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首页> 外文期刊>European journal of clinical nutrition >Changes in iodine metabolism during late pregnancy and lactation: a longitudinal study among Sudanese women.
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Changes in iodine metabolism during late pregnancy and lactation: a longitudinal study among Sudanese women.

机译：妊娠晚期和哺乳期碘代谢的变化：苏丹妇女的一项纵向研究。

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OBJECTIVE: To elucidate the persistence, or otherwise, of the pregnancy-related changes in the iodine metabolism and thyroid function in a population residing in an area of mild iodine deficiency in the Sudan. DESIGN: A longitudinal prospective cohort study involving pregnant women who were recruited during their third trimester of pregnancy and were followed up for up to nine months after delivery. SETTING: The study was conducted among Sudanese women residing in the Omdurman area in Khartoum, an area with a total goitre rate of 17.5%. Subjects: Forty-seven pregnant women were recruited during their third trimester of pregnancy. Their mean age and weight were 29+/-4.6 y and 62.4+/-8.7 kg, respectively. Age matched healthy non-pregnant women living in the same area (n=40) served as a control group. METHODS: Serum levels of thyrotropin (TSH), thyroxine (T4), triiodothyronine (T3), thyroglobulin (Tg) and the urinary iodine concentration (UIC) were determined during the third trimester (first occasion), and subsequently at three months (second occasion), six months (third occasion) and nine months after delivery (fourth occasion). Control subjects provided corresponding samples on one occasion. Main outcomes measures: UIC, TSH, Tg, FT4 and T3. RESULTS: During the third trimester of pregnancy the median UIC and the free T4 (FT4) were lower than in the control group (P<0. 0001, P<0.0001, respectively), while the median Tg was higher than in the controls (P<0.03). Three months post-partum maximum thyroidal stimulation was evident, with elevated serum levels of TSH and Tg (P<0.0001, P<0.03) and reduced UIC and serum T3 and FT4 (P<0.0004, P<0.0005, P<0.0001), compared with the control group. Nine months post-partum the thyroid function was restored to the pre-pregnancy state, and the median values of TSH, Tg, T3, FT4 and UIC did not differ significantly from those in the control group. CONCLUSIONS: Our study suggests that the reversibility of the pregnancy-induced changes in the iodine status and thyroid function to the pre-pregnancy levels may depend on the iodine status of the mother during and after pregnancy. The thyroidal stress during the first three months of the post-partum period, which is partially due to the iodine loss in the breast milk, justifies further detailed studies to assess the iodine content of the breast milk and the role of breast milk as a vehicle for iodine supply of infants in situations of iodine deficiency. SPONSORSHIP: This study was supported by a grant from the Swedish Agency for Research Co-operation with Developing Countries.
机译：目的：阐明苏丹轻度缺碘地区人群中与妊娠有关的碘代谢和甲状腺功能变化的持续性或其他原因。设计：一项纵向前瞻性队列研究，涉及孕妇，这些孕妇是在妊娠晚期三个月中招募的，并且在分娩后长达9个月接受随访。地点：这项研究是针对居住在喀土穆Omdurman地区（总甲状腺肿率为17.5％）的苏丹妇女进行的。对象：四十七名孕妇在怀孕的三个月中被招募。他们的平均年龄和体重分别为29 +/- 4.6 y和62.4 +/- 8.7 kg。居住在同一地区（n = 40）的年龄匹配的健康非孕妇妇女作为对照组。方法：在孕晚期（第一次）和随后的三个月（第二次）测定血清中促甲状腺激素（TSH），甲状腺素（T4），三碘甲状腺素（T3），甲状腺球蛋白（Tg）和尿中碘浓度（UIC）。交货），六个月（第三次）和交货后九个月（第四次）。对照对象一次提供了相应的样品。主要结果指标：UIC，TSH，Tg，FT4和T3。结果：在妊娠中期，UIC和游离T4（FT4）中位数低于对照组（P <0。0001，P <0.0001），而Tg中位数高于对照组（ P ＜0.03）。产后三个月明显出现最大的甲状腺刺激，血清TSH和Tg水平升高（P <0.0001，P <0.03），UIC和血清T3和FT4降低（P <0.0004，P <0.0005，P <0.0001），与对照组相比。产后九个月，甲状腺功能恢复到孕前状态，TSH，Tg，T3，FT4和UIC的中值与对照组无显着差异。结论：我们的研究表明，怀孕引起的碘状态和甲状腺功能变化与怀孕前水平的可逆性可能取决于母亲在怀孕期间和之后的碘状态。产后前三个月的甲状腺压力部分是由于母乳中的碘流失所致，因此有必要进行进一步的详细研究以评估母乳中的碘含量以及母乳作为媒介物的作用在碘缺乏的情况下为婴儿提供碘。赞助：这项研究得到瑞典与发展中国家研究合作局的资助。

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