ABSTRACT
Objective To set up the reference ranges of thyroid hormones for pregnant and lactating woman in Zhejiang.Methods A total of 338 pregnancy,322 lactating women and 139 non-pregnant women (as a control) were selected from 1 079 women in 13 survey sites of Zhejiang as survey subjects,through the questionnaire survey and thyroid B-ultrasound tests from June 2010 to September 2010.The level of urinary iodine was measured by spectrophotometer,and the thyroid hormone [free triiodothyronine (FT3),free (unbound) thyroxin (FT4),triiodothyronine (T3),tetraiodothyronine (T4),thyroid stimulating hormone (TSH)] was measured by automated chemiluminescence immunoassay.Analysis of thyroid hormone 95％ in pregnant women and lactating women.Results The median urinary iodine of all women investigated were in optimal urine levels (150-249 μg/L),which indicated they were in iodine sufficient status.The FT3 index of lactating women was higher than that of pregnant women and non pregnant women (Zlactating-pregnant =3.98,Zlactating-pregnant =2.46,all P ＜ 0.05);the FT4 index level of lactating women was higher than that of pregnant women and non pregnant women (Zlactating-pregnant =2.68,Zlactating-non-pregnant =2.25,all P ＜ 0.05);the T3 index level of lactating women was higher than that of pregnant women and non pregnant women (Zlactating-pregnant =3.51,Zlactating-non pregnant =2.41,all P ＜ 0.05);levels of T4 in lactating women was the highest (Zlactating-pregnant =2.30,Zlactating-pregnant =4.90,Zlactating-non pregnant =1.57,all P ＜ 0.05);TSH index of lactating women and non pregnant women were higher than that of pregnant women (Zlactating-pregnant =2.81,Zlactating-non pregnant =1.68,all P ＜ 0.05).And in pregnant,the 95％ medical reference interval of FT3 was 3.37-6.53 pmol/L,FT4 was 10.68-20.85 pmol/L,T3 was 1.40-2.79 nmol/L,T4 was 72.72-166.41 nmol/L,and TSH was 0.15-4.44 mU/L;in lactating woman,FT3 was 3.39-6.44 pmol/L,FT4 was 10.81-20.33 pmol/L,T3 was 1.44-2.77 nmol/L,T4 was 71.94-164.61 nmol/L,and TSH was 0.25-4.47 mU/L.Conclusion The thyroid hormone levels of pregnant and lactating women are different from those of non-pregnant women,therefore establishing reference data of thyroid hormones for pregnant and lactating women may be a very important step for clinical practice.
ABSTRACT
Objective To find out the status of iodine nutrition and the goiter of population in Zhejiang Province after adjustment of salt iodine concentration.Methods From April to June 2013,the probability proportionate to size sampling method was applied in 31 countries in Zhejiang Province to select 1 650 school-age children aged 8-10 to examine thyroid by B ultrasound,to collect urine and salt samples,and to test the iodine level using the colorimetric titration method and the spectrophotometer method.Six hundred and twenty pregnant women were selected to collect urine samples and urinary iodine was tested by the spectrophotometer method.Results The coverage rate of iodized salt and the consumption rate of qualified iodized salt in Zhejiang Province after adjustment of salt iodine concentration were 93.20％ (1 521/1 632) and 89.71％ (1 464/1 632),respectively;and the medians urinary iodine in children and pregnant women were 178.40 μg/L and 127.23 μg/L,respectively;and the goiter and median thyroid volume were 5.27％ (87/1 650) and 3.45 ml,respectively;the P97 thyroid volume of children in Zhejiang Province in the 8,9 and 10 years old groups (4.76,5.29,6.36 ml) were higher than those (4.5,5.0,6.0 ml) in the thyroid volume reference (WS 276-2007);and the correlations between thyroid volume,goiter and urinary iodine were not found.Conclusions After adjustment of salt iodine concentration,the status of iodine nutrition in Zhejiang Province in general is down to optimum level,which indicates that it is appropriate for this adjustment,but the level of iodine nutrition in pregnant women is less than appropriate,which should be pay attention to.