兰州市区碘营养适宜孕妇的甲状腺相关激素参考区间调查

摘要

目的 调查兰州市区孕妇妊娠期碘营养状况并建立碘营养适宜孕妇的血清促甲状腺激素(TSH)和游离甲状腺素(FT4)的参考区间.方法 对1290名孕妇进行尿碘检测以评价孕妇碘营养状况,评估不同碘营养状况对孕妇血清TSH及FT4的影响,建立碘营养适宜孕妇TSH和FT4的参考区间.结果 1290名孕妇尿碘水平为118.0(71.0~254.0)μg/L,低于世界卫生组织和国际控制碘缺乏病委员会推荐的孕妇碘营养评价标准(150~250μg/L);碘营养不足(尿碘<150μg/L)组和碘营养过量(尿碘>250μg/L)组孕妇TSH水平分别为2.09(0.26~6.38)和2.15(0.19~5.84)mIU/L,低于碘营养适宜(尿碘150~250μg/L)组孕妇[2.42(0.32~7.03)mIU/L](P<0.05);兰州市区碘营养适宜孕妇TSH和FT495%参考区间分别为:孕早期TSH(0.15~5.56)mIU/L,FT4(11.00~20.56)pmol/L;孕中期TSH(0.29~6.28)mIU/L,FT4(9.86~18.38)pmol/L;孕晚期TSH(0.81~6.98)mIU/L,FT4(8.30~15.60)pmol/L.结论 孕期碘营养水平对TSH有明显影响,在建立妊娠期特异的甲状腺指标参考区间时一定要以妊娠期碘营养适宜为前提.%Objective To investigate the nutrition status of iodine for pregnant women in Lanzhou,and to establish the reference ranges of serum thyroid stimulating hormone (TSH) and free thyroxine (FT4) for pregnant women in Lanzhou. Methods The levels of urine iodine and the nutrition status of iodine in 1290 pregnant women were determined,and the influence of different nutrition statuses on serum TSH and FT4 in pregnant women were evaluated. The reference ranges of TSH and FT4 were established. Results The level of urine iodine in 1290 pregnant women was 118.0(71.0-254.0)μg/L,which was lower than that recommended by World Health Organization and the International Council for Control of Iodine deficiency Disorders(150-250 μg/L). The levels of TSH in women with urine iodine <150 μg/L and urine iodine >250 μg/L were 2.09(0.26-6.38) and 2.15 (0.19-5.84) mIU/L,respectively,which were lower than that in appropriate urine iodine(150-250 μg/L) women [2.42(0.32-7.03) mIU/L](P<0.05). For pregnant women,the 95% reference ranges of TSH and FT4 were (0.15-5.56) mIU/L and (11.00-20.56) pmol/L for early pregnancy,(0.29-6.28) mIU/L and (9.86-18.38) pmol/L for middle pregnancy,and (0.81-6.98) mIU/L and (8.30-15.60) pmol/L for late pregnancy, respectively. Conclusions The nutrition status of iodine is associated with TSH in pregnant women. The reference ranges of thyroid-related hormones during pregnancy should be established according to appropriate nutrition of iodine for pregnant women.