母亲妊娠期甲状腺过氧化物酶抗体暴露对5 ~ 6岁儿童心脏代谢风险评分的性别特异性影响：马鞍山出生队列（MABC）研究

Sex-specific effect of maternal thyroid peroxidase antibody exposure during pregnancy on 5- to 6-year-old children's cardiometabolic risk score: The Ma'anshan birth cohort (MABC) study

母亲妊娠期甲状腺过氧化物酶抗体暴露对5 ~ 6岁儿童心脏代谢风险评分的性别特异性影响：马鞍山出生队列（MABC）研究

Authors: Teng Y, Zhou J, Zhang M, Wu P, Chen L, Cai W, Tong J, Han Y, Yan S, Tao F, Huang K.

Source：Eur J Endocrinol. 2024 Aug 22:lvae105. doi: 10.1093/ejendo/lvae105.

Abstract

Objective: To explore the association between maternal thyroid peroxidase antibody (TPOAb) exposure and 5- to 6-year-old children's cardiometabolic risk (CMR).

Methods: A total of 2129 mother-child pairs were recruited from the Ma'anshan Birth Cohort (MABC) study. Serum TPOAb was retrospectively measured in pregnant women using an electrochemiluminescence immunoassay. CMR score was evaluated by the serum glycolipids, blood pressure and waist circumference for children aged 5-6 years. Growth mixture modeling (GMM) was used to fit trajectories of TPOAb levels throughout pregnancy. Multiple linear regression models and logistic regression models were used for statistical analyses.

Results: 2129 mother-child pairs (mean [SD] age, 26.6 [3.6] years) were enrolled for the final study. Maternal TPOAb exposure in the 1st trimester increased children's overall CMR, glucose level, HOMA-IR, triglyceride level, boys' overall CMR, boys' glucose level and girls' glucose level. TPOAb exposure in the 1st trimester was also associated with lower boys' high-density lipoprotein cholesterol (HDL-C) level. In the 2nd trimester, maternal TPOAb exposure was positively associated with children's triglyceride level. Compared with low TPOAb trajectory, children with high maternal TPOAb trajectory had an increased risk of developing high CMR (OR = 3.40; 95% CI, 1.30-8.90), hyperglycemia (OR = 5.20; 95% CI, 2.20-12.28), insulin-resistance (adjusted OR = 2.12; 95% CI, 1.10-4.07), hypertriglyceridemia (OR = 2.55; 95% CI, 1.06-6.14).

Conclusions: The 1st trimester of pregnancy is a critical period for maternal TPOAb exposure to affect cardiometabolic risk in children, with some sex specificity, mainly to the detriment of boys.

Keywords: Cardiometabolic risk; Pregnancy; Sex-specific effect; TPOAb exposure.

摘要

目的：探讨母亲甲状腺过氧化物酶抗体（TPOAb）暴露与5 ~ 6岁儿童心脏代谢风险（CMR）的关系。

方法：从马鞍山市出生队列研究（MABC）中收集了2129对母子。采用电化学发光免疫分析法对孕妇血清TPOAb进行回顾性测定。以5-6岁儿童的血糖、血压和腰围为指标进行CMR评分。使用生长混合模型（GMM）来拟合整个怀孕期间TPOAb水平的轨迹。采用多元线性回归模型和逻辑回归模型进行统计分析。

结果：最终研究入组了2129对母子（平均[SD]年龄，26.6 [3.6]岁）。妊娠早期母亲TPOAb暴露增加了儿童的总体CMR、血糖水平、HOMA-IR、甘油三酯水平、男孩的总体CMR、男孩的血糖水平和女孩的血糖水平。妊娠早期TPOAb暴露也与男孩的低高密度脂蛋白胆固醇（HDL-C）水平有关。在孕中期，母亲TPOAb暴露与儿童的甘油三酯水平呈正相关。与低TPOAb轨迹相比，母亲TPOAb轨迹高的儿童发生高CMR的风险增加（OR = 3.40; 95%CI，1.30-8.90），高血糖胰岛素抵抗（校正OR = 2.12; 95% CI，1.10-4.07）、高甘油三酯血症（OR = 2.55; 95% CI，1.06-6.14）。

结论：妊娠早期是母亲TPOAb暴露影响儿童心脏代谢风险的关键时期，具有一定的性别特异性，主要对男孩不利。

关键词：心脏代谢风险;妊娠;性别特异性效应; TPOAb暴露。