妊娠期甲减患者孕晚期鸢尾素水平与机体代谢指标及母婴妊娠结局的相关性分析

目的 分析妊娠期甲减患者孕晚期体内血清鸢尾素水平与机体代谢指标及母婴不良妊娠结局之间的关系。方法 研究纳入2017年5月—2018年12月共120例孕晚期甲减患者，将其分为高鸢尾素组（60例）与低鸢尾素组（60例），同时选取100例同孕期甲状腺功能正常的孕妇作为对照。记录相关血液代谢指标和妊娠结局及胎儿或新生儿相关并发症。结果 高鸢尾素妊娠期甲减患者体重指数大于低鸢尾素组（P＜0.05）；促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPO - Ab）高于低鸢尾素组（P＜0.05）；游离甲状腺素（FT4）低于低鸢尾素组（P＜0.05）；低密度脂蛋白胆固醇(LDL - C)、总胆固醇(TC)、三酰甘油(TG)高于低鸢尾素组（P＜0.05）；高密度脂蛋白胆固醇(HDL - C)低于低鸢尾素组（P＜0.05）。妊娠期甲减患者血清鸢尾素水平与TSH正相关（r = 0.329，P＜0.05），而与FT4负相关（r = - 0.286，P＜0.05）。高鸢尾素妊娠期甲减患者产后出血发生率高于低鸢尾素组（P＜0.05）。同样，新生儿低体重、新生儿呼吸窘迫综合征的发生率也高于低鸢尾素组（P＜0.05）。结论 血清鸢尾素水平可反映妊娠期甲减患者病情严重程度。母婴妊娠相关并发症发生率在高鸢尾素妊娠甲减患者中较高。

Analysis of correlation between irisin level and blood metabolic indexes and pregnancy outcome in gestational hypothyroidism patients in the third trimester

To analyze the association between serum irisin level and metabolic indexes as well as gestational adverse outcomes in patients with clinical hypothyroidism during pregnancy in the third trimester. Methods A total of 120 patients with clinical hypothyroidism during pregnancy from May 2017 to December 2018 were included in this study. The patients were divided into the high-irisin group and the low-irisin group, with 60 cases in each group. 100 healthy women in same trimester of pregnancy were selected as controls. Related blood biochemical indicators, pregnancy outcomes, and fetal or neonatal complications were recorded. Results Compared with gestational hypothyroidism patients in low irisin group, the body mass index(BMI) of patients in high irisin group was higher(P<0.05), thyroid stimulating hormone(TSH) and thyroid peroxidase-antibody(TPO-Ab) levels were higher(P<0.05), the free thyroxine(FT4) level was lower(P<0.05), the levels of low-density lipoprotein cholesterol(LDL-C), total cholesterol(TC) and triglyceride(TG) were higher(P<0.05), and high-density lipoprotein cholesterol(HDL-C) level were lower(P<0.05). Serum irisin level was positively correlated with TSH level(r=0.329,P<0.05) and negatively correlated with FT4 level(r=-0.286, P<0.05) in gestational hypothyroidism patients. The incidence of postpartum hemorrhage in patients with high irisin was higher than that in the low irisin group(P <0.05). Similarly, the incidence of low birth weight and neonatal respiratory distress syndrome was also higher(P<0.05). Conclusion Serum irisin level can reflect the severity of gestational hypothyroidism. The incidence of pregnancy-related complications of mothers and infants is higher in gestational hypothyroidism patients with high irisin.