Studi di Messina, 98125 Messina, Italy
| | - Alfredo Ercoli
- Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali, Università degli Studi di Messina, 98125 Messina, Italy
| | - Salvatore Benvenga
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Messina, 98125 Messina, Italy
| | - Francesco Vermiglio
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Messina, 98125 Messina, Italy
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17
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Grossklaus R, Liesenkötter KP, Doubek K, Völzke H, Gaertner R. Iodine Deficiency, Maternal Hypothyroxinemia and Endocrine Disrupters Affecting Fetal Brain Development: A Scoping Review. Nutrients 2023; 15:nu15102249. [PMID: 37242131 DOI: 10.3390/nu15102249] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
This scoping review critically discusses the publications of the last 30 years on the impact of mild to moderate iodine deficiency and the additional impact of endocrine disrupters during pregnancy on embryonal/fetal brain development. An asymptomatic mild to moderate iodine deficiency and/or isolated maternal hypothyroxinemia might affect the development of the embryonal/fetal brain. There is sufficient evidence underlining the importance of an adequate iodine supply for all women of childbearing age in order to prevent negative mental and social consequences for their children. An additional threat to the thyroid hormone system is the ubiquitous exposure to endocrine disrupters, which might exacerbate the effects of iodine deficiency in pregnant women on the neurocognitive development of their offspring. Ensuring adequate iodine intake is therefore essential not only for healthy fetal and neonatal development in general, but it might also extenuate the effects of endocrine disruptors. Individual iodine supplementation of women of childbearing age living in areas with mild to moderate iodine deficiency is mandatory as long as worldwide universal salt iodization does not guarantee an adequate iodine supply. There is an urgent need for detailed strategies to identify and reduce exposure to endocrine disrupters according to the "precautional principle".
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Affiliation(s)
- Rolf Grossklaus
- Department of Food Safety, Federal Institute for Risk Assessment, D-10589 Berlin, Germany
| | | | - Klaus Doubek
- Professional Association of Gynecologists, D-80337 Munich, Germany
| | - Henry Völzke
- Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, D-17475 Greifswald, Germany
| | - Roland Gaertner
- Medical Clinic IV, University of Munich, D-80336 Munich, Germany
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18
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Zhao S, Du Y, Zhang Y, Wang X, Xia Y, Sun H, Huang Y, Zou H, Wang X, Chen Z, Zhou H, Yan R, Tang H, Lu Q, Yao Z. Gray matter reduction is associated with cognitive dysfunction in depressed patients comorbid with subclinical hypothyroidism. Front Aging Neurosci 2023; 15:1106792. [PMID: 36845662 PMCID: PMC9945283 DOI: 10.3389/fnagi.2023.1106792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/17/2023] [Indexed: 02/11/2023] Open
Abstract
Introduction To explore the association between regional gray matter volume (GMV) and cognitive impairments and ascertain whether the regional brain alterations related to cognitive impairments occur in major depressive disorder (MDD) patients with comorbid subclinical hypothyroidism (SHypo). Methods We enrolled 32 MDD patients, 32 MDD patients with comorbid SHypo, and 32 normal controls and subjected them to thyroid function tests, neurocognitive tests, and magnetic resonance imaging (MRI). Using voxel-based morphometry (VBM) analysis, we examined the pattern of gray matter (GM) in these participants. We also used ANOVA to detect group differences and partial correlation to explore the potential association between GMV alterations and cognitive tests in comorbid patients. Results The comorbid patients exhibited significantly smaller GMV in the right middle frontal gyrus (MFG) than the non-comorbid group. Furthermore, the partial correlation analysis showed that GMV of the right MFG was associated with poor executive function (EF) performance in comorbid patients. Conclusion These findings provide valuable insight into the relationship between the alteration of GMV and cognitive dysfunction of MDD patients with comorbid SHypo.
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Affiliation(s)
- Shuai Zhao
- Department of Psychiatry, The Affiliated Psychological Hospital of Anhui Medical University, Hefei, China,Hefei Fourth People’s Hospital, Hefei, China,Anhui Mental Health Center, Hefei, China,Anhui Clinical Research Center for Mental Disorders, Hefei, China,Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yishan Du
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoqin Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yi Xia
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Sun
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yinghong Huang
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China
| | - Haowen Zou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xumiao Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhilu Chen
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hongliang Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Rui Yan
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Tang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China,Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, China,*Correspondence: Qing Lu, ; Zhijian Yao,
| | - Zhijian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China,Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China,*Correspondence: Qing Lu, ; Zhijian Yao,
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19
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Li A, Hou J, Fu J, Wang Y, Hu Y, Zhuang T, Li M, Song M, Jiang G. Association between serum levels of TSH and free T4 and per- and polyfluoroalkyl compounds concentrations in pregnant women. J Environ Sci (China) 2023; 124:11-18. [PMID: 36182121 DOI: 10.1016/j.jes.2021.10.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/23/2021] [Accepted: 10/26/2021] [Indexed: 06/16/2023]
Abstract
Many per- and polyfluoralkyl substances (PFASs) may disrupt maternal thyroid hormone homeostasis in pregnancy. Concerns should be raised regarding the PFASs exposure in pregnant women because thyroid hormones are involved in the early development of the fetus. In this study, we measured the concentrations of 13 PFASs, including five novel short-chain PFASs, in serum from 123 pregnant women in Beijing, China. Linear regression models were used to investigate the association between thyroid-stimulating hormone (TSH) or free thyroxine (FT4) levels and PFASs concentrations under consideration of the impacts of pregnancy-induced physiological factors. We found that perfluorobutanoic acid (PFBA) (β=0.189, 95%CI=-0.039, 0.417, p=0.10) and perfluorodecanoic acid (PFDA) (β=-0.554, 95%CI=-1.16, 0.049, p=0.071) were suggestive of significant association with TSH in thyroid peroxidase antibody (TPOAb) negative women. No association was observed between all PFASs and FT4 levels after controlling for these confounding factors, such as BMI, gestational weight gain and maternal age. These findings suggest that it should pay more attention to the association between thyroid hormone levels and short-chain PFASs concentrations. Future studies could consider a greater sample and the inclusion of other clinical indicators of thyroid function, such as free T3 and total T3.
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Affiliation(s)
- Aijing Li
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Jianjie Fu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China
| | - Yinan Wang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Yifei Hu
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Taifeng Zhuang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Menglong Li
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Maoyong Song
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
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20
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Chen Y, Luo ZC, Zhang T, Fan P, Ma R, Zhang J, Ouyang F. Maternal Thyroid Dysfunction and Neuropsychological Development in Children. J Clin Endocrinol Metab 2023; 108:339-350. [PMID: 36198069 DOI: 10.1210/clinem/dgac577] [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: 04/06/2022] [Revised: 09/29/2022] [Indexed: 01/20/2023]
Abstract
CONTEXT Thyroid hormones are essential for fetal brain development. The potential effects of maternal gestational thyroid dysfunction on offspring neuropsychological development remain inconclusive. OBJECTIVE This work aimed to estimate effects of maternal thyroid dysfunction during pregnancy on offspring neuropsychological development in the first 2 years. METHODS We prospectively examined 1903 mothers and their children from the Shanghai Birth Cohort. Thyroid hormones were assessed at about 12 gestational weeks. Maternal thyroid function was classified into 7 categories: euthyroid, overt/subclinical hyperthyroidism, overt/subclinical hypothyroidism, hyperthyroxinemia, and hypothyroxinemia. Neuropsychological development was assessed by the Ages and Stages Questionnaire at age 6 months, and Bayley Scales at age 24 months. RESULTS Compared with children of euthyroid mothers, maternal overt hypothyroidism was associated with 7.0 points (95% CI, 1.7-12.4) lower scores in personal-social domain in girls aged 6 months, 7.3 points (95% CI, 2.0-12.6) lower in motor domain, and 7.7 points (95% CI, 1.1-14.2) lower social-emotional scores in boys at age 24 months; maternal subclinical hypothyroidism was associated with 6.5 points (95% CI, 1.0-12.1) poorer social-emotional domain in boys at age 6 months, and 7.4 points (95% CI, 0.1-14.8) poorer adaptive behavior domain in boys at age 24 months; maternal hypothyroxinemia was associated with 9.3 points (95% CI, 3.5-15.1) lower motor scores in boys at age 24 months; and maternal subclinical hyperthyroidism was associated with 6.9 points (95% CI, 0.1-13.7) lower language scores in girls at age 24 months. CONCLUSION Maternal overt hypothyroidism, subclinical hypothyroidism/hyperthyroidism, and hypothyroxinemia during early pregnancy were associated with weakened neuropsychological development in infancy, and some effects may be sex specific.
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Affiliation(s)
- Yuanzhi Chen
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Zhong-Cheng Luo
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
- Department of Obstetrics and Gynecology, Lunenfeld-Tanenbaum Research Institute, Prosserman Centre for Population Health Research, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, M5G 1X5, Canada
| | - Ting Zhang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Pianpian Fan
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Rui Ma
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jun Zhang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Fengxiu Ouyang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
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21
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Zuñiga LFF, Muñoz YS, Pustovrh MC. Thyroid hormones: Metabolism and transportation in the fetoplacental unit. Mol Reprod Dev 2022; 89:526-539. [PMID: 36208482 DOI: 10.1002/mrd.23647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 09/20/2022] [Accepted: 09/25/2022] [Indexed: 12/25/2022]
Abstract
The thyroid hormones (THs), thyroxine (T4) and triiodothyronine (T3), are of vital importance for fetal development. The concentration of THs in fetal circulation varies throughout gestation and differs from the concentration in the maternal serum, indicating the presence of maternal-fetal thyroid homeostasis regulatory mechanisms in the placenta. The passage of THs from maternal circulation to fetal circulation is modulated by plasma membrane transporters, enzymes, and carrier proteins. Monocarboxylate transporter 8, iodothyronine deiodinases (DIO2 and DIO3), and transthyretin are especially involved in this maternal-fetal thyroid modulation, shown by a greater expression in the placenta. THs also play a role in placental development and as expected, abnormal variations in TH levels are associated with pregnancy complications and can result in damage to the fetus. Although new evidence regarding TH regulation during pregnancy and its effects in the mother, placenta, and fetus has been published, many aspects of these interactions are still poorly understood. The objective of this review is to provide an evidence-based update, drawn from current data, on the metabolism and transport of THs in the placenta and their vital role in the maternal-fetal relationship.
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Affiliation(s)
- Luis Felipe Falla Zuñiga
- Department of Morphology, College of Basic Sciences, Faculty of Health, Universidad del Valle, Cali, Colombia
| | - Yhoiss Smiht Muñoz
- Department of Morphology, College of Basic Sciences, Faculty of Health, Universidad del Valle, Cali, Colombia
| | - Maria Carolina Pustovrh
- Department of Morphology, College of Basic Sciences, Faculty of Health, Universidad del Valle, Cali, Colombia
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22
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Andersen HR, David A, Freire C, Fernández MF, D'Cruz SC, Reina-Pérez I, Fini JB, Blaha L. Pyrethroids and developmental neurotoxicity - A critical review of epidemiological studies and supporting mechanistic evidence. ENVIRONMENTAL RESEARCH 2022; 214:113935. [PMID: 35870501 DOI: 10.1016/j.envres.2022.113935] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/15/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Pyrethroid metabolites are widely detectable in urine from the general population, including pregnant women and children. Pyrethroids are neurotoxic and suggested endocrine disruptors. Exposure during vulnerable developmental time windows may have long-term impacts on neurodevelopment. OBJECTIVE To evaluate the epidemiological evidence for neurodevelopmental effects related to prenatal and childhood pyrethroid exposure in a systematic review and to assess biological plausibility by evaluating mechanistic evidence. METHODS We searched PubMed and Web of Science up to September 1, 2021 and included original studies published in English in which pyrethroid exposure was measured or estimated during pregnancy or childhood and associations with neurodevelopmental outcomes in the children were investigated. The Navigation Guide Systematic Review Methodology was used to evaluate the epidemiological evidence. For mechanistic evidence, we focused on relevant key events (KEs) suggested in Adverse Outcome Pathways (AOPs) using the OECD-supported AOP-wiki platform. A systematic search combining the KEs with pyrethroids, including 26 individual compounds, was performed in the ToxCast database. RESULTS Twenty-five epidemiological studies met the inclusion criteria, 17 presented findings on prenatal exposure, 10 on childhood exposure and two on both exposure windows. The overall body of evidence was rated as "moderate quality" with "sufficient evidence" for an association between prenatal pyrethroid exposure and adverse neurodevelopment. For childhood exposure, the overall rating was "low quality" with "limited evidence" because of cross-sectional study design. Regarding mechanistic evidence, we found that pyrethroids are able to interfere with neurodevelopmental KEs included in established AOPs for adverse neurodevelopmental. The evidence was strongest for interference with thyroid hormone (TH) function. CONCLUSION Pyrethroids are probably human developmental neurotoxicants and adverse impacts of pyrethroid exposure on neurodevelopment are likely at exposure levels occurring in the general population. Preventive measures to reduce exposure among pregnant women and children are warranted.
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Affiliation(s)
- Helle Raun Andersen
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Arthur David
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
| | - Carmen Freire
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012, Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERSP), Spain
| | - Mariana F Fernández
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012, Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERSP), Spain; Biomedical Research Center (CIBM); School of Medicine, University of Granada, 18016, Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Shereen Cynthia D'Cruz
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
| | - Iris Reina-Pérez
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012, Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERSP), Spain; Biomedical Research Center (CIBM); School of Medicine, University of Granada, 18016, Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Jean-Baptiste Fini
- Unité PhyMA laboratory, Adaptation du Vivant Department, UMR 7221 MNHN/CNRS, Sorbonne Université, Paris, 75005, France
| | - Ludek Blaha
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
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Geng M, Gao H, Wang B, Huang K, Wu X, Liang C, Yan S, Han Y, Ding P, Wang W, Wang S, Zhu P, Liu K, Cao Y, Tao F. Urinary tetracycline antibiotics exposure during pregnancy and maternal thyroid hormone parameters: A repeated measures study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156146. [PMID: 35605876 DOI: 10.1016/j.scitotenv.2022.156146] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/13/2022] [Accepted: 05/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Studies on potential maternal thyrotoxicity related to tetracycline antibiotics exposure during pregnancy are lacking. Based on a large prospective cohort study, this study aimed to examine the associations between tetracycline antibiotics exposure in maternal urine and maternal thyroid hormone parameters. METHODS Based on the Ma'anshan Birth Cohort study, urine and serum samples of 2969 pregnant women were collected in the first, second and third trimesters. Tetracycline antibiotics, including oxytetracycline, chlorotetracycline, tetracycline and doxycycline in urine samples, as well as free thyroxine (FT4), thyroid stimulating hormone (TSH), total triiodothyronine (TT3) and total thyroxine (TT4) levels in serum samples, were measured. Linear mixed models and multivariate linear regression models were employed to examine associations between tetracycline antibiotics exposure during pregnancy and maternal thyroid hormone parameters. RESULTS The detection rates of four individual tetracycline antibiotics and all antibiotics (sum of four individual tetracycline antibiotics) in the three trimesters were 5.0%-52.3%, and the 95th percentile concentration ranged from 0.11 to 4.84 ng/mL. After adjusting for potential confounding factors, the repeated measures analyses indicated that pregnant women exposed to doxycycline and all antibiotics during the entire pregnancy were negatively associated with serum FT4 and TT4 levels but positively associated with serum TSH and TT3 levels. Trimester-stratified analyses found that doxycycline and all antibiotics exposure during the first trimester were negatively associated with serum FT4 and TT4 levels, while doxycycline was positively associated with TSH levels. In the third trimester, a significant association was only found between all antibiotics and TSH levels. CONCLUSIONS Our results suggest that exposure of pregnant women to tetracycline antibiotics is associated with maternal thyroid hormone parameters, and the first trimester might be the most critical window. More studies are needed to substantiate our findings and determine the underlying biological mechanisms.
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Affiliation(s)
- Menglong Geng
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Hui Gao
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, Anhui, China; Department of Pediatric, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230022, Anhui, China
| | - Baolin Wang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Kun Huang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Xiaoyan Wu
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Chunmei Liang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Shuangqin Yan
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; Ma'anshan Maternal and Child Healthcare (MCH) Center, Ma'anshan 243011, China
| | - Yan Han
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Peng Ding
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Wei Wang
- Suzhou Vocational Health College, No. 28, Kehua Road, North District, Suzhou International Education Park, Suzhou 215000, Jiangsu, China
| | - Sheng Wang
- The Center for Scientific Research of Anhui Medical University, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Peng Zhu
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Kaiyong Liu
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yunxia Cao
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Fangbiao Tao
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.
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Jensen RC, Glintborg D, Timmermann CAG, Nielsen F, Boye H, Madsen JB, Bilenberg N, Grandjean P, Jensen TK, Andersen MS. Higher free thyroxine associated with PFAS exposure in first trimester. The Odense Child Cohort. ENVIRONMENTAL RESEARCH 2022; 212:113492. [PMID: 35597289 DOI: 10.1016/j.envres.2022.113492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/18/2022] [Accepted: 05/14/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFAS) are endocrine disrupting chemicals with elimination half-lives ranging from four to eight years. Experimental studies found PFAS able to interfere with thyroid hormone-binding proteins. During the first 20 weeks of gestation (GW), the fetus is reliant on placental transfer of maternal thyroid hormones, mainly free thyroxine (FT4). However, previous studies investigating associations between exposure to PFAS and thyroid hormone status mainly focused on blood samples from late pregnancy or umbilical cord with mixed findings. OBJECTIVES To investigate associations between serum-PFAS concentrations and thyroid hormone status in early pregnancy as reflected by FT4 and thyroid-stimulating hormone (TSH). METHODS In the Odense Child Cohort, a single-center study, we measured maternal pregnancy serum concentrations of five PFAS: perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA); and FT4 and TSH in 1048 pregnant women at median GW 12 (25th, 75th percentile: 10, 15). Multivariate linear regression models were performed to estimate associations between PFAS exposure and thyroid hormone status. RESULTS A doubling in PFOS, PFOA, and PFNA concentrations was associated with an increment in FT4 concentration by 1.85% (95% CI: 0.66%, 3.05%), 1.29% (95% CI: 0.21%, 2.39%), and 1.70% (95% CI: 0.48%, 2.94%), respectively, in adjusted analyses. A statistically significant dose-response relationship was observed across exposure quartiles for PFOS, PFOA, and PFNA in the association with FT4. No association was found between concentrations of PFAS and TSH in adjusted analyses. CONCLUSION Exposure to PFOS, PFOA, and PFNA was associated with higher FT4 concentrations in women during early pregnancy. The potential clinical implications of these findings remain to be clarified.
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Affiliation(s)
- Richard Christian Jensen
- Department of Endocrinology, Odense University Hospital, Søndre Blvd. 29, 5000, Odense C, Denmark; Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, J.B. Winsløws Vej 17A, 5000, Odense C, Denmark.
| | - Dorte Glintborg
- Department of Endocrinology, Odense University Hospital, Søndre Blvd. 29, 5000, Odense C, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, 5000, Odense, Denmark
| | - Clara Amalie Gade Timmermann
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, J.B. Winsløws Vej 17A, 5000, Odense C, Denmark; National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, København K, Denmark
| | - Flemming Nielsen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, J.B. Winsløws Vej 17A, 5000, Odense C, Denmark
| | - Henriette Boye
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000, Odense C, Denmark
| | - Jeppe Buur Madsen
- Department of Biochemistry and Immunology, Lillebaelt Hospital, Kabbeltoft 25, University Hospital of Southern Denmark, 7100, Vejle, Denmark
| | - Niels Bilenberg
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, 5000, Odense, Denmark; Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000, Odense C, Denmark; Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, J. B. Winsløws Vej 16, 5000, Odense, Denmark
| | - Philippe Grandjean
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, J.B. Winsløws Vej 17A, 5000, Odense C, Denmark; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 677 Huntington Avenue Boston, MA, 02115, USA
| | - Tina Kold Jensen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, J.B. Winsløws Vej 17A, 5000, Odense C, Denmark; Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000, Odense C, Denmark; OPEN, University of Southern Denmark, J. B. Winsløws Vej 9a, 5000, Odense C, Denmark
| | - Marianne S Andersen
- Department of Endocrinology, Odense University Hospital, Søndre Blvd. 29, 5000, Odense C, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, 5000, Odense, Denmark
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Chen Z, van der Sman AE, Groeneweg S, de Rooij LJ, Visser WE, Peeters RP, Meima ME. Thyroid Hormone Transporters in a Human Placental Cell Model. Thyroid 2022; 32:1129-1137. [PMID: 35699060 PMCID: PMC9526468 DOI: 10.1089/thy.2021.0503] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background: Fetal brain development in the first half of pregnancy is dependent on maternal thyroid hormone (TH), highlighting the importance of trans-placental TH transport. It is yet unclear which transporters are involved in this process. We aimed to identify the major TH transporters in a human placental cell model (BeWo cells). Methods: Messenger RNA expression of the known TH transporters (the monocarboxylate transporter [MCT]8, MCT10, the L-type amino acid transporter [LAT]1, LAT2, the organic anion transporting peptide [OATP]1A2 and OATP4A1) in BeWo cells and human placenta were determined by quantitative PCR. To determine the specificity and efficacy of transporter inhibitors, we first determined TH uptake at different inhibitor concentrations in African green monkey kidney fibroblast-like cells (COS1 cells) overexpressing TH transporters. We then tested TH uptake in BeWo cells in the presence or absence of the optimal inhibitor concentrations. Results: All tested TH transporters were expressed in human term placentas, whereas MCT8 was absent in BeWo cells. Both 2-amino-2-norbornanecarboxylic acid (BCH) and L-tryptophan at 1 mM inhibited LATs, whereas at the highest concentration (10 mM) L-tryptophan also inhibited MCT10. Verapamil inhibited OATP1A2 and less efficiently both MCTs, but not LATs. Both rifampicin and naringin reduced OATP1A2 activity. Finally, silychristin inhibited MCT8 at submicromolar concentrations and OATP1A2 partially only at the highest concentration tested (10 μM). In BeWo cells, verapamil reduced triiodothyronine (T3) uptake by 24%, BCH by 31%, and 1 mM L-tryptophan by 41%. The combination of BCH and verapamil additively decreased T3 uptake by 53% and the combination of BCH and 10 mM L-tryptophan by 60%, suggesting a major role for MCT10 and LATs in placental T3 uptake. Indeed, transfection of BeWo cells with MCT10-specific small interfering RNA significantly reduced T3 uptake. Only the combination of BCH and verapamil significantly reduced thyroxine (T4) uptake in BeWo cells, by 32%. Conclusions: Using pharmacological inhibitors, we show that MCT10 and LATs play a major role in T3 uptake in BeWo cells. T4 uptake appears independent of known TH transporters, suggesting the presence of, currently unknown, alternative transporter(s).
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Affiliation(s)
- Zhongli Chen
- Erasmus MC Academic Centre for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A.S. Elise van der Sman
- Erasmus MC Academic Centre for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Stefan Groeneweg
- Erasmus MC Academic Centre for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Linda Johanna de Rooij
- Erasmus MC Academic Centre for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - W. Edward Visser
- Erasmus MC Academic Centre for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Robin P. Peeters
- Erasmus MC Academic Centre for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marcel E. Meima
- Erasmus MC Academic Centre for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
- Address correspondence to: Marcel E. Meima, PhD, Erasmus MC Academic Centre for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015 CN, The Netherlands
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26
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Lyu Y, Xiu Q, Zuo H, Xu G, Cui X, Sun Z, Mi R, Wu L. Effect of vitamin A on the relationship between maternal thyroid hormones in early pregnancy and fetal growth: A prospective cohort study. Front Nutr 2022; 9:980853. [PMID: 36091237 PMCID: PMC9449534 DOI: 10.3389/fnut.2022.980853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022] Open
Abstract
Background Fetal growth patterns are influenced by maternal thyroid function and vitamin A level during pregnancy. Vitamin A presents interactions with thyroid tissues and hormonal systems. We examined whether vitamin A status modified the associations of maternal thyroid hormones in early pregnancy and fetal growth outcomes among euthyroid pregnant women in a prospective cohort study (n = 637). Methods We performed multiple linear regression and multinomial logistic regression analysis to investigate the effects of thyroid hormones in early pregnancy on fetal growth according to different levels of serum vitamin A based on median value. Results A 1 pmol/L increase in maternal free triiodothyronine (FT3) levels was associated with an increased birth weight of 0.080 kg (p = 0.023) in women with lower maternal vitamin A levels in early pregnancy. Increased maternal free thyroxine (FT4) was associated with decreased odds for both small size for gestational age (SGA) [odds ratios (OR) = 0.66, 95% confidence interval (CI): 0.45–0.95] and large size for gestational age (LGA) (OR = 0.66, 95% CI: 0.45–0.98) in women with higher vitamin A level in early pregnancy after adjustment for maternal prepregnancy body mass index, gestational weight gain, maternal employed, parity, gestational week at sampling, and gestational diabetes mellitus. Conclusions In Chinese pregnant women without overt thyroid dysfunction, maternal FT4 in early pregnancy was positively associated with optimal fetal growth among women with higher serum vitamin A concentrations.
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Affiliation(s)
- Yanyu Lyu
- Experiment Center, Capital Institute of Pediatrics, Beijing, China
| | - Qingyong Xiu
- Department of Pediatrics, Beijing Daxing Maternal and Child Care Hospital, Beijing, China
| | - Hanxiao Zuo
- Experiment Center, Capital Institute of Pediatrics, Beijing, China
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Guangfei Xu
- Department of Nutrition, School of Public Health, Nantong University, Nantong, China
| | - Xiaodai Cui
- Experiment Center, Capital Institute of Pediatrics, Beijing, China
| | - Zhenfeng Sun
- Department of Obstetrics, Beijing Daxing Maternal and Child Care Hospital, Beijing, China
| | - Rong Mi
- Department of Neonatology, Children's Hospital of Capital Institute of Pediatrics, Beijing, China
| | - Lijun Wu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
- *Correspondence: Lijun Wu
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Yang Y, Guo T, Fu J, Zhao J, Wang Y, He Y, Peng Z, Zhang Y, Zhang H, Zhang Y, Wang Q, Shen H, Zhang Y, Yan D, Ma X, Guan H. Association of Preconception Thyrotropin Levels With Fecundability and Risk of Spontaneous Abortion in China. JAMA Netw Open 2022; 5:e2228892. [PMID: 36044217 PMCID: PMC9434356 DOI: 10.1001/jamanetworkopen.2022.28892] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Abundant evidence suggests thyroid dysfunction is associated with adverse pregnancy outcomes. However, associations of preconception thyrotropin levels outside of reference range with reproductive health outcomes are not well characterized. OBJECTIVE To evaluate the associations of preconception thyrotropin levels with time to pregnancy (TTP) and risk of spontaneous abortion (SA). DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study used data from the Chinese National Free Prepregnancy Checkups Project. Female participants aged 20 to 49 years who were trying to conceive were enrolled between January 1, 2013, and December 31, 2016, for the analysis of TTP or SA. Data were analyzed between August 1, 2020, and July 5, 2021. EXPOSURES Levels of thyrotropin within 1 year prior to pregnancy. MAIN OUTCOMES AND MEASURES The main outcomes were TTP, assessed using hazard ratios (HRs), and SA, assessed using odds ratios (ORs), according to preconception thyrotropin levels. Thyrotropin dose-response associations were assessed using restricted cubic spline regression. RESULTS Among 11 194 002 female participants (mean [SD] age, 27.56 [5.10] years) in the TTP cohort, 4 739 421 (42.34%) participants became pregnant within 1 year. Both low and high preconception thyrotropin levels were associated with delayed TTP compared with thyrotropin levels of 0.37 to 2.49 mIU/L (thyrotropin <0.10 mIU/L: HR, 0.90; 95% CI, 0.89-0.92; thyrotropin 4.88-9.99 mIU/L: HR, 0.86; 95% CI, 0.86-0.87; thyrotropin ≥10.00 mIU/L: HR, 0.78; 95% CI, 0.77-0.79). In the SA analysis cohort including 4 678 679 pregnancies, 108 064 SA events (2.31%) were documented. High thyrotropin groups showed an increased risk of SA compared with the group with thyrotropin levels of 0.37 to 2.49 mIU/L (thyrotropin 4.88-9.99 mIU/L: OR, 1.33; 95% CI, 1.28-1.38; thyrotropin ≥10.00 mIU/L: OR, 1.25; 95% CI, 1.14-1.36). Preconception thyrotropin levels showed an inverted J-shaped dose-response association with TTP (χ2 = 311.29; nonlinear P < .001) and a J-shaped dose-response association with SA (χ2 = 58.29; nonlinear P < .001). CONCLUSIONS AND RELEVANCE In this cohort study, preconception thyrotropin levels outside of reference range were associated with increased risk of reduced fecundity and SA. These findings may provide insights for the implementation of preconception thyroid function screening and the design of future levothyroxine supplementation trials.
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Affiliation(s)
- Ying Yang
- National Research Institute for Family Planning, National Human Genetic Resource Center, Beijing, China
- Graduate School of Peking Union Medical College, Dongdan Santiao, Beijing, China
| | - Tonglei Guo
- Graduate School of Peking Union Medical College, Dongdan Santiao, Beijing, China
| | - Jinrong Fu
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, China
| | - Jun Zhao
- National Research Institute for Family Planning, National Human Genetic Resource Center, Beijing, China
| | - Yuanyuan Wang
- National Research Institute for Family Planning, National Human Genetic Resource Center, Beijing, China
| | - Yuan He
- National Research Institute for Family Planning, National Human Genetic Resource Center, Beijing, China
- Graduate School of Peking Union Medical College, Dongdan Santiao, Beijing, China
| | - Zuoqi Peng
- National Research Institute for Family Planning, National Human Genetic Resource Center, Beijing, China
| | - Ya Zhang
- National Research Institute for Family Planning, National Human Genetic Resource Center, Beijing, China
| | - Hongguang Zhang
- National Research Institute for Family Planning, National Human Genetic Resource Center, Beijing, China
| | - Yue Zhang
- National Research Institute for Family Planning, National Human Genetic Resource Center, Beijing, China
| | - Qiaomei Wang
- Department of Maternal and Child Health, National Health Commission of the People’s Republic of China, Beijing, China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health Commission of the People’s Republic of China, Beijing, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health Commission of the People’s Republic of China, Beijing, China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health Commission of the People’s Republic of China, Beijing, China
| | - Xu Ma
- National Research Institute for Family Planning, National Human Genetic Resource Center, Beijing, China
- Graduate School of Peking Union Medical College, Dongdan Santiao, Beijing, China
| | - Haixia Guan
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Goodman CV, Hall M, Green R, Chevrier J, Ayotte P, Martinez-Mier EA, McGuckin T, Krzeczkowski J, Flora D, Hornung R, Lanphear B, Till C. Iodine Status Modifies the Association between Fluoride Exposure in Pregnancy and Preschool Boys' Intelligence. Nutrients 2022; 14:2920. [PMID: 35889877 PMCID: PMC9319869 DOI: 10.3390/nu14142920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 12/07/2022] Open
Abstract
In animal studies, the combination of in utero fluoride exposure and low iodine has greater negative effects on offspring learning and memory than either alone, but this has not been studied in children. We evaluated whether the maternal urinary iodine concentration (MUIC) modifies the association between maternal urinary fluoride (MUF) and boys' and girls' intelligence. We used data from 366 mother-child dyads in the Maternal-Infant Research on Environmental Chemicals Study. We corrected trimester-specific MUF and MUIC for creatinine, and averaged them to yield our exposure variables (MUFCRE, mg/g; MUICCRE, µg/g). We assessed children's full-scale intelligence (FSIQ) at 3 to 4 years. Using multiple linear regression, we estimated a three-way interaction between MUFCRE, MUICCRE, and child sex on FSIQ, controlling for covariates. The MUICCRE by MUFCRE interaction was significant for boys (p = 0.042), but not girls (p = 0.190). For boys whose mothers had low iodine, a 0.5 mg/g increase in MUFCRE was associated with a 4.65-point lower FSIQ score (95% CI: -7.67, -1.62). For boys whose mothers had adequate iodine, a 0.5 mg/g increase in MUFCRE was associated with a 2.95-point lower FSIQ score (95% CI: -4.77, -1.13). These results suggest adequate iodine intake during pregnancy may minimize fluoride's neurotoxicity in boys.
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Affiliation(s)
- Carly V. Goodman
- Department of Psychology, York University, Toronto, ONT M3J 1P3, Canada; (C.V.G.); (M.H.); (R.G.); (T.M.); (J.K.); (D.F.)
| | - Meaghan Hall
- Department of Psychology, York University, Toronto, ONT M3J 1P3, Canada; (C.V.G.); (M.H.); (R.G.); (T.M.); (J.K.); (D.F.)
| | - Rivka Green
- Department of Psychology, York University, Toronto, ONT M3J 1P3, Canada; (C.V.G.); (M.H.); (R.G.); (T.M.); (J.K.); (D.F.)
| | - Jonathan Chevrier
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3A 1G1, Canada;
| | - Pierre Ayotte
- Département de Médecine Sociale et Préventive, Faculté de Médecine, Université Laval, Québec, QC G1V 0A6, Canada;
| | - Esperanza Angeles Martinez-Mier
- Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN 46202, USA;
| | - Taylor McGuckin
- Department of Psychology, York University, Toronto, ONT M3J 1P3, Canada; (C.V.G.); (M.H.); (R.G.); (T.M.); (J.K.); (D.F.)
| | - John Krzeczkowski
- Department of Psychology, York University, Toronto, ONT M3J 1P3, Canada; (C.V.G.); (M.H.); (R.G.); (T.M.); (J.K.); (D.F.)
| | - David Flora
- Department of Psychology, York University, Toronto, ONT M3J 1P3, Canada; (C.V.G.); (M.H.); (R.G.); (T.M.); (J.K.); (D.F.)
| | - Richard Hornung
- Pediatrics and Environmental Health, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada;
| | - Christine Till
- Department of Psychology, York University, Toronto, ONT M3J 1P3, Canada; (C.V.G.); (M.H.); (R.G.); (T.M.); (J.K.); (D.F.)
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Zeng Z, Xu X, Wang Q, Zhang Z, Meng P, Huo X. Maternal exposure to atmospheric PM 2.5 and fetal brain development: Associations with BAI1 methylation and thyroid hormones. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 308:119665. [PMID: 35738517 DOI: 10.1016/j.envpol.2022.119665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/13/2022] [Accepted: 06/18/2022] [Indexed: 02/05/2023]
Abstract
Maternal exposure to atmospheric fine particulate matter (PM2.5) during pregnancy is associated with adverse fetal development, including abnormal brain development. However, the underlying mechanisms and influencing factors remain uncertain. This study investigated the roles of DNA methylation in genes involving neurodevelopment and thyroid hormones (THs) in fetal brain development after maternal exposure to PM2.5 from e-waste. Among 939 healthy pregnant women recruited from June 2011 to September 2012, 101 e-waste-exposed and 103 reference mother-infant pairs (204 pairs totally) were included. Annual ground-level PM2.5 concentrations over e-waste-exposed area (116.38°E, 23.29°N) and reference area (116.67°E, 23.34°N) in 2011, 2012 were obtained by estimates and maternal exposure was evaluated by calculating individual chronic daily intakes (CDIs) of PM2.5. Methylation and THs including thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) level were measured in umbilical cord blood collected shortly after delivery. We found higher ground-level PM2.5 concentrations led to greater individual CDI of PM2.5 in e-waste-exposed pregnant women. After adjustment for gender and birth BMI, significant mediation effects on the adverse associations of maternal PM2.5 exposure with birth head circumference were observed for methylations at positions +13 and + 32 (respectively mediated proportion of 9.8% and 5.3%, P < 0.05 and P < 0.01) in the brain-specific angiogenesis inhibitor 1 (BAI1) gene, but not for methylations in the catenin cadherin-associated protein, alpha 2 (CTNNA2) gene. BAI1 (position +13) methylation was also significantly correlated with FT3 levels (rs = -0.156, P = 0.032), although maternal CDI of PM2.5 was positively associated with higher odds of abnormal TSH levels (OR = 5.03, 95% CI: 1.00, 25.20, P = 0.05) rather than FT3 levels. Our findings suggest that methylation (likely linked to THs) in neonates may play mediation roles associated with abnormal brain development risk due to maternal exposure to atmospheric PM2.5 from e-waste.
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Affiliation(s)
- Zhijun Zeng
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, 511443, Guangdong, China
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, 515041, Guangdong, China; Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Qihua Wang
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, 511443, Guangdong, China
| | - Zhuxia Zhang
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, 511443, Guangdong, China
| | - Peipei Meng
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, 511443, Guangdong, China
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, 511443, Guangdong, China.
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30
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Du H, Wu D, Zhou X, Yang H, Zhu H, Chen S, Pan H. Preconception TSH and Adverse Pregnancy Outcomes in China: A Nationwide Prospective Cohort Study. J Clin Endocrinol Metab 2022; 107:e2770-e2776. [PMID: 35381090 DOI: 10.1210/clinem/dgac208] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND The relationship between maternal thyroid function and pregnancy outcomes remains controversial and the safe range of TSH is still unclear in women planning pregnancy. METHODS This population-based cohort study enrolled Chinese women who became pregnant in 30 provinces from 2010 to 2012 from the National Free Preconception Checkups Project. The maternal TSH level within 6 months before pregnancy and different pregnancy outcomes were collected and analyzed using restricted cubic spline regression model for dose-response relationship and potential optimal cutoff values. Logistic regression was used to reveal the relationship between different TSH groups and the risk of adverse outcomes. RESULTS Among 175 112 women, a J-shaped association was revealed between TSH and large for gestational age (LGA; P < 0.001). When TSH was lower than 1.27 or 0.91 mIU/L, lower TSH was associated with higher odds ratio of low birth weight (LBW; P = 0.003) or preterm delivery (P < 0.001). There was no significant association of preconception TSH with SGA, macrosomia, fetal anomalies, stillbirth, natural or induced abortion, and cesarean delivery. The range of TSH for odds ratio lower than 1.0 was within 0.91 to 1.82 mIU/L in dose-response association. Compared with TSH 0.91 to 1.82 mIU/L, TSH low (< 0.40 mIU/L and 0.40-0.90 mIU/L) and high (1.83-2.49 mIU/L, 2.50-3.99 mIU/L, and >4.00 mIU/L) were associated with higher risk of preterm delivery and LGA. There was no significant association between TSH groups and the risk of LBW except for TSH < 0.40 mIU/L. CONCLUSION Preconception TSH was associated with preterm delivery, LGA, and LBW. Preconception TSH had a bidirectional effect on LGA, indicating a potential mechanism regarding influence of TSH on birth weight. TSH within 0.91 to 1.82 mIU/L was the potential safe range for preconception women.
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Affiliation(s)
- Hanze Du
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Centre, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Danning Wu
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Centre, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
- Eight-year Program of Clinical Medicine, Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiang Zhou
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Centre, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Hongbo Yang
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Centre, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Huijuan Zhu
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Centre, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Shi Chen
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Centre, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Hui Pan
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
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31
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van Velsen EFS, Leung AM, Korevaar TIM. Diagnostic and Treatment Considerations for Thyroid Cancer in Women of Reproductive Age and the Perinatal Period. Endocrinol Metab Clin North Am 2022; 51:403-416. [PMID: 35662449 DOI: 10.1016/j.ecl.2021.11.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Thyroid cancer is one of the most common cancers diagnosed in women of reproductive age and during pregnancy. This leads to important questions about thyroid cancer prognosis and treatment, but also fertility and risk for adverse obstetric and/or fetal and neonatal outcomes. The benefits of thyroid cancer treatment should be weighed against its harms, as various options may adversely impact maternal and fetal health. In the current review, the authors focus on perinatal-specific clinical considerations related to the care of patients with thyroid cancer.
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Affiliation(s)
- Evert F S van Velsen
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Dr Molewaterplein 40, 3015 CE, Rotterdam, The Netherlands.
| | - Angela M Leung
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, UCLA David Geffen School of Medicine, 100 Medical Plaza, Suite 310, Los Angeles, CA 90095, USA; Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd (111D), Los Angeles, CA 90073, USA
| | - Tim I M Korevaar
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Dr Molewaterplein 40, 3015 CE, Rotterdam, The Netherlands
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32
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Carlson JM, Janulewicz PA, Kleinstreuer NC, Heiger-Bernays W. Impact of High-Throughput Model Parameterization and Data Uncertainty on Thyroid-Based Toxicological Estimates for Pesticide Chemicals. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:5620-5631. [PMID: 35446564 PMCID: PMC9070357 DOI: 10.1021/acs.est.1c07143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 05/23/2023]
Abstract
Chemical-induced alteration of maternal thyroid hormone levels may increase the risk of adverse neurodevelopmental outcomes in offspring. US federal risk assessments rely almost exclusively on apical endpoints in animal models for deriving points of departure (PODs). New approach methodologies (NAMs) such as high-throughput screening (HTS) and mechanistically informative in vitro human cell-based systems, combined with in vitro to in vivo extrapolation (IVIVE), supplement in vivo studies and provide an alternative approach to calculate/determine PODs. We examine how parameterization of IVIVE models impacts the comparison between IVIVE-derived equivalent administered doses (EADs) from thyroid-relevant in vitro assays and the POD values that serve as the basis for risk assessments. Pesticide chemicals with thyroid-based in vitro bioactivity data from the US Tox21 HTS program were included (n = 45). Depending on the model structure used for IVIVE analysis, up to 35 chemicals produced EAD values lower than the POD. A total of 10 chemicals produced EAD values higher than the POD regardless of the model structure. The relationship between IVIVE-derived EAD values and the in vivo-derived POD values is highly dependent on model parameterization. Here, we derive a range of potentially thyroid-relevant doses that incorporate uncertainty in modeling choices and in vitro assay data.
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Affiliation(s)
- Jeffrey M. Carlson
- Environmental
Health Department, Boston University School
of Public Health, 715 Albany Street, Boston, Massachusetts 02118, United States
| | - Patricia A. Janulewicz
- Environmental
Health Department, Boston University School
of Public Health, 715 Albany Street, Boston, Massachusetts 02118, United States
| | - Nicole C. Kleinstreuer
- Division
of Intramural Research, Biostatistics and Computational Biology Branch,
and National Toxicology Program Interagency Center for the Evaluation
of Alternative Toxicological Methods, National
Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Durham, North Carolina 27709, United States
| | - Wendy Heiger-Bernays
- Environmental
Health Department, Boston University School
of Public Health, 715 Albany Street, Boston, Massachusetts 02118, United States
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33
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Yao Q, Vinturache A, Lei X, Wang Z, Pan C, Shi R, Yuan T, Gao Y, Tian Y. Prenatal exposure to per- and polyfluoroalkyl substances, fetal thyroid hormones, and infant neurodevelopment. ENVIRONMENTAL RESEARCH 2022; 206:112561. [PMID: 34954147 DOI: 10.1016/j.envres.2021.112561] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are believed to impair early neurodevelopment and disrupt thyroid hormone (TH) levels. However, there are limited epidemiological data on the neurodevelopmental effects in infancy of prenatal PFAS exposure and the potential mediating effects of TH. OBJECTIVES To evaluate potential associations between prenatal PFAS exposure and early neurodevelopmental deficiencies, and assess mediator effects of TH. METHODS From 2010 to 2013, 274 mother-infant pairs were recruited to the Laizhou Wan Birth Cohort in China. Ten PFAS and five TH were measured in cord serum. Developmental quotient (DQ) from 5 domains (adaptive, social, language, gross and fine motor) was assessed using Gesell Developmental Schedules for each child at 1 year of age. The associations between PFAS and DQs were evaluated using multivariable linear regressions. TH-mediated effects of PFAS on DQs were calculated by mediation analyses. RESULTS Among our study population, PFAS exposures were common and associated with DQ decrement in infants. For each 10-fold increase in PFBS concentrations, gross motor and adaptive DQ decreased by 8.56 (95%CI: -15.15, -1.97) and 5.87 (95%CI: -8.07, -3.67) points, respectively. TSH mediated 12.90% of the association of PFBS with gross motor DQ and FT4 explained 19.63% of the association of PFBS with adaptive DQ. The negative association was also found between PFHxS exposure and gross motor DQ (β = 8.14, 95%CI: -15.39, -0.98). CONCLUSIONS PFBS and PFHxS were negatively associated with early neurodevelopment, especially consistent in gross motor domain. The associations were partly explained by TSH and FT4.
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Affiliation(s)
- Qian Yao
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Xiaoning Lei
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zixia Wang
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chengyu Pan
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Shi
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tao Yuan
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yu Gao
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ying Tian
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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34
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Toloza FJK, Derakhshan A, Männistö T, Bliddal S, Popova PV, Carty DM, Chen L, Taylor P, Mosso L, Oken E, Suvanto E, Itoh S, Kishi R, Bassols J, Auvinen J, López-Bermejo A, Brown SJ, Boucai L, Hisada A, Yoshinaga J, Shilova E, Grineva EN, Vrijkotte TGM, Sunyer J, Jiménez-Zabala A, Riaño-Galan I, Lopez-Espinosa MJ, Prokop LJ, Singh Ospina N, Brito JP, Rodriguez-Gutierrez R, Alexander EK, Chaker L, Pearce EN, Peeters RP, Feldt-Rasmussen U, Guxens M, Chatzi L, Delles C, Roeters van Lennep JE, Pop VJM, Lu X, Walsh JP, Nelson SM, Korevaar TIM, Maraka S. Association between maternal thyroid function and risk of gestational hypertension and pre-eclampsia: a systematic review and individual-participant data meta-analysis. Lancet Diabetes Endocrinol 2022; 10:243-252. [PMID: 35255260 PMCID: PMC10314731 DOI: 10.1016/s2213-8587(22)00007-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/24/2021] [Accepted: 01/04/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Adequate maternal thyroid function is important for an uncomplicated pregnancy. Although multiple observational studies have evaluated the association between thyroid dysfunction and hypertensive disorders of pregnancy, the methods and definitions of abnormalities in thyroid function tests were heterogeneous, and the results were conflicting. We aimed to examine the association between abnormalities in thyroid function tests and risk of gestational hypertension and pre-eclampsia. METHODS In this systematic review and meta-analysis of individual-participant data, we searched MEDLINE (Ovid), Embase, Scopus, and the Cochrane Database of Systematic Reviews from date of inception to Dec 27, 2019, for prospective cohort studies with data on maternal concentrations of thyroid-stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase (TPO) antibodies, individually or in combination, as well as on gestational hypertension, pre-eclampsia, or both. We issued open invitations to study authors to participate in the Consortium on Thyroid and Pregnancy and to share the individual-participant data. We excluded participants who had pre-existing thyroid disease or multifetal pregnancy, or were taking medications that affect thyroid function. The primary outcomes were documented gestational hypertension and pre-eclampsia. Individual-participant data were analysed using logistic mixed-effects regression models adjusting for maternal age, BMI, smoking, parity, ethnicity, and gestational age at blood sampling. The study protocol was registered with PROSPERO, CRD42019128585. FINDINGS We identified 1539 published studies, of which 33 cohorts met the inclusion criteria and 19 cohorts were included after the authors agreed to participate. Our study population comprised 46 528 pregnant women, of whom 39 826 (85·6%) women had sufficient data (TSH and FT4 concentrations and TPO antibody status) to be classified according to their thyroid function status. Of these women, 1275 (3·2%) had subclinical hypothyroidism, 933 (2·3%) had isolated hypothyroxinaemia, 619 (1·6%) had subclinical hyperthyroidism, and 337 (0·8%) had overt hyperthyroidism. Compared with euthyroidism, subclinical hypothyroidism was associated with a higher risk of pre-eclampsia (2·1% vs 3·6%; OR 1·53 [95% CI 1·09-2·15]). Subclinical hyperthyroidism, isolated hypothyroxinaemia, or TPO antibody positivity were not associated with gestational hypertension or pre-eclampsia. In continuous analyses, both a higher and a lower TSH concentration were associated with a higher risk of pre-eclampsia (p=0·0001). FT4 concentrations were not associated with the outcomes measured. INTERPRETATION Compared with euthyroidism, subclinical hypothyroidism during pregnancy was associated with a higher risk of pre-eclampsia. There was a U-shaped association of TSH with pre-eclampsia. These results quantify the risks of gestational hypertension or pre-eclampsia in women with thyroid function test abnormalities, adding to the total body of evidence on the risk of adverse maternal and fetal outcomes of thyroid dysfunction during pregnancy. These findings have potential implications for defining the optimal treatment target in women treated with levothyroxine during pregnancy, which needs to be assessed in future interventional studies. FUNDING Arkansas Biosciences Institute and Netherlands Organization for Scientific Research.
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Affiliation(s)
- Freddy J K Toloza
- Division of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Department of Medicine, MetroWest Medical Center, Tufts Medical School, Framingham, MA, USA
| | - Arash Derakhshan
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Tuija Männistö
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland; Northern Finland Laboratory Center Nordlab, University of Oulu, Oulu, Finland
| | - Sofie Bliddal
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Polina V Popova
- Department of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia; Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia; World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia; Department of Internal Diseases and Endocrinology, St Petersburg Pavlov State Medical University, Saint Petersburg, Russia
| | - David M Carty
- Department of Diabetes, Endocrinology and Clinical Pharmacology, Glasgow Royal Infirmary, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Liangmiao Chen
- Department of Endocrinology and Rui'an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peter Taylor
- Thyroid Research Group, Institute of Molecular and Experimental Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Lorena Mosso
- Department of Endocrinology and Centro Traslacional en Endocrinologia, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA, USA
| | - Eila Suvanto
- Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Biomedical Research Institute, Dr Josep Trueta Hospital, Girona, Spain
| | - Juha Auvinen
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Biomedical Research Institute, Dr Josep Trueta Hospital, Girona, Spain
| | - Suzanne J Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Laura Boucai
- Division of Endocrinology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, Weill Cornell University, New York, NY, USA
| | - Aya Hisada
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Jun Yoshinaga
- Faculty of Life Sciences, Toyo University, Gunma, Japan
| | - Ekaterina Shilova
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia; Department of Gynecology and Endocrinology, DO Ott Research Institute of Obstetrics and Gynecology, Saint Petersburg, Russia
| | - Elena N Grineva
- Department of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia; Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Tanja G M Vrijkotte
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Ana Jiménez-Zabala
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain; BIODONOSTIA Health Research Institute, San Sebastian, Spain; Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Spain
| | - Isolina Riaño-Galan
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain; AGC Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain; IUOPA-Departamento de Medicina-ISPA, Universidad de Oviedo, Oviedo, Spain
| | - Maria-Jose Lopez-Espinosa
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain; Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain
| | | | - Naykky Singh Ospina
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Juan P Brito
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Rene Rodriguez-Gutierrez
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Division of Endocrinology, Department of Internal Medicine, University Hospital Dr Jose E Gonzalez, Autonomous University of Nuevo León, Monterrey, Mexico; Plataforma INVEST Medicina UANL-KER Unit, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Erik K Alexander
- Division of Endocrinology, Hypertension and Diabetes, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Layal Chaker
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA, USA
| | - Robin P Peeters
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mònica Guxens
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, Netherlands; ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Leda Chatzi
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | | | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Xuemian Lu
- Department of Endocrinology and Rui'an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; Medical School, University of Western Australia, Crawley, WA, Australia
| | | | - Tim I M Korevaar
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Spyridoula Maraka
- Division of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Central Arkansas Veterans Healthcare System, Little Rock, AR, USA.
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Banigé M, Kariyawasam D, Gauthereau V, Luton D, Polak M. Neonatal Screening for Hyperthyroidism Proof of Concept. J Clin Endocrinol Metab 2022; 107:e1374-e1381. [PMID: 34894265 DOI: 10.1210/clinem/dgab890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Early treatment is essential to avoid the cardiac complication of neonatal hyperthyroidism (NH). Our results have direct implications for clinical care. OBJECTIVE NH can cause potentially fatal neonatal thyrotoxicosis. Here, we have evaluated the feasibility of neonatal hyperthyroidism screening using the thyroid-stimulating hormone value in dried blood collected routinely on filter paper on the third postnatal day of life for congenital hypothyroidism screening. METHODS Retrospective case-control study. Cases were identified using data from our previously published study of 280 000 infants born in 10 maternity units in France in 2007-2014. Controls were identified among the 1 362 564 infants born in the Ile-de-France region during the same period. RESULTS A screening thyroid-stimulating hormone level below 0.18 mIU/L on the third postnatal day had 71% (95% CI 44-90%) sensitivity, 99% (95% CI 99-100%) specificity, 81% (95% CI 74-86%) positive predictive value, and 98% (95% CI 97-99%) negative predictive value for detecting severe NH. By univariate regression analysis, the screening thyroid-stimulating hormone value was the strongest predictor of NH (P < .00001), with an area under the receiver-operating characteristics curve of 0.98 (95% CI 0.95-1.0). Expected frequencies were not significantly different from observed frequencies (Hosmer-Lemeshow test, P = .99). CONCLUSION The screening thyroid-stimulating hormone test can be used to detect severe NH, the optimal cut-off being 0.18 mIU/L. The additional cost compared with screening for congenital hypothyroidism would be small. Infants with neonatal hyperthyroidism would benefit from an earlier diagnosis with treatment initiation at the presymptomatic stage in many cases, ensuring optimal outcomes.
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Affiliation(s)
- Maïa Banigé
- Department of Neonatal Pediatrics and Intensive Care, Hôpital Universitaire Cochin-Port Royal, Assistance Publique Hôpitaux de Paris, (AP-HP), Paris, France
| | - Dulanjalee Kariyawasam
- Pediatric Endocrinology, Gynecology and Diabetology Department, Hôpital Universitaire Necker-Enfants Malades, AP-HP, INSERM U1016, IMAGINE Institute, Paris, France
| | - Valerie Gauthereau
- Fédération Parisienne pour le dépistage et la prévention des handicaps de l'enfant, Paris, France
| | - Dominique Luton
- Department of Obstetrics and Gynecology, Hôpital Universitaire Bichat-Claude Bernard, AP-HP, Université de Paris, IMAGINE Institute, Paris, France
| | - Michel Polak
- Pediatric Endocrinology, Gynecology and Diabetology Department, Centre Régional de Dépistage Néonatal (CRDN), Hôpital Universitaire Necker-Enfants Malades, AP-HP, Université de Paris, INSERM U1016, Centre for Rare Endocrine Diseases affecting Growth and Development, IMAGINE Institute, Paris, France
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Lee SY, Pearce EN. Assessment and treatment of thyroid disorders in pregnancy and the postpartum period. Nat Rev Endocrinol 2022; 18:158-171. [PMID: 34983968 PMCID: PMC9020832 DOI: 10.1038/s41574-021-00604-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2021] [Indexed: 12/13/2022]
Abstract
Thyroid disorders are prevalent in pregnant women. Furthermore, thyroid hormone has a critical role in fetal development and thyroid dysfunction can adversely affect obstetric outcomes. Thus, the appropriate management of hyperthyroidism, most commonly caused by Graves disease, and hypothyroidism, which in iodine sufficient regions is most commonly caused by Hashimoto thyroiditis, in pregnancy is important for the health of both pregnant women and their offspring. Gestational transient thyrotoxicosis can also occur during pregnancy and should be differentiated from Graves disease. Effects of thyroid autoimmunity and subclinical hypothyroidism in pregnancy remain controversial. Iodine deficiency is the leading cause of hypothyroidism worldwide. Despite global efforts to eradicate iodine deficiency disorders, pregnant women remain at risk of iodine deficiency due to increased iodine requirements during gestation. The incidence of thyroid cancer is increasing worldwide, including in young adults. As such, the diagnosis of thyroid nodules or thyroid cancer during pregnancy is becoming more frequent. The evaluation and management of thyroid nodules and thyroid cancer in pregnancy pose a particular challenge. Postpartum thyroiditis can occur up to 1 year after delivery and must be differentiated from other forms of thyroid dysfunction, as treatment differs. This Review provides current evidence and recommendations for the evaluation and management of thyroid disorders in pregnancy and in the postpartum period.
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Affiliation(s)
- Sun Y Lee
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA, USA
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA, USA.
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Corrales Vargas A, Peñaloza Castañeda J, Rietz Liljedahl E, Mora AM, Menezes-Filho JA, Smith DR, Mergler D, Reich B, Giffin A, Hoppin JA, Lindh CH, van Wendel de Joode B. Exposure to common-use pesticides, manganese, lead, and thyroid function among pregnant women from the Infants' Environmental Health (ISA) study, Costa Rica. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 810:151288. [PMID: 34756903 PMCID: PMC9162492 DOI: 10.1016/j.scitotenv.2021.151288] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/03/2021] [Accepted: 10/23/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND Pesticides and metals may disrupt thyroid function, which is key to fetal brain development. OBJECTIVES To evaluate if current-use pesticide exposures, lead and excess manganese alter free thyroxine (FT4), free triiodothyronine (FT3), and thyroid stimulating hormone (TSH) concentrations in pregnant women from the Infants' Environmental Health Study (ISA). METHODS At enrollment, we determined women's (n = 400) specific-gravity corrected urinary pesticide (μg/L) metabolite concentrations of mancozeb (ethylene thiourea (ETU)), pyrimethanil, thiabendazole, chlorpyrifos, synthetic pyrethroids, and 2,4-D. We also measured manganese hair (MnH) (μg/g) and blood (MnB) (μg/L), and blood lead (PbB) (μg/L) concentrations. To detect an immediate and late effect on thyroid homeostasis, we determined TSH, FT4 and FT3 in serum obtained at the same visit (n = 400), and about ten weeks afterwards (n = 245). We assessed associations between exposures and outcomes with linear regression and general additive models, Bayesian multivariate linear regression, and Bayesian kernel machine regression. RESULTS About 80%, 94%, and 100% of the women had TSH, FT4, and FT3 within clinical reference ranges, respectively. Women with higher urinary ETU, and pyrimethanil-metabolites, had lower FT4: β = -0.79 (95%CI = -1.51, -0.08) and β = -0.29 (95%CI = -0.62, -0.03), respectively, for each tenfold increase in exposure. MnB was positively associated with FT4 (β = 0.04 (95%CI = 0.00, 0.07 per 1 μg/L increase), and women with high urinary pyrethroid-metabolite concentrations had decreased TSH (non-linear effects). For the late-effect analysis, metabolites of pyrethroids and chlorpyrifos, as well as MnH, and PbB were associated decreased TSH, or increased FT4 and/or FT3. DISCUSSION Mancozeb (ETU) and pyrimethanil may inhibit FT4 secretion (hypothyroidism-like effect), while chlorpyrifos, pyrethroids, MnB, MnH, PbB and Mn showed hyperthyroidism-like effects. Some effects on thyroid homeostasis seemed to be immediate (mancozeb (ETU), pyrimethanil, MnB), others delayed (chlorpyrifos, MnH, PbB), or both (pyrethroids), possibly reflecting different mechanisms of action.
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Affiliation(s)
- Andrea Corrales Vargas
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - Jorge Peñaloza Castañeda
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - Emelie Rietz Liljedahl
- Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Ana María Mora
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica; Center for Environmental Research and Children's Health (CERCH), University of California at Berkeley, United States
| | - Jose Antonio Menezes-Filho
- Laboratory of Toxicology, College of Pharmacy, Federal University of Bahia, Av. Barão de Jeremoabo s/n Campus Universitário de Ondina, 40170-115 Salvador, Bahia, Brazil
| | - Donald R Smith
- Microbiology and Environmental Toxicology, University of California, Santa Cruz, 1156 High Street, Santa Cruz, CA 95064, United States
| | - Donna Mergler
- Centre de recherche interdisciplinaire sur le bien-être, la santé, la société et l'environnement (CINBIOSE), Université du Québec à Montréal, Montreal, Canada
| | - Brian Reich
- Department of Statistics, North Carolina State University, United States; Center for Human Health and the Environment, North Carolina State University, United States
| | - Andrew Giffin
- Department of Statistics, North Carolina State University, United States; Center for Human Health and the Environment, North Carolina State University, United States
| | - Jane A Hoppin
- Center for Human Health and the Environment, North Carolina State University, United States; Department of Biological Sciences, North Carolina State University, United States
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Berna van Wendel de Joode
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica.
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Cediel-Ulloa A, Lupu DL, Johansson Y, Hinojosa M, Özel F, Rüegg J. Impact of endocrine disrupting chemicals on neurodevelopment: the need for better testing strategies for endocrine disruption-induced developmental neurotoxicity. Expert Rev Endocrinol Metab 2022; 17:131-141. [PMID: 35255767 DOI: 10.1080/17446651.2022.2044788] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/17/2022] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Brain development is highly dependent on hormonal regulation. Exposure to chemicals disrupting endocrine signaling has been associated with neurodevelopmental impairment. This raises concern about exposure to the suspected thousands of endocrine disruptors, and has resulted in efforts to improve regulation of these chemicals. Yet, the causal links between endocrine disruption and developmental neurotoxicity, which would be required for regulatory action, are still largely missing. AREAS COVERED In this review, we illustrate the importance of two endocrine systems, thyroid hormone and retinoic acid pathways, for neurodevelopment. We place special emphasis on TH and RA synthesis, metabolism, and how endocrine disrupting chemicals known or suspected to affect these systems are associated with developmental neurotoxicity. EXPERT OPINION While it is clear that neurodevelopment is dependent on proper hormonal functioning, and evidence is increasing for developmental neurotoxicity induced by endocrine disrupting chemicals, this is not grasped by current chemical testing. Thus, there is an urgent need to develop test methods detecting endocrine disruption in the context of neurodevelopment. Key to this development is further mechanistic insights on the involvement of endocrine signaling in neurodevelopment as well as increased support to develop and validate new test methods for the regulatory context.
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Affiliation(s)
| | | | - Ylva Johansson
- Department of Biochemistry and Biophysics, Stockholm University, Sweden
| | - Maria Hinojosa
- Department of Biochemistry and Biophysics, Stockholm University, Sweden
| | - Fatih Özel
- Department of Organismal Biology, Uppsala University, Sweden
- Centre for Women's Mental Health during the Reproductive Lifespan - Womher, Uppsala University, Sweden
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Joëlle Rüegg
- Department of Organismal Biology, Uppsala University, Sweden
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
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Chen GD, Gou XY, Pang TT, Li PS, Zhou ZX, Lin DX, Fan DZ, Guo XL, Wang LJ, Liu ZP. Associations between thyroid function and gestational diabetes mellitus in Chinese pregnant women: a retrospective cohort study. BMC Endocr Disord 2022; 22:44. [PMID: 35189861 PMCID: PMC8862524 DOI: 10.1186/s12902-022-00959-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 02/14/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Thyroid function is known to be closely linked with type 2 diabetes, but data on the association between thyroid function and gestational diabetes mellitus (GDM) are inconsistent. METHODS A total of 2849 pregnant women were included in this retrospective study. Serum concentrations of thyroid indicators (free tetraiodothyronine, FT4; thyroid-stimulating hormone, TSH; and thyroid peroxidase antibody, TPO Ab) were obtained from a clinical laboratory. The presence of GDM were drawn from medical records. The clinical subtypes of thyroid function (euthyroidism, subclinical hypothyroidism, hyperthyroidism, and isolated hypothyroxinemia) were categorized according to the thresholds of the 2.5th/97.5th and 10th/90th percentiles of TSH and FT4 concentrations. A concentration of > 34 IU/L was defined as indicating TPO Ab-positivity. RESULTS Two hundred and thirty-five (8.25%) of the 2849 women were TPO Ab-positive. Higher serum concentrations of FT4 (top vs. bottom tertiles) was found to be negatively associated with the risk of GDM. The corresponding odds (OR) values (top tertile vs. bottom tertile) were 0.71 [95% confidence interval (CI): 0.54, 0.93]. No significant associations were observed between the extremely 2.5th/97.5th or 10th/90th percentiles of FT4 concentration, TSH concentration, thyroid function subtypes (vs. euthyroidism), TPO Ab-positivity (vs. -negativity), and the GDM risk. The corresponding results remained similar when TPO Ab-positive subjects were excluded. CONCLUSIONS A negative association with the risk of GDM was observed for the highest FT4 concentrations tertile. No significant associations were found between the TSH concentration, thyroid function subtypes, TPO Ab positivity, and the GDM risk.
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Affiliation(s)
- Geng-Dong Chen
- Foshan Institute of Fetal Medicine, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, No.11 Renmin West Road, Foshan, 528000, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Xiao-Yan Gou
- Foshan Institute of Fetal Medicine, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, No.11 Renmin West Road, Foshan, 528000, Guangdong, China
| | - Ting-Ting Pang
- Department of Medical Records, Child Healthcare Hospital, Southern Medical University, Affiliated Foshan Maternity &, Foshan, 528000, Guangdong, China
| | - Peng-Sheng Li
- Foshan Institute of Fetal Medicine, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, No.11 Renmin West Road, Foshan, 528000, Guangdong, China
| | - Zi-Xing Zhou
- Foshan Institute of Fetal Medicine, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, No.11 Renmin West Road, Foshan, 528000, Guangdong, China
| | - Dong-Xin Lin
- Foshan Institute of Fetal Medicine, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, No.11 Renmin West Road, Foshan, 528000, Guangdong, China
| | - Da-Zhi Fan
- Foshan Institute of Fetal Medicine, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, No.11 Renmin West Road, Foshan, 528000, Guangdong, China
| | - Xiao-Ling Guo
- Foshan Institute of Fetal Medicine, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, No.11 Renmin West Road, Foshan, 528000, Guangdong, China
| | - Li-Juan Wang
- Department of Obstetrics, Changchen District, Child Healthcare Hospital, Southern Medical University, Affiliated Foshan Maternity &No.11 Renmin West Road, Foshan, 528000, Guangdong, China.
| | - Zheng-Ping Liu
- Foshan Institute of Fetal Medicine, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, No.11 Renmin West Road, Foshan, 528000, Guangdong, China.
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Sun M, Cao X, Wu Y, Shen L, Wei G. Prenatal exposure to endocrine-disrupting chemicals and thyroid function in neonates: A systematic review and meta-analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 231:113215. [PMID: 35065506 DOI: 10.1016/j.ecoenv.2022.113215] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/07/2022] [Accepted: 01/16/2022] [Indexed: 06/14/2023]
Abstract
Thyroid hormone homeostasis is essential for normal brain development in fetuses and infants. Exposure to endocrine-disrupting chemicals (EDCs) during pregnancy is associated with compromised maternal thyroid homeostasis, and thus may lead to adverse neurodevelopmental outcomes in newborns. However, evidence regarding the association of prenatal EDC exposure and thyroid hormones in newborns is controversial. Therefore, a meta-analysis to elucidate the relationship between maternal exposure to EDCs and neonatal THs was performed. A systematic search of PubMed, EMBASE, and the Cochrane Library (CENTRAL) for relevant published studies that provided quantitative data on the association between prenatal EDC exposure and neonatal thyroid hormones was conducted in August 2021. To calculate the overall estimates, we pooled the adjusted β regression coefficients with 95% confidence intervals (CIs) from each study by the inverse variance method. The pooling results indicated that prenatal EDC exposure had no significant influence on neonatal TSH, TT3, FT3, TT4 or FT4 level in the global assessment. However, in the specific exposure and outcome assessment, we found that prenatal exposure to organochlorine (β coefficient, -0.022; 95% CI, -0.04 to -0.003) and PFAS (β coefficient, -0.017; 95% CI, -0.033 to 0) was negatively associated with neonatal TT4 level. In conclusion, prenatal exposure to organochlorine and PFAS may be associated with lower neonatal TT4 level.
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Affiliation(s)
- Mang Sun
- Ministry of Education Key Laboratory of Child Development and Disorders; International Science and Technology Cooperation Base of Child Development and Critical Disorders; National Clinical Research Center for Child Health and Disorders; Chongqing Key Laboratory of Pediatrics; Department of Urology, Children's Hospital of Chongqing Medical University; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China; The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xining Cao
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuhao Wu
- Ministry of Education Key Laboratory of Child Development and Disorders; International Science and Technology Cooperation Base of Child Development and Critical Disorders; National Clinical Research Center for Child Health and Disorders; Chongqing Key Laboratory of Pediatrics; Department of Urology, Children's Hospital of Chongqing Medical University; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China.
| | - Lianju Shen
- Ministry of Education Key Laboratory of Child Development and Disorders; International Science and Technology Cooperation Base of Child Development and Critical Disorders; National Clinical Research Center for Child Health and Disorders; Chongqing Key Laboratory of Pediatrics; Department of Urology, Children's Hospital of Chongqing Medical University; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China.
| | - Guanghui Wei
- Ministry of Education Key Laboratory of Child Development and Disorders; International Science and Technology Cooperation Base of Child Development and Critical Disorders; National Clinical Research Center for Child Health and Disorders; Chongqing Key Laboratory of Pediatrics; Department of Urology, Children's Hospital of Chongqing Medical University; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
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Bohlega B, Zahedi A, Tomlinson G, Feig DS. Weight-based thyroid dosing vs fixed dosing during pregnancy for subclinical hypothyroidism: A retrospective cohort study. Clin Endocrinol (Oxf) 2022; 96:263-269. [PMID: 33891710 DOI: 10.1111/cen.14488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/23/2021] [Accepted: 04/07/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Thyroid hormones play a crucial role in foetal growth and neurocognitive development. Our aim was to compare a weight-based dosing method of starting thyroxine to a fixed-dose method in newly diagnosed women with subclinical hypothyroidism during pregnancy. DESIGN We performed a retrospective cohort study of consecutive women with newly diagnosed subclinical hypothyroidism during pregnancy seen at Mount Sinai Hospital and Women's College Hospital, Toronto, Canada 2015-2018. PATIENTS We identified women that were treated based on pre-pregnancy weight and those that were given a fixed dose of 50 mcg/day. MEASUREMENTS The percent of women who reached the target TSH of <2.5 mIU/L within 4-8 weeks was compared using a chi-squared test and a logistic regression model, adjusting for age, initial TSH and gestational age treatment was started. RESULTS 393 women were included: 252 treated using a fixed-dose approach; 141 treated based on pre-pregnancy weight. In the unadjusted analysis, there was no difference between the groups in the percentage of women in the target range within 4-8 weeks (89.6% in the fixed-dose group vs 88.8% in the weight-based group (p = .954)). However, after adjustment for between-group differences in age, initial TSH and gestational age treatment was started, there was a significantly greater odds of achieving the target range using the weight-based dosing (OR 4.26 (1.60-11.7), p = .004). CONCLUSIONS Treating women with newly diagnosed subclinical hypothyroidism during pregnancy with a weight-based strategy increased the odds of reaching the target TSH range within 4-8 weeks. Clinicians caring for these women should consider this approach when starting treatment during pregnancy.
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Affiliation(s)
- Balsam Bohlega
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Afshan Zahedi
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Women's College Hospital, Toronto, ON, Canada
| | - George Tomlinson
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- University Hospital Network, Toronto General Hospital, Toronto, ON, Canada
| | - Denice S Feig
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
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Amouzegar A, Pearce EN, Mehran L, Lazarus J, Takyar M, Azizi F. TPO antibody in euthyroid pregnant women and cognitive ability in the offspring: a focused review. J Endocrinol Invest 2022; 45:425-431. [PMID: 34515961 DOI: 10.1007/s40618-021-01664-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 08/13/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE A link between maternal thyroid dysfunction during pregnancy and the risk of cognitive and behavioral problems in the offspring has previously been established; however, the potential effects of maternal thyroid autoimmunity on neurodevelopment in the absence of maternal hypothyroidism are less clear. The present review aims to highlight the gaps in knowledge in this regard and provide a thorough assessment of relevant literature. METHOD Related keywords searched in MEDLINE, Web of Science, and Scopus till January 2021. RESULTS There is some evidence that neuropsychological and intellectual developments of offspring are adversely affected by maternal thyroid autoimmunity, although the results of available studies are not concordant. The tools and measurements that have been applied in different studies to assess neurodevelopment or IQ vary widely and the children born to mothers with thyroid autoimmunity have been assessed at different chronological stages of life. Such variations may explain some of the differences across studies. In addition, the definition of thyroid autoimmunity has been based on TPOAb cut points provided by manufacturers in most cases, but it is preferable to define these values based on age, trimester, and method-specific reference ranges. CONCLUSION Well-designed studies are needed to assess verbal and non-verbal neurocognition of offspring born to mothers with autoimmune thyroid disease before or during pregnancy.
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Affiliation(s)
- A Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 19395-4763, Tehran, Iran
| | - E N Pearce
- Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine, 88 East Newton Street, Evans 201, Boston, MA, 02118, USA
| | - L Mehran
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 19395-4763, Tehran, Iran
| | - J Lazarus
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, UK
| | - M Takyar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 19395-4763, Tehran, Iran
| | - F Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 19395-4763, Tehran, Iran.
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Zgliczynska M, Ostrowska M, Szymusik I, Ciebiera M, Kosinska-Kaczynska K. Maternal thyroid function in multiple pregnancies - a systematic review. Front Endocrinol (Lausanne) 2022; 13:1044655. [PMID: 36733802 PMCID: PMC9887021 DOI: 10.3389/fendo.2022.1044655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The function of the thyroid gland during pregnancy undergoes physiological changes to ensure the proper amount of thyroid hormones for both the pregnant woman and the fetus. Multiple pregnancies (MP) are characterized by specific differences compared to single pregnancies, e.g., higher concentrations of human chorionic gonadotropin, which also affect thyroid function. The aim was to collect available knowledge on maternal thyroid function in MP. METHODS We have systematically searched three databases: the PubMed/MEDLINE, Scopus and the Cochrane Library. The last search was run on the 4th of August 2022. We included full-text original observational and experimental studies written in English. Case reports, editorials, letters, conference abstracts, reviews and meta-analyses were excluded. No time criterion was established. Studies were considered eligible if at least one maternal thyroid function test was performed and reported. Studies on MP with a co-existing mole were excluded. The risk of bias was assessed with the use of the AXIS tool. The qualitative synthesis of evidence was applied. RESULTS The search strategy resulted in the identification of 821 manuscripts. After removing duplicates, we screened the titles and abstracts of 552 articles, out of which 57 were selected for full-text analysis. Finally, 12 articles were included in the review. They were conducted in 6 different countries and published between the years 1997 and 2022. The number of examined women with MP ranged from 9 to 1 626. DISCUSSION AND CONCLUSIONS Thyroid function differs between women with MP and SP. Scarce data are available on the topic, but MPs are most likely characterized by higher HCG levels, which influences thyroid-stimulating hormone and free thyroid hormone levels. These differences are mainly expressed in the 1st trimester of pregnancy. Separate population-based reference ranges are needed to correctly diagnose thyroid diseases in MP and to avoid unnecessary treatment. Further research is needed to fill the knowledge gaps.
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Affiliation(s)
- Magdalena Zgliczynska
- Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Warsaw, Poland
- *Correspondence: Magdalena Zgliczynska,
| | - Magdalena Ostrowska
- Department of Endocrinology, Centre of Postgraduate Medical Education, Warsaw, Warsaw, Poland
| | - Iwona Szymusik
- Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Michal Ciebiera
- Second Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Katarzyna Kosinska-Kaczynska
- Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Warsaw, Poland
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Sorrenti S, Baldini E, Pironi D, Lauro A, D’Orazi V, Tartaglia F, Tripodi D, Lori E, Gagliardi F, Praticò M, Illuminati G, D’Andrea V, Palumbo P, Ulisse S. Iodine: Its Role in Thyroid Hormone Biosynthesis and Beyond. Nutrients 2021; 13:nu13124469. [PMID: 34960019 PMCID: PMC8709459 DOI: 10.3390/nu13124469] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022] Open
Abstract
The present review deals with the functional roles of iodine and its metabolism. The main biological function of iodine concerns its role in the biosynthesis of thyroid hormones (THs) by the thyroid gland. In addition, however, further biological roles of iodine have emerged. Precisely, due to its significant action as scavenger of reactive oxygen species (ROS), iodine is thought to represent one of the oldest antioxidants in living organisms. Moreover, iodine oxidation to hypoiodite (IO−) has been shown to possess strong bactericidal as well as antiviral and antifungal activity. Finally, and importantly, iodine has been demonstrated to exert antineoplastic effects in human cancer cell lines. Thus, iodine, through the action of different tissue-specific peroxidases, may serve different evolutionarily conserved physiological functions that, beyond TH biosynthesis, encompass antioxidant activity and defense against pathogens and cancer progression.
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Pedaran M, Oelkrug R, Sun Q, Resch J, Schomburg L, Mittag J. Maternal Thyroid Hormone Programs Cardiovascular Functions in the Offspring. Thyroid 2021; 31:1424-1435. [PMID: 34269617 DOI: 10.1089/thy.2021.0275] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background: Maternal thyroid hormone (TH) plays an essential role for fetal development, especially for the cardiovascular system and its central control. However, the precise consequences of altered TH action during the different periods in pregnancy remain poorly understood. Methods: To address this question, we used mice heterozygous for a mutant thyroid hormone receptor α1 (TRα1) and wild-type controls that were born to wild-type mothers treated with 3,3',5-triiodothyronine (T3) during the first or the second half of pregnancy. We then phenotyped the offspring animals as adults by in vivo measurements and postmortem tissue analyses. Results: Maternal T3 treatment in either half of the pregnancy did not affect postnatal growth development. Serum thyroxine and hypophyseal thyrotropin subunit beta or deiodinase type II expression was also not affected in any group, only TRα1 mutant males exhibited a reduction in serum T3 levels after the treatment. Likewise, hepatic deiodinase type I was not altered, but serum selenium levels were reduced by the maternal treatment in wild-type offspring of both genders. Most interestingly, a significant increase in heart weight was found in adult wild-types born to mothers that received T3 during the first or second half of pregnancy, while TRα1 mutant males were protected from this effect. Moreover, we detected a significant increase in heart rate selectively in male mice that were exposed to elevated maternal T3 in the second half of the pregnancy. Conclusion: Taken together, our findings demonstrate that maternal TH is of particular relevance during the second half of pregnancy for establishing cardiac properties, with specific effects depending on TRα1 or gender. The data advocate routinely monitoring TH levels during pregnancy to avoid adverse cardiac effects in the offspring.
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Affiliation(s)
- Mehdi Pedaran
- Institut für Endokrinologie und Diabetes, Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Rebecca Oelkrug
- Institut für Endokrinologie und Diabetes, Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Qian Sun
- Institut für Experimentelle Endokrinologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Julia Resch
- Institut für Endokrinologie und Diabetes, Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Lutz Schomburg
- Institut für Experimentelle Endokrinologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jens Mittag
- Institut für Endokrinologie und Diabetes, Center of Brain Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
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Andersen MS, Jensen TK, Dreyer AF, Madsen JB, Christesen HT, Brandslund I, Bilenberg N, Glintborg D. Free thyroxine in early pregnancy is an independent negative predictor of 3rd trimester HbA1c. Odense child cohort. Clin Endocrinol (Oxf) 2021; 95:508-519. [PMID: 33930937 DOI: 10.1111/cen.14492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Lower thyroid function outside pregnancy is associated with an increased risk of type 2 diabetes mellitus. The relationship between thyroid function in early pregnancy and glucose status in 3rd trimester has not been investigated. AIMS To study the association between 1st trimester thyroid function and 3rd trimester glucose status. DESIGN In the prospective study Odense Child Cohort (OCC), 1,041 women had 1st trimester blood samples analysed for thyroid-stimulating hormone (TSH), free T4 (FT4), thyroid peroxidase antibody and HbA1c. Third trimester (week 28) fasting blood samples included plasma glucose, insulin and HbA1c. Oral glucose tolerance test (OGTT, 75 g glucose) was performed in 509 women. First trimester FT4 was dichotomized >vs. ≤ the 25th percentile (25p = 12.9 pmol/L). Homeostatic model assessment-insulin resistance (HOMA)-IR and HOMA-β were calculated. RESULTS Women with FT4 ≤25p had significantly higher HbA1c in 1st and 3rd trimesters and higher 3rd trimester fasting glucose, insulin, HOMA-IR and HOMA-β compared to women with FT4 >25p. In multiple regression analyses, FT4 was an independent negative predictor of 3rd trimester HbA1c. FT4 levels in 3rd and 4th quartiles (high-normal FT4 levels) showed closest inverse associations with HbA1c (p-trend <.001). TSH was not associated with 3rd trimester HbA1c. CONCLUSION Women with lower levels of FT4 in early pregnancy had higher HbA1c in 3rd trimester and FT4 was an independent negative predictor of 3rd trimester HbA1c.
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Affiliation(s)
| | - Tina Kold Jensen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
- Odense Patient data Explorative Network (OPEN), Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Anja Fenger Dreyer
- Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Jeppe Buur Madsen
- Department of Biochemistry and Immunology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Henrik Thybo Christesen
- Odense Patient data Explorative Network (OPEN), Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Ivan Brandslund
- Department of Biochemistry and Immunology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Niels Bilenberg
- Department of Child and Adolescent Mental Health Odense, Research Unit Mental Health Services in the Region of Southern Denmark, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science University of Southern Denmark, Denmark
| | - Dorte Glintborg
- Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
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Monaghan AM, Mulhern MS, Mc Sorley EM, Strain J, Winter T, van Wijngaarden E, Myers GJ, Davidson PW, Shamlaye C, Gedeon J, Yeates AJ. Associations between maternal thyroid function in pregnancy and child neurodevelopmental outcomes at 20 months in the Seychelles Child Development Study, Nutrition Cohort 2 (SCDS NC2). J Nutr Sci 2021; 10:e71. [PMID: 34527229 PMCID: PMC8411260 DOI: 10.1017/jns.2021.66] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 12/24/2022] Open
Abstract
Maternal thyroid hormones facilitate optimal foetal neurodevelopment; however, the exact role of the thyroid hormones on specific cognitive outcomes is unknown. The present study aimed to investigate associations between maternal thyroid function and neurodevelopmental outcomes in the Seychelles Child Development Study (SCDS) Nutrition 2 cohort (n 1328). Maternal free thyroid hormones (fT3, fT4 and fTSH) were assessed at 28 weeks' gestation with a range of child cognitive outcomes analysed at 20 months. Dietary iodine intake was analysed for a subset of women through a Food Frequency Questionnaire. Linear regression analysis was used to test associations between serum concentrations of maternal thyroid hormones and child neurodevelopment outcomes. Thyroid hormones were analysed as continuous data and categorised as quintiles. 95% of mothers had optimal thyroid function based on fTSH concentrations. Overall, the present study shows that maternal thyroid function is not associated with neurodevelopmental outcomes in this high fish-eating population. However, a positive association, using quintiles for fT3, was reported for the Mental Developmental Index, between Q3 v. Q4 (β 0⋅073; P 0⋅043) and for Q3 v. Q5 (β value 0⋅086; P 0⋅018). To conclude, mothers in our cohort, who largely have optimal thyroid function and iodine intakes, appear able to regulate thyroid function throughout pregnancy to meet neurodevelopmental needs. However, it is possible that minor imbalances of fT3, as indicated from our secondary analysis, may impact offspring neurodevelopment. Further investigation of the relationship between maternal thyroid function and infant neurodevelopment is warranted, particularly in populations with different dietary patterns and thereby iodine intakes.
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Affiliation(s)
- Anna M. Monaghan
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, UK
| | - Maria S. Mulhern
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, UK
| | - Emeir M. Mc Sorley
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, UK
| | - J.J. Strain
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, UK
| | - Theresa Winter
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - Edwin van Wijngaarden
- Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Gary J. Myers
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Philip W. Davidson
- Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | | | - Jude Gedeon
- Child Development Centre, Ministry of Health, Mahe, Republic of Seychelles
| | - Alison J. Yeates
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, UK
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Næss S, Markhus MW, Strand TA, Kjellevold M, Dahl L, Stokland AEM, Nedrebø BG, Aakre I. Iodine Nutrition and Iodine Supplement Initiation in Association with Thyroid Function in Mildly-to-Moderately Iodine-Deficient Pregnant and Postpartum Women. J Nutr 2021; 151:3187-3196. [PMID: 34255063 PMCID: PMC8485914 DOI: 10.1093/jn/nxab224] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/18/2021] [Accepted: 06/15/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Whereas the adverse effects of severe iodine deficiency during pregnancy are well documented, the effects of mild-to-moderate deficiency are not well established. OBJECTIVES We aimed to explore whether iodine nutrition and timing of iodine supplement initiation are associated with thyroid function in pregnant and postpartum women. METHODS In this cohort study, 137 pregnant women were enrolled and followed up at gestational weeks (GWs) 18 and 36, and 3 and 6 mo postpartum. Thyroid function tests [thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4)], urinary iodine and creatinine concentration (UIC:Cr), and iodine intake (including iodine supplement use) were measured at each time point. The associations between thyroid hormone concentrations and UIC:Cr, iodine intakes, and iodine supplement use were estimated using multiple generalized estimating equation models. RESULTS The median UIC at GW18 was 94 μg/L, indicating mild-to-moderate iodine deficiency. UIC:Cr (β; 95% CI) per 100 μg/g was negatively associated with fT3 (-0.191; -0.331, -0.051) and fT4 (-0.756; -1.372, -0.141) concentrations. Iodine intake (β; 95% CI) per 100 μg/d was positively associated with TSH (0.099; 0.022, 0.177), and negatively associated with fT3 (-0.084; -0.0141, -0.027) and fT4 (-0.390; -0.599, -0.182) concentrations. Compared with no use of supplement, those initiating an iodine-containing supplement prepregnancy and continuing through pregnancy had lower TSH (estimated means) (1.35 compared with 1.68 mIU/L, P = 0.021), and higher fT3 (4.48 compared with 4.28 pmol/L, P = 0.035) and fT4 (15.2 compared with 14.4 pmol/L, P = 0.024) concentrations. CONCLUSIONS Lower iodine availability during pregnancy and postpartum was associated with lower TSH, and higher fT3 and fT4 concentrations. The use of an iodine-containing supplement that was initiated prepregnancy and continuing through pregnancy was associated with lower TSH, and higher fT3 and fT4 concentrations, which may suggest improved thyroid function. These findings support the notion that optimization of iodine intake should start before pregnancy.This trial was registered at clinicaltrials.gov as NCT02610959.
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Affiliation(s)
| | - Maria W Markhus
- Seafood, Nutrition and Environmental State, Institute of Marine Research, Bergen, Norway
| | - Tor A Strand
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway,Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
| | - Marian Kjellevold
- Seafood, Nutrition and Environmental State, Institute of Marine Research, Bergen, Norway
| | - Lisbeth Dahl
- Seafood, Nutrition and Environmental State, Institute of Marine Research, Bergen, Norway
| | - Ann-Elin M Stokland
- Department of Endocrinology, Stavanger University Hospital, Stavanger, Norway
| | - Bjørn G Nedrebø
- Department of Internal Medicine, Haugesund Hospital, Haugesund, Norway,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Inger Aakre
- Seafood, Nutrition and Environmental State, Institute of Marine Research, Bergen, Norway
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Qi C, Shang L, Yang W, Huang L, Yang L, Xin J, Wang S, Yue J, Zeng L, Chung MC. Maternal exposure to O 3 and NO 2 may increase the risk of newborn congenital hypothyroidism: a national data-based analysis in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:34621-34629. [PMID: 33655476 PMCID: PMC8275538 DOI: 10.1007/s11356-021-13083-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
Maternal exposure to air pollution during pregnancy is associated with adverse outcomes in the offspring, but limited studies focused on the impacts of gaseous air pollution on newborn congenital hypothyroidism (CH). Therefore, a national data-based analysis was conducted to explore the association between maternal exposure to gaseous air pollution and the incidence of CH in China. Annual average exposure levels of SO2, NO2, CO, and O3 from January 1, 2014, to December 30, 2014, were acquired from the Chinese Air Quality Online Monitoring and Analysis Platform. The annual incidence of newborn CH from October 1, 2014, to September 30, 2015, was collected from the Chinese Maternal and Child Health Surveillance Network. Temperature and toxic metal in wastewater in 2014 were also collected as covariates. Maternal exposure to O3 and NO2 in 1 μg/m3 level increment was positively associated with newborn CH, with an OR of 1.055 (95% CI 1.011, 1.102) and 1.097 (95% CI 1.019, 1.182) after adjusting for covariates completely. Compared with the lowest level of O3, maternal exposure to the 4th quartile of O3 was positively associated with newborn CH (OR 1.393, 95% CI 1.081, 1.794) after adjusting for covariates completely. And the 3rd and 4th quartiles of NO2 were associated positively with CH (OR 1.576, 95% CI 1.025, 2.424, and OR 1.553, 95% CI 0.999, 2.414, respectively) compared with the lowest level of NO2. By fitting the ROC curve, 93.688 μg/m3 in O3 might be used as cutoff to predict the incidence of newborn CH in China.
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Affiliation(s)
- Cuifang Qi
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Li Shang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Liyan Huang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Liren Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Juan Xin
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Shanshan Wang
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Jie Yue
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Lingxia Zeng
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Mei Chun Chung
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA USA
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50
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Marty S, Beekhuijzen M, Charlton A, Hallmark N, Hannas BR, Jacobi S, Melching-Kollmuss S, Sauer UG, Sheets LP, Strauss V, Urbisch D, Botham PA, van Ravenzwaay B. Towards a science-based testing strategy to identify maternal thyroid hormone imbalance and neurodevelopmental effects in the progeny - part II: how can key events of relevant adverse outcome pathways be addressed in toxicological assessments? Crit Rev Toxicol 2021; 51:328-358. [PMID: 34074207 DOI: 10.1080/10408444.2021.1910625] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The current understanding of thyroid-related adverse outcome pathways (AOPs) with adverse neurodevelopmental outcomes in mammals has been reviewed. This served to establish if standard rodent toxicity test methods and in vitro assays allow identifying thyroid-related modes-of-action potentially leading to adverse neurodevelopmental outcomes, and the human relevance of effects - in line with the European Commission's Endocrine Disruptor Criteria. The underlying hypothesis is that an understanding of the key events of relevant AOPs provides insight into differences in incidence, magnitude, or species sensitivity of adverse outcomes. The rodent studies include measurements of serum thyroid hormones, thyroid gland pathology and neurodevelopmental assessments, but do not directly inform on specific modes-of-action. Opportunities to address additional non-routine parameters reflecting critical events of AOPs in toxicological assessments are presented. These parameters appear relevant to support the identification of specific thyroid-related modes-of-action, provided that prevailing technical limitations are overcome. Current understanding of quantitative key event relationships is often weak, but would be needed to determine if the triggering of a molecular initiating event will ultimately result in an adverse outcome. Also, significant species differences in all processes related to thyroid hormone signalling are evident, but the biological implications thereof (including human relevance) are often unknown. In conclusion, careful consideration of the measurement (e.g. timing, method) and interpretation of additional non-routine parameters is warranted. These findings will be used in a subsequent paper to propose a testing strategy to identify if a substance may elicit maternal thyroid hormone imbalance and potentially also neurodevelopmental effects in the progeny.
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Affiliation(s)
- Sue Marty
- The Dow Chemical Company, Midland, MI, USA
| | | | | | | | | | | | | | - Ursula G Sauer
- Scientific Consultancy - Animal Welfare, Neubiberg, Germany
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