硒水平及其与妊娠期甲状腺自身免疫和严重子痫前期的关系:前瞻性理想母乳队列研究的启示

IF 3.5 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM European Thyroid Journal Pub Date : 2024-07-09 Print Date: 2024-08-01 DOI:10.1530/ETJ-24-0007
Chae Won Chung, Kyungsik Kim, Sue K Park, Dal Lae Ju, Young Joo Park, Choong Ho Shin, Jong Kwan Jun, June-Key Chung, Yoon Ju Song, Young Ah Lee, Gi Jeong Cheon, Sun Wook Cho
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引用次数: 0

摘要

目的本研究旨在评估韩国孕妇的硒状况及其对母体甲状腺功能和妊娠结局的影响:血浆硒的中位数为 98.8(范围为 46.7-206.4)微克/升,30 人(8%)被归为缺硒组,164 人(45%)被归为次优组。硒缺乏与自身免疫性甲状腺炎的标志物有关,包括抗甲状腺过氧化物酶抗体阳性结果(13.3 [缺乏] vs. 4.6 [最佳] %,P=0.031)和超声检查甲状腺实质异质性(33.3 [缺乏] vs. 14.6 [次佳] vs. 17.3 [最佳] %,P=0.042),与胎龄无关。与服用硒补充剂的孕妇组相比,未服用硒补充剂的孕妇组,尤其是双胎孕妇组,重度子痫前期的发生率更高(0 [Se 补充剂] vs. 9.0 [未补充剂] %,P=0.015):孕妇轻度缺硒可导致严重的健康问题,包括母体甲状腺自身免疫和孕期产科并发症。需要根据妊娠阶段和胎儿数量制定适当的硒摄入量指南。
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Selenium levels and their association with thyroid autoimmunity and severe preeclampsia in pregnancy: Insights from a prospective ideal breast milk cohort study.

Objective: This study aimed to assess selenium status in South Korean pregnant women and its impact on maternal thyroid function and pregnancy outcomes.

Methods: 'Ideal Breast Milk (IBM) Cohort Study' included 367 pregnant women out of 442 participants and categorized into three groups based on plasma selenium levels: deficient (< 70 μg/L), suboptimal (70-99 μg/L), and optimal (≥ 100 μg/L). During the second or third trimester, various blood parameters, including selenium, thyroid-stimulating hormone, free T4, free T3, and anti-thyroid peroxidase antibody levels, were measured. Thyroid parenchymal echogenicity was assessed as another surrogate marker for thyroid autoimmunity using ultrasonography.

Results: The median plasma selenium was 98.8 (range: 46.7-206.4) μg/L, and 30 individuals (8%) were categorized as deficient, while 164 (45%) were classified in the suboptimal group. Selenium deficiency was associated with markers of autoimmune thyroiditis, including positive anti-thyroid peroxidase antibody results (13.3 (deficient) vs 4.6 (optimal) %, P = 0.031) and thyroid parenchymal heterogeneity on ultrasound (33.3 (deficient) vs 14.6 (suboptimal) vs 17.3 (optimal) %, P = 0.042), independently of gestational age. The incidence of severe preeclampsia was higher in the group not taking selenium supplements, particularly among those with twin pregnancies, compared to the group taking selenium supplements (0 (selenium supplement) vs 9.0 (no supplement) %, P = 0.015).

Conclusion: Pregnant women experience mild selenium deficiency, which can lead to significant health issues including maternal thyroid autoimmunity and obstetrical complications during pregnancy. Guidelines for appropriate selenium intake according to the stage of pregnancy and the number of fetuses are needed.

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来源期刊
European Thyroid Journal
European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.70
自引率
2.10%
发文量
156
期刊介绍: The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.
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