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Wu Y, Long HH, Zhang SJ, Li MM, Chen CG, Wang C, Sheng ZY, Ye YB, Zuo SY, Pan WJ, Liu ZM. Reference Intervals of Serum Iodine Concentration in Chinese Pregnant Women. Biol Trace Elem Res 2024; 202:2457-2465. [PMID: 37713053 DOI: 10.1007/s12011-023-03859-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023]
Abstract
The study aims to establish trimester-specific reference ranges for serum iodine (SI) in Chinese pregnant women and explore its associations with maternal and infantile thyroid function. Apparently healthy pregnant women were enrolled during their first antenatal visit. Fasting venous and spot urine samples were collected for determining serum and urinary iodine (UI) levels by a validated inductively coupled plasma mass spectrometry. Serum free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin (TSH), and neonatal TSH levels were tested by electro-chemiluminescent assay. The reference ranges of SI were established by percentile method and reported as 2.5-97.5%. ROC analysis was applied to compare the discriminative ability of SI, UI, and UI to urinary creatine ratio (UI /UCr) in early pregnancy for various thyroid conditions. The trimester-specific reference ranges of SI for Chinese pregnant women were 60.91-114.53 μg/L for the first trimester (T1, n = 1029), 54.57-103.42 μg/L for the second trimester (T2, n = 379), and 52.03-110.40 μg/L for the third trimester (T3, n = 455). Maternal SI at T1 but not UI and UI/UCr was significantly correlated with FT3 (r = 0.393, P < 0.001), FT4 (r = 0.637, P < 0.001), and TSH (r = -0.299, P<0.001). Maternal SI change% from T1 to T2 (but not SI change% from T1 to T3) had marginal correlation with neonatal TSH (r=-0.106, P=0.046). ROC analysis showed that maternal SI at T1 had better predictability for several thyroid conditions than UIC and UI/UCr.
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Affiliation(s)
- Yi Wu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, 510080, People's Republic of China
| | - Huan-Huan Long
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, 510080, People's Republic of China
| | - Su-Juan Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, 510080, People's Republic of China
| | - Min-Min Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, 510080, People's Republic of China
| | - Chao-Gang Chen
- Department of Clinical Nutrition, The Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510235, People's Republic of China
| | - Cheng Wang
- Department of Clinical Nutrition, The Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510235, People's Republic of China
| | - Zheng-Yu Sheng
- Department of Paediatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Yan-Bin Ye
- Department of Clinical Nutrition, The First Affiliated Hospital, Jinan University, Guangzhou, 510632, People's Republic of China
| | - Shu-Yu Zuo
- Department of Clinical Nutrition, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Wen-Jing Pan
- Huizhou First Maternal and Child Health Care Hospital, Guangdong Province, Huizhou, 516001, People's Republic of China.
| | - Zhao-Min Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, 510080, People's Republic of China.
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Magri F, Bellingeri C, De Maggio I, Croce L, Coperchini F, Rotondi M, Chiovato L, Spinillo A, Beneventi F. A first-trimester serum TSH in the 4-10 mIU/L range is associated with obstetric complications in thyroid peroxidase antibody-negative women. J Endocrinol Invest 2022:10.1007/s40618-022-01996-z. [PMID: 36562959 DOI: 10.1007/s40618-022-01996-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE The impact of mild subclinical hypothyroidism on pregnancy outcomes in TPOAb-negative women is poorly explored. The aim of the present study was the evaluation in a wide cohort of TPOAb-negative pregnant women the role of subclinical hypothyroidism (SCH) on several pregnancy outcomes. METHODS The study included women aged ≥ 18 years with a singleton pregnancy without known thyroid disease with serum TSH concentration between 0.4 and 10 mIU/L and TPOAb negative. Data about clinical and demographic features were collected. A blood sample was drown to test TSH, TPOAb, ANA and ENA concentration. The mean uterine artery pulsatility index was measured. Risk of adverse obstetric and fetal outcomes was collected. RESULTS The cohort included 2135 pregnant women. Pregnant women with TSH 4-10 mUI/L had a significantly higher frequency of family history of thyroid diseases, and personal history of celiac disease diseases, type 1 diabetes mellitus, rheumatic disease, antinuclear antibody (ANA) and anti-extractable nuclear antigen (ENA) positive tests. The risk for pre-eclampsia and small for gestational age (SGA) was significantly higher in pregnant women with first-trimester TSH 4-10 mIU/L. A first-trimester TSH serum level greater than 4 mIU/L was associated with a significant increase in the occurrence of abnormal uterine artery pulsatility index, with a more than threefold increase in the risk of developing pre-eclampsia and with the risk of SGA. CONCLUSIONS In TPOAb-negative pregnant women, a first-trimester serum TSH level ranging from 4 to 10 mIU/L is significantly and independently linked to an increased uterine artery pulsatility index as well as to negative pregnancy outcomes such as pre-eclampsia, SGA and gestational diabetes.
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Affiliation(s)
- F Magri
- Unit of Internal Medicine and Endocrinology, Department of Internal Medicine and Therapeutics, Istituti Clinici Scientifici Maugeri IRCCS, University of Pavia, via Maugeri 10, 27100, Pavia, Italy.
| | - C Bellingeri
- Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - I De Maggio
- Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - L Croce
- Unit of Internal Medicine and Endocrinology, Department of Internal Medicine and Therapeutics, Istituti Clinici Scientifici Maugeri IRCCS, University of Pavia, via Maugeri 10, 27100, Pavia, Italy
| | - F Coperchini
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - M Rotondi
- Unit of Internal Medicine and Endocrinology, Department of Internal Medicine and Therapeutics, Istituti Clinici Scientifici Maugeri IRCCS, University of Pavia, via Maugeri 10, 27100, Pavia, Italy
| | - L Chiovato
- Unit of Internal Medicine and Endocrinology, Department of Internal Medicine and Therapeutics, Istituti Clinici Scientifici Maugeri IRCCS, University of Pavia, via Maugeri 10, 27100, Pavia, Italy
| | - A Spinillo
- Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - F Beneventi
- Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia, Italy
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Zhang X, Huels A, Makuch R, Zhou A, Zheng T, Xia W, Gaskins A, Makuch J, Zhu Z, Zhu C, Qian Z, Xu S, Li Y. Association of exposure to ambient particulate matter with maternal thyroid function in early pregnancy. Environ Res 2022; 214:113942. [PMID: 35870505 DOI: 10.1016/j.envres.2022.113942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/15/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND It is known that maternal thyroid dysfunction during early pregnancy can cause adverse pregnancy complications and birth outcomes. This study was designed to examine the association between ambient particulate matter with aerodynamic diameters ≤2.5 μm (PM2.5) and particulate matter with aerodynamic diameters ≤10 μm (PM10) exposure and maternal thyroid function during early pregnancy. METHODS This study was based on data from a birth cohort study of 921 pregnant women in China. We estimated associations between ambient PM2.5 and PM10 exposure during the first trimester of pregnancy (estimated with land-use regression models) and maternal thyroid hormone concentrations (free thyroxine (FT4), free tri-iodothyronine (FT3), and thyroid-stimulating hormone (TSH)) collected between weeks 10 and 17 of gestation using linear regression models adjusting for potential confounders. Ambient PM2.5 and PM10 concentrations were modeled per interquartile range (IQR) increment and as tertiles based on the distribution of the exposure levels. RESULTS An IQR increment (68 μg/m3) in PM2.5 exposure was associated with a significant decrease in maternal FT4 levels (β = -0.60, 95% CI: -1.07, -0.12); and a significant decrease in FT4/FT3 ratio (β = -0.13, 95% CI: -0.25, -0.02). Further analyses showed that, relative to the lowest tertile, women in both the middle and highest tertiles of PM2.5 had significantly lower concentrations of maternal FT4 and FT4/FT3 ratio. No significant associations were found between PM2.5 and FT3 or TSH levels. PM10 exposure was not significantly associated with maternal thyroid function. CONCLUSIONS Our study suggested that higher ambient PM2.5, not PM10, exposed during the first trimester of pregnancy were associated with a significant decrease in maternal serum FT4 concentrations and FT4/FT3 ratio. Studies in populations with different exposure levels are needed to replicate our study results.
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Affiliation(s)
- Xichi Zhang
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anke Huels
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Robert Makuch
- Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Aifen Zhou
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, People's Republic of China
| | - Tao Zheng
- Molecular Microbiology and Immunology, Warren Alpert Medical School of Brown University, USA
| | - Wei Xia
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Audrey Gaskins
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jad Makuch
- Department of Ecosystem Science and Policy, University of Miami, Miami, FL, USA.Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO
| | - Zhou Zhu
- Molecular Microbiology and Immunology, Warren Alpert Medical School of Brown University, USA
| | - Cairong Zhu
- Huaxi School of Public Health, Chengdu, Sichuan, China
| | - Zhengmin Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, USA
| | - Shunqing Xu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuanyuan Li
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Li S, Wu Y, Zhang SJ, Li G, Xiang YT, Zhang WZ, Pan WJ, Chen WQ, Hao YT, Ling WH, Liu ZM. Higher maternal thyroid resistance indices were associated with increased neonatal thyroid-stimulating hormone- analyses based on the Huizhou mother-infant cohort. Front Endocrinol (Lausanne) 2022; 13:937430. [PMID: 36246895 PMCID: PMC9561092 DOI: 10.3389/fendo.2022.937430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study aimed to explore the relationship of maternal thyroid function and thyroid resistance parameters with neonatal thyroid-stimulating hormone (TSH). METHODS This work was a longitudinal study. Singleton pregnant women without a history of thyroid disorders were recruited in their first prenatal visit from October 2018 to June 2020. Maternal thyroid markers including TSH, free triiodothyronine (FT3), free thyroxine (FT4), and neonatal TSH were tested in the clinical laboratory of the hospital by electrochemiluminescence immunoassay. Thyroid resistance indices including Thyroid Feedback Quantile-based Index (TFQI), TSH index (TSHI), and thyrotroph T4 resistance index (TT4RI) were estimated in accordance with maternal FT4 and TSH levels. Multivariable linear and logistic regression was applied to explore the associations of maternal thyroid indices with infantile TSH level. RESULTS A total of 3,210 mothers and 2,991 newborns with valid TSH data were included for analysis. Multivariable linear regression indicated that maternal thyroid variables were significantly and positively associated with neonatal TSH levels with standardized coefficients of 0.085 for TSH, 0.102 for FT3, 0.100 for FT4, 0.076 for TSHI, 0.087 for TFQI, and 0.089 for TT4RI (all P < 0.001). Compared with the lowest quartile, the highest quartile of TSHI [odds ratio (OR) = 1.590, 95% CI: 0.928-2.724; Ptrend = 0.025], TFQI (OR = 1.746, 95% CI: 1.005-3.034; Ptrend = 0.016), and TT4RI (OR = 1.730, 95% CI: 1.021-2.934; Ptrend = 0.030) were significantly associated with an increased risk of elevated neonatal TSH (>5 mIU/L) in a dose-response manner. CONCLUSION The longitudinal data demonstrated that maternal thyroid resistance indices and thyroid hormones in the first half of gestation were positively associated with neonatal TSH levels. The findings offered an additionally practical recommendation to improve the current screening algorithms for congenital hypothyroidism.
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Affiliation(s)
- Shuyi Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yi Wu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Su-juan Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guoyi Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Department of Clinical Nutrition, The First Huizhou Central Hospital, Huizhou, China
| | - Yu Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, University of Macao, Macao, Macau SAR, China
| | - Wei-zhong Zhang
- Department of Pediatrics and Department of Health-care for Children Huizhou First Mother and Child Health-Care Hospital, Huizhou, China
| | - Wen-jing Pan
- Department of Pediatrics and Department of Health-care for Children Huizhou First Mother and Child Health-Care Hospital, Huizhou, China
| | - Wei-qing Chen
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuan-tao Hao
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wen-hua Ling
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhao-min Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Zhao-min Liu,
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Choi G, Keil AP, Villanger GD, Richardson DB, Daniels JL, Hoffman K, Sakhi AK, Thomsen C, Herring AH, Drover SSM, Nethery R, Aase H, Engel SM. Pregnancy exposure to common-detect organophosphate esters and phthalates and maternal thyroid function. Sci Total Environ 2021; 782:146709. [PMID: 33839654 PMCID: PMC8222630 DOI: 10.1016/j.scitotenv.2021.146709] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/17/2021] [Accepted: 03/19/2021] [Indexed: 05/15/2023]
Abstract
BACKGROUND Contemporary human populations are exposed to elevated concentrations of organophosphate esters (OPEs) and phthalates. Some metabolites have been linked with altered thyroid function, however, inconsistencies exist across thyroid function biomarkers. Research on OPEs is sparse, particularly during pregnancy, when maintaining normal thyroid function is critical to maternal and fetal health. In this paper, we aimed to characterize relationships between OPEs and phthalates exposure and maternal thyroid function during pregnancy, using a cross-sectional investigation of pregnant women nested within the Norwegian Mother, Father, and Child Cohort (MoBa). METHODS We included 473 pregnant women, who were euthyroid and provided bio-samples at 17 weeks' gestation (2004-2008). Four OPE and six phthalate metabolites were measured from urine; six thyroid function biomarkers were estimated from blood. Relationships between thyroid function biomarkers and log-transformed concentrations of OPE and phthalate metabolites were characterized using two approaches that both accounted for confounding by co-exposures: co-pollutant adjusted general linear model (GLM) and Bayesian Kernal Machine Regression (BKMR). RESULTS We restricted our analysis to common-detect OPE and phthalate metabolites (>94%): diphenyl phosphate (DPHP), di-n-butyl phosphate (DNBP), and all phthalate metabolites. In GLM, pregnant women with summed di-isononyl phthalate metabolites (∑DiNP) concentrations in the 75th percentile had a 0.37 ng/μg lower total triiodothyronine (TT3): total thyroxine (TT4) ratio (95% credible interval: [-0.59, -0.15]) as compared to those in the 25th percentile, possibly due to small but diverging influences on TT3 (-1.99 ng/dL [-4.52, 0.53]) and TT4 (0.13 μg/dL [-0.01, 0.26]). Similar trends were observed for DNBP and inverse associations were observed for DPHP, monoethyl phthalate, mono-isobutyl phthalate, and mono-n-butyl phthalate. Most associations observed in co-pollutants adjusted GLMs were attenuated towards the null in BKMR, except for the case of ∑DiNP and TT3:TT4 ratio (-0.48 [-0.96, 0.003]). CONCLUSIONS Maternal thyroid function varied modestly with ∑DiNP, whereas results for DPHP varied by the type of statistical models.
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Affiliation(s)
- Giehae Choi
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Alexander P Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julie L Daniels
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kate Hoffman
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | | | | | - Amy H Herring
- Department of Statistical Science and Global Health Institute, Duke University, Durham, NC, USA
| | - Samantha S M Drover
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rachel Nethery
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Heidi Aase
- Norwegian Institute of Public Health, Oslo, Norway
| | - Stephanie M Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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