关键词:

甲状腺功能减退症, 孕妇, 脂质代谢, 妊娠结局

Abstract:

Objective　To explore the characteristics of plasma lipid metabolism in pregnant women with hypothyroidism and their association with pregnancy outcomes. Methods　One hundred and fourteen late pregnant patients with hypothyroidism who visited Second Hospital, Shaanxi University of Traditional Chinese Medicine from January 2022 to January 2024 were selected as an observation group; they were (30.41±4.22) years old. One hundred and fourteen normal late pregnant women during the same period were selected as a control group; they were (29.73±5.06) years old. The levels of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), phosphatidylcholine (PC), lysophosphatidylcholine (LPC), and phosphatidylethanolamine (PE) were compared between the two groups by independent-sample t test. The correlations of the lipid indicators with thyroid stimulating hormone (TSH), triiodothyronine (FT3), and total thyroxine (FT4) were analyzed by the Pearson correlation analysis. The values of PC, LPC, and PE in the prediction of adverse pregnancy outcomes were analyzed by the receiver operating characteristic curve (ROC). Results　The levels of TG, TC, LDL-C, PC, LPC, and PE of the observation group were higher than those of the control group [(4.58±1.01) mmol/L vs. (2.66±0.72) mmol/L, (6.72±1.03) mmol/L vs. (4.89±1.11) mmol/L, (3.92±1.00) mmol/L vs. (2.62±0.68) mmol/L, (382.45±36.66) ng/L vs. (334.20±41.18) ng/L, (16.40±1.81) μg/L vs. (14.22±1.95) ng/L, (17.40±1.81) μg/L vs. (14.05±1.68) ng/L, and (5.12±0.77) uIU/L vs. (1.26±0.22) uIU/L; all P<0.05]; the levels of FT3 and FT4 of the observation group were lower than those of the control group [(3.81±0.72) pmol/L vs. (4.50±0.68) pmol/L and (6.00±0.81) pmol/L vs. (10.44±0.77) pmol/L; both P<0.05]. PC, LPC, PE were positively correlated with TSH (r=0.472, 0.453, and 0.552; all P<0.05), and negatively with FT3 and FT4 (r=-0.322, -0.341, -0.399, -0.336, -0.314, and -0.417; all P<0.05). The levels of PC, LPC, and PE of the women with adverse pregnancy outcomes in the observation group were higher than those in the women without adverse pregnancy outcomes [(399.74±38.81) ng/L vs. (372.36±39.40) ng/L, (17.95±1.92) μg/L vs. (15.50±1.87) μg/L, and (18.22±1.92) μg/L vs. (16.92±1.81) μg/L; all P<0.05]. The areas under the ROC's of PC, LPC, and PE for predicting adverse pregnancy outcomes were 0.733, 0.854, and 0.724, respectively (all P<0.05). Conclusions　Pregnant women with combined hypothyroidism have increase in blood lipid related indicators; among which, PC, LPC, and PE are correlated with the three indicators of hypothyroidism and pregnancy outcomes. At the same time, they have certain application value in predicting adverse pregnancy outcomes.

Key words:

Hypothyroidism, Pregnant women, Lipid metabolism, Pregnancy outcomes