母体甲状腺激素的动态变化可能与学龄前儿童的糖脂代谢有关

Association Between Maternal Thyroid Hormone Concentration with Normal Thyroid Function During Pregnancy and Preschoolers' Glycolipid Metabolism: A Birth Cohort Study

孕期甲状腺功能正常的母亲甲状腺激素浓度与学龄前儿童糖脂代谢之间的关系： 出生队列研究

Authors: Wenjin Cai, Lu Chen, Manyu Zhang, Jiajun Ouyang, Penggui Wu, Juan Tong, Guopeng Gao, Shuangqin Yan, Fangbiao Tao, Kun Huang

Source: Thyroid

DOI: 10.1089/thy.2024.0334

Abstract

Background: Thyroid hormones (THs) are essential endocrine hormones that play key roles in individual's growth and development. There is limited knowledge about the association between maternal TH concentrations variations with normal thyroid function during pregnancy and offspring's glycolipid metabolism. 

Methods: A total of 1130 mother-child pairs from the Ma'anshan birth cohort were included in this prospective study. Maternal TH levels and thyroid peroxidase antibodies were measured in the 1^st, 2^nd, and 3^rd trimesters of pregnancy during the childhood follow-up period. Fasting venous blood was collected from children at 4-6 years of age and glycolipid metabolic indicators were assayed. Analyses were performed using Binary logistic regression models, linear regression models, and Generalized linear regression model. 

Results: Maternal TH trajectories were fitted via latent category growth models. During the 1st trimester of pregnancy, maternal T3 and free thyroxine (fT4) levels were positively associated with children's blood glucose levels (β = 0.007 [CI 0.028-0.181]; β = 0.022 [CI 0.004-0.040]), whereas high levels of fT4 may be associated with decreased risk of children's hypercholesterolemia (OR = 0.870 [CI 0.768-0.986]). Maternal T4 concentrations during the 3rd trimester of pregnancy were negatively associated with children's cholesterol levels (β = -0.002 [CI -0.003-0.00]). High maternal TH levels were associated with high fasting glucose level and low low-density lipoprotein concentrations in children. 

Conclusions: Maternal TH dynamic variations may be associated with glycolipid metabolism in preschoolers, even when women do not have clinically diagnosed thyroid disorders. The exact associations between maternal THs in specific trimesters of pregnancy under normal thyroid function conditions and glycolipid metabolism in offspring require further investigation.

Keywords: children; cohort study; glycolipid metabolism; pregnant women; thyroid hormones

摘要

背景：甲状腺激素（THs）是人体必需的内分泌激素，在个体的生长发育过程中发挥着关键作用。目前，人们对孕期母体甲状腺激素浓度变化与正常甲状腺功能和后代糖脂代谢之间的关系了解有限。

研究方法：这项前瞻性研究共纳入了马鞍山出生队列中的 1,130 对母子。在儿童随访期间，分别在妊娠的第一、第二和第三季度测量母体的 TH 水平和甲状腺过氧化物酶抗体。收集儿童 4-6 岁时的空腹静脉血，检测糖脂代谢指标。采用二元逻辑回归模型、线性回归模型和广义线性回归模型进行分析。

结果：母体 TH 轨迹是通过潜在类别增长模型拟合的。在妊娠头三个月，母体 T3 和游离甲状腺素（fT4）水平与儿童血糖水平呈正相关（β = 0.007 [CI 0.028-0.181]; β = 0.022 [CI 0.004-0.040]），而高水平的 fT4 可能与儿童高胆固醇血症风险的降低有关（OR = 0.870 [CI 0.768-0.986]）。妊娠三个月期间母体的 T4 浓度与儿童的胆固醇水平呈负相关（β = -0.002 [CI -0.003-0.00]）。母体TH水平高与儿童空腹血糖水平高和低密度脂蛋白浓度低有关。

结论：母体TH的动态变化可能与学龄前儿童的糖脂代谢有关，即使妇女没有临床诊断的甲状腺疾病。在甲状腺功能正常的情况下，特定孕期的母体TH与后代糖脂代谢之间的确切关系还需要进一步研究。

关键词：儿童；队列研究；糖脂代谢；孕妇；甲状腺激素