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Objective:To explore the association between dietary patterns and the incidence of type 2 diabetes mellitus(T2DM), so as to provide insights for the prevention and management of T2DM.Methods:Participants were recruited from the " The Tianjin Chronic Inflammation and Health Cohort Study(TCLSIH)" cohort study from 2013 to 2018, who had completed the modified semiquantitative food frequency questionnaire(FFQ) and blood glucose testing( n=26 425), free of cardiovascular disease, cancer, or diabetes at baseline. The relevant information collected includes food frequency, blood glucose concentration, and other confounding factors. In this study, the correlation between dietary patterns and T2DM was tested using Cox proportional risk regression model, and the gender stratification analysis and body mass index stratification analysis of different gender groups were carried out. All statistical analysis was performed using SAS 9.3 software. Results:The age of all participants was (41.0±11.5)years, and the cumulative incidence was 3.84% for T2DM. The cumulative incidence of T2DM in male population was 5.29%, while that in female population was 2.16%. There were significant differences in the incidence of T2DM among different genders( P <0.001). The multivariable-adjusted hazard ratios( HR) and corresponding 95% CI of T2DM across the plant-based dietary pattern score were 1.09(95% CI 0.91-1.31), 0.80(95% CI 0.66-0.97), and 0.76(95% CI 0.62-0.94; Ptrend =0.010). Moreover, no statistically significant differences were observed between animal and traditional northern Chinese diets with the incidence of T2DM. Conclusions:The plant-based dietary patterns were associated with substantially lower risk of developing T2DM, and there were no significant association between animal and traditional northern Chinese dietary patterns with T2DM. Plant-based dietary patterns characterized by a variety of fruit, leeks, onions, seaweed may be beneficial to the prevention and control of T2DM.
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Objective:To investigate the prevalence of thyroid nodules (TN) among people undergoing physical examination in Taiyuan City, and evaluate the impact of hyperuricemia (HUA) on the risk of TN.Methods:Using a prospective design, a total of 42 966 people who underwent routine physical examination at Shanxi Shangning Health Examination Center from October 2020 to October 2021 were selected as subjects and divided into the HUA group ( n = 7 235) and the non-HUA group ( n = 35 731) based on the serum uric acid levels. The propensity score matching (PSM) method was used to balance the confounding factors between groups, and logistic regression was used to analyze the impact of HUA on the risk of TN. Results:The total detection rate of TN in the physical examination population was 55.6% (23 907/42 966). The detection rate of TN in females [61.0% (15 011/24 618)] was higher than that in males [48.5% (8 896/18 348)], and the difference was statistically significant (χ 2 = 664.55, P < 0.001). A total of 2 438 pairs of matching data were obtained after PSM, and the distribution of confounding factors in HUA and non-HUA groups reached equilibrium (the absolute values of standardized differences < 0.10). Logistic regression analysis before PSM showed that HUA was a protective factor for the incidence of TN in general population and males [odds ratio ( OR) = 0.696, 0.817, 95% confidence interval ( CI): 0.661 - 0.732, 0.768 - 0.868], while HUA was a risk factor for the incidence of TN in females ( OR = 1.370, 95% CI: 1.192 - 1.574). After PSM, HUA was not a influencing factor for the incidence of TN in general population and males ( P > 0.05), but it was still a risk factor in females for the onset of TN ( OR = 1.373, 95% CI: 1.014 - 1.858). Conclusion:In the physical examination population in Taiyuan City, HUA is an independent risk factor for TN in females.
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MicroRNA (miRNA) is a kind of small non-coding RNA, which can specifically bind to the 3' untranslated region of the target RNA, inducing the degradation or inhibiting the translation of the target mRNA, and ultimately affecting the important biological processes such as cell proliferation, differentiation, and apoptosis.Cataract, a leading blinding eye disease in the world, is a kind of disease that causes blindness because of lens opacification, including age-related cataracts, diabetic cataracts, congenital cataracts and posterior capsule opacification.In recent years, it has been found that many kinds of miRNA are expressed in lens and participate in the development of cataract, having significant influences on the proliferation, migration, epithelial-mesenchymal transition and apoptosis of lens epithelial cells, and take part in the occurrence and development of cataracts.The advances of different miRNAs in cataract were reviewed in this article so as to provide new ideas and methods for the prevention and treatment of cataract.
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Objective:To evaluate the efficacy and safety of corneal bandage lens in the treatment of dry eye after cataract surgery in patients with mild meibomian gland dysfunction (MGD).Methods:A non-randomized controlled clinical study was conducted.Sixty eyes of 60 patients with mild MGD after cataract surgery were enrolled in Yantai Yuhuangding Hospital from June 2020 to February 2021.The patients were divided into bandage lens group and control group according their willingness, with 30 eyes in each group.All the patients received phacoemulsification and intraocular lens implantation and were administered with the same postoperative medication.Patients in bandage lens group wore lenses for 14 days continuously after the operation.Patients in control group did not wear the corneal bandage lens after the operation.The structure and inflammation of the anterior segment were observed with a slit-lamp microscope before operation and on days 1, 7, and 14 after the operation.Best corrected visual acuity (BCVA) was obtained using a standard logarithmic visual acuity chart.Ocular surface symptoms were evaluated via an ocular surface disease index (OSDI) questionnaire.The intraoperative changes of meibomian glands were assessed with an ocular surface analyzer and the non-invasive first tear film break-up time (NIFBUT) was recorded.Corneal epithelium defects were observed by corneal fluorescein sodium staining (CFS). This study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Yantai Yuhuangding Hospital (No.2021-363). Written informed consent was obtained from each patient before any medical examination.Results:On the 1st, 7th, and 14th day after surgery, no inflammatory reaction or complication was observed in both groups.Statistically significant differences in BCVA among different postoperative time points were found ( Ftime=3.610, P=0.016). BCVA on the 7th day after surgery were higher than that on the 1st day after surgery, and the BCVA on the 14th day after surgery were significantly higher than those on the 1st and 7th day after surgery in both groups, with statistically significant differences (all at P<0.05). There were statistically significant differences in OSDI scores between the two groups at different postoperative time points ( Fgroup=31.219, P<0.001; Ftime=15.672, P<0.001). The OSDI scores of bandage lens group were significantly lower than those of control group on the 7th and 14th day after surgery, OSDI scores in both groups on the 14th day after surgery were significantly lower than those on the 1st and 7th day after surgery, with statistical significance (all at P<0.05). The NIFBUT values on the 7th and 14th day after surgery were (6.62±0.93)s and (8.02±1.13)s, in control group, bandage lens group and (9.81±0.91)s and (10.03±0.49)s in bandage lens group, with a statistically significant difference between them ( Fgroup=2.351, P=0.037), and the NIFBUT values of bandage lens group on the 7th and 14th day after surgery were higher than those of control group, with statistically significant differences (both at P<0.05). The number of high CFS score eyes of bandage lens group were lower than those of control group on the 7th and 14th day after surgery, and the differences were statistically significant ( χ 2=7.391, P=0.025; χ 2=9.317, P=0.002). Conclusions:For patients with mild MGD after cataract surgery, wearing bandage contact lens has no obvious ocular adverse reaction and can promote the growth of corneal epithelium, enhance the stability of tear film, improve dry eye symptoms, and relieve dry eye manifestations after surgery.
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Objective:To investigate the relationship between blood glucose fluctuation and carotid intima-media thickness (CIMT) in newly diagnosed patients with type 2 diabetes mellitus (T2DM) and the predictive value of betatrophin.Methods:A total of 180 newly diagnosed T2DM patients in Taiyuan Central Hospital from June 2018 to December 2019 were included for the study. And they were divided into normal intima-media group (81 cases), intima-media thickening group (60 cases) and plaque formation group (39 cases) according to the results of carotid ultrasound. The body test indexes, glucose and lipid metabolism indexes, blood glucose fluctuation and betatrophin level were compared among the three groups, and the correlation of these indexes with CIMT and risk factors of CIMT were analyzed.Results:The mean and maximal amplitude of glycemic excursions (AGE) in the plaque formation group and intima-media thickening group were significantly higher than those in the normal intima-media group [(5.08±0.62), (4.06±0.54) vs (3.17±0.41) mmol/L and (5.20±0.72), (4.26±0.54) vs (3.34±0.59) mmol/L] (all P<0.05), and these indexes in the plaque formation group were significantly higher than the intima-media thickening group (all P<0.05). Betatrophin levels in intima-media thickening group and plaque formation group were significantly higher than those in normal intima-media group [(423.35±76.24) and (490.68±97.84) vs (358.29±92.27) ng/L] (both P<0.05). Hip circumference and triglyceride (TG) in plaque formation group were obviously higher than those of the normal intima-media group and intima-media thickening group [(103.5±6.3) vs (97.6±7.0), (99.5±7.4) cm and 2.99 (1.32, 3.92) vs 1.70 (1.21, 2.39), 1.84(1.43, 2.93) mmol/L] (all P<0.05), and waist circumference, systolic blood pressure, fasting blood glucose (FBG), total cholesterol (TC), insulin resistance of homeostasis model assessment (HOMA-IR) levels in plaque formation group were significantly higher than those in normal intima-media group [(94.0 (86.0, 102.0) vs 88.0 (82.5, 94.0) cm, (136.2±18.0) vs (125.9±15.3) mmHg, 10.16 (8.43, 13.23) vs 8.49 (6.98, 9.97) mmol/L, (6.31±0.90) vs (4.99±0.99) mmol/L, 4.90 (3.50, 7.13) vs 2.77 (1.32, 5.07)] (all P<0.05). CIMT was positively correlated with waist circumference, hip circumference, systolic blood pressure (SBP), FBG, TC, TG, HOMA-IR, betatrophin, the mean and maximal AGE, blood glucose fluctuation coefficient (BGFC) (all P<0.05), and it was negatively correlated with time in range (TIR) ( P<0.05). The mean and maximal AGE, TC, TG and betatrophin were independent risk factors of CIMT (all P<0.05). Conclusion:Blood glucose fluctuation is closely related to CIMT in patients with T2DM, and betatrophin is expected to be an early predictor of diabetic macroangiopathy.
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Objective To investigate the association between serum 25(OH)D3 and high sensitive C -reac-tive protein (hs-CRP),tumor necrosis factor -alpha (TNF-α),interleukin-6 (IL-6) inflammatory markers in non-obese patients with type 2 diabetes mellitus (T2DM).Methods From June 2015 to September 2015,in this cross-sectional study,120 non-obese patients with T2DM(female in 58 cases,male in 62 cases) in Taiyuan Central Hospital were selected as T2DM group,and 120 non-obese patients with T2DM and 96 healthy subjects ( control group) were recruited.The serum concentrations of glucose,HbA1c,insulin,25( OH) D3 and inflammatory markers including TNF-α,IL-6 and hs-CRP were measured.A homeostatic model of insulin resistance (HOMA-IR) was also evaluated.The clinical and biochemical characteristics of T 2DM were observed in the group of vitamin D deficien-cy group,vitamin D insufficiency group and vitamin D normal group.And the relativities were analyzed between it with hs-CRP,TNF-α,IL-6,HOMA-IR,INF,FBG,BMI,WHR,and so on.The relativities were observed between 25(OH)D3 with all the factors.Results The mean serum concentration of 25(OH)D3 in the non -obese T2DM group was (10.65 ±3.55)ng/mL,which was significantly lower than (18.44 ±5.21)ng/mL in the normal control group (t＝-6.84,P ＝0.012).The levels of serum TNF -αand IL -6 in the T2DM group were (15.51 ± 4.87)ng/L and (18.12 ±4.13) ng/L,respectively,which were significantly higher than those in the control group [(8.99 ±2.54)ng/L,(8.89 ±2.07)ng/L](t＝7.95,10.04,P＝0.017,0.007).The proportions of deficiency,insufficiency and normal of vitamin D in T2DM patients were 60.83%,31.67%and 7.50%,respectively .The levels of TNF-αand IL-6 in the serum 25(OH) D3 deficiency group were significantly higher than those in the normal 25(OH)D3 group [(17.93 ±4.94)ng/L vs.(10.30 ±4.52)ng/L,F＝6.897,P＝0.026;(20.14 ±4.99)ng/L vs. (16.39 ±5.06)ng/L,F＝10.589,P＝0.017].There was a significant correlation between serum 25(OH)D3 and HOMA-IR(r＝-0.041;P＝0.030),TNF-α(r＝-0.229;P＝0.040) and IL -6 levels (r＝-0.299;P＝0.032),but there was no significant correlation with inflammatory factor hs -CRP and fasting blood glucose. Conclusion Vitamin D deficiency is common in patients with T2DM,and systemic chronic inflammation may also play an important role in the pathogenesis of T 2DM.This study shows that vitamin D may play an important role in the pathogenesis of insulin resistance and chronic systemic inflammatory response,an important pathogenesis of T2DM.
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OBJECTIVE:To observe the clinical efficacy and safety of different doses of atorvastatin in the treatment of chron-ic subdural hematoma(CSDH). METHODS:One hundred and tweaty-eighie CSDH patients selected from our hospital during Jun. 2013-May 2015 were divided into observation group(n=62)and control group(n=66)in accordance with random number table. Both groups were given conventional treatment of brain cell nutrition. Control group received Atorvastatin tablet 20 mg,po,qd;observation group received Atorvastatin tablet 40 mg,po,qd. Both groups were treated for 6 months. Clinical efficacy,CSS and ADL score,hematoma volume,the levels of serum inflammatory factors (hs-CRP,MMP-9,IL-6,TNF-α) were observed in 2 groups. ADR was recorded during treatment and recurrence rate was also recorded. RESULTS:2 patients withdrew from observa-tion group and 6 from control group. Finally,120 patients met the criteria were included,with 60 cases in each group. Total re-sponse rate of observation group(88.3%)was significantly better than that of control group(73.3%),with statistical significance (P0.05). The recurrence rate of control group(13.3%)was significantly higher than that of observation group(3.3%),with statistical significance(P<0.05). CONCLUSIONS:Daily dose of shows ator-vastatin 40 mg better therapeutic efficacy and lower recurrence rate in the treatment of CSDH with good safety.
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AIM: To investigate the effect of nucleolin on diabetic cardiomyopathy in mice.METHODS: A type II diabetic cardiomyopathy mouse model was prepared using a cardiac-specific nucleolin-overexpressing transgenic mice.The mice were divided into wild-type mouse control group, nucleolin transgenic mouse control group, wild-type mouse diabetes group and nucleolin transgenic mouse diabetes group.Wheat germ agglutinin (WGA) fluorescent dye, Masson staining and PowerLab system detection were used to further clarify the role of nucleolin on cardiac hypertrophy, fibrosis and cardiac function in type II diabetic cardiomyopathy mice.RESULTS: Compared with wild-type mouse control group, no significant increase in blood glucose level was found, while genetical myocardial cell hypertrophy was significantly attenuated in nucleolin transgenic mouse diabetes group.The collagen fibers were also significantly reduced, and hemodynamic indexes ± dp/dtmax, left ventricular end-diastolic pressure, left ventricular systolic pressure and heart rate were also improved.The above differences were statistically significant.CONCLUSION: Nucleolin may reduce the occurrence of myocardial hypertrophy and fibrosis, thus improving the cardiac function of diabetic cardiomyopathy mice.
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Background Cataract with preexisted dry eye is a common eye disease.It is speculated that preservative-free artificial tears can inhibit inflammatory procedure,prevent postoperative eye infections and reduce dry eye symptoms.However,relevant literature is rare up to now.Objective This study was to evaluate and compare the therapeutic effects between preservative-free or preservative sodium hyaluronate combined with fluorometholone eyedrops for cataract with dry-eye.Methods A randomized controlled single-blind clinical study was performed.Sixty patients with dry-eye syndrome who was going to receive surgery for cataract removal were enrolled in Yuhuangding Hospital from January to December 2015 under the informed consent.The patients were randomly divided into the test group and control group.Preservative-free or preservative 0.1％ sodium hyaluronate combined with 0.1％ fluorometholone eye drops were topically administered in the eyes of the test group and control group,respectively.Ocular Surface Disease Index (OSDI) score,breakup time of tearfilm (BUT),Schirmer Ⅰ test (S I t),corneal fluorescein staining,impression cytology,goblet cell density and the concentrations of interleukin (IL)-1β,tumor necrosis factor (TNF)-α,catalase (CAT),superoxide dismutase 2 (SOD2) in tears were evaluated and compared.Results There were significant differences in gender,ages,OSDI scores,BUT,S I t value,corneal fluorescein staining scores,impression cytology findings,and goblet cell density between the two groups (all at P＞0.05).OSDI,corneal fluorescein staining scores and imprint cellular level were evidently reduced,and BUT,S I t values and goblet cell density were significantly increased 1 month and 2 months after operation in comparison with the baseline values in the test group (F =13.058,8.027,3.755,21.652,70.962,92.354,all at P ＜ 0.05).The concentrations of IL-1β and TNF-α in tears of the test group were significantly lower,and CAT and SOD2 in the tears of the test group were significantly higher than those in the control group 1 month and 2 months after operation (F=18.731,9.070,15.357,351.359,all at P＞0.05).Conclusions 0.1％ preservative-free sodium hyaluronate combined with 0.1％ fluorometholone eyedrops can relieve the symptoms and signs of dry-eyes following cataract surgery by playing antiinflammatory and antioxidant effects.
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OBJECTIVE:To investigate antioxidant effects of different extract parts from Aquilaria sinensis leaves. METH-ODS:A. sinensis leaves were extracted by reflux extraction with petroleum ether,ethyl acetate,absolutely ethanol,water to obtain corresponding parts (AGP,AGE,AGA and AGW parts). The ability of different extracts eliminating ABTS+ free radical,DPPH free radical and O2-free radical and reducing Cu2+ were investigated. IC50 was also calculated. Vitamin C(VC)was used as positive control in above tests. RESULTS:Those parts eliminated above free radicals and reduced Cu2+ in concentration-dependant manner, among which maximal elimination rate of AGA and AGW parts to ABTS+ free radical were 100% and 81.07%(IC50=14.89,23.12 mg/L)and higher than that of VC(88%);those of other parts were less than 50%. The maximal elimination rate of AGA parts to DPPH free radical was 67.74%(IC50=47.96 mg/L),but still lower than that of VC(91.44%);the elimination rates of other parts were all weak and lower than 40%. The maximal elimination rates of AGA and AGW parts to O2-free radical were 67.79% and 61.79%(IC50=393.01,421.04 mg/L),but still lower than that of VC(88%);the elimination rates of other parts were all lower than 33%. The maximal reduction percentage of AGP,AGE,AGA and AGW parts to Cu2+ were all higher than 50%(IC50=55.99, 40.27,25.44,31.06 mg/L,respectively),but still lower than that of VC (100%). CONCLUSIONS:Different extract parts from A. sinensis leaves have antioxidant activity in vitro,and that of AGA is the strongest.
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OBJECTIVE@#To investigate the nucleolus expression in the diabetic cardiomyopathy.@*METHODS@#The rats were divided into a control group and a type II diabetic cardiomyopathy group (model group). In the model group, rats were fed with high-fat and high-sugar food (rats were intravenously injected with 60 mg/kg chain urea with cephalosporins in the 5th and 6th weeks in mice). The level of blood glucose was determined at the end of 8th week and the level of fasting blood glucose was examined at the end of 20th week. The ratio of the heart mass and body mass was calculated, and the pathological changes in myocardial morphology were observed. The immunohistochemical method and Western blot were used to detect the expression level of myocardial nucleolin.@*RESULTS@#The level of fasting blood glucose was significantly increased in the diabetic model group than that in the control group (P<0.05). Rats in the model group were found hypertrophic cardic cells, with fracture, dissolusion, and disordered arrangement. Immunohistochemical staining and Western blot showed the protein levels of myocardial nucleolin in the model group were obviously higher than those in the control group (P<0.05).@*CONCLUSION@#Nucleolin may play a role in the pathogenesis and development of the diabetic cardiomyopathy.
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Animals , Rats , Blood Glucose , Diabetes Mellitus, Experimental , Metabolism , Diabetic Cardiomyopathies , Metabolism , Myocardium , Pathology , Phosphoproteins , Metabolism , RNA-Binding Proteins , MetabolismABSTRACT
AIM:To construct myocardium-specific nucleolin ( Ncl) transgenic mice and to provide an animal model for the studies of the myocardial protection of nucleolin .METHODS:To create nucleolin transgenic mice , a myo-cardium-specific expression plasmid of nucleolin ( Alpha-MyHC clone 26-Ncl) was constructed .The gene type of transgenic mice was identified by PCR and the nucleolin protein level was tested by Western blotting .The myocardium morphology , heart weight index (HWI) and left ventricular pressure maximum rise rate were observed in nucleolin transgenic (TG) mice and wild-type ( WT) mice.RESULTS:We gained 4 transgenic mice (51, 52, 56 and 86 lines, only 52 line and 86 line were eugonic) by PCR.Western blotting analysis showed the expression of nucleolin up-regulated specifically in the myocardium .However , the myocardium morphology , HWI and left ventricular pressure maximum rise rate in the nucleolin transgenic mice were similar to those in the wild-type mice.CONCLUSION:We constructed myocardium-specific nucleo-lin transgenic mice successfully .
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Objective To assess the relationship between serum vitamin D and autoimmune thyroid disease.Methods Subjects included total 520 persons receiving regular health examination,and serum calcium,phosphorus,parathyroid hormone (PTH),thyroid peroxidase autoantibody (TPOAb) and 25-dihydroxy vitamin Ds was measured.The incidence of 25-dihydroxy vitamin D3 deficiency (≤30 μ g/L)was observed.The relationship between 25-dihydroxy vitamin D3 deficiency and autoimmune thyroid disease was analyzed.Results The serum 25-dihydroxy vitamin D3 of all the subjects was (24.47 ± 7.21) μ g/L,and the incidence of 25-dihydroxy vitamin D3 deficiency (≤30 μg/L) was 61.15％ (318/520),and the positive rate of TPOAb was 21.54％ (112/520).The proportion of TPOAb ＞ 50 kU/L or ＞ 100 kU/L in subjects with 25-dihydroxy vitamin D3≤30 μ g/L was higher than that in subjects with 25-dihydroxy vitamin D3 ＞ 30 μg/L [25.79％(82/318) vs.19.80％(40/202) and 9.43％(30/318) vs.4.46％(9/202)],and there was significant difference (P ＜ 0.05).The relationship between 25-dihydroxy vitamin D3 and TPOAb was assessed and showed significant inverse correlation (r =-0.13,P ＜0.05).Conclusions Vitamin D deficiency is very common in the population,and autoimmune thyroid disease is related with vitamin D deficiency,which may has impact on the body's immune regulation.Specific mechanism and whether vitamin D supplementation can intervene and treat autoimmune thyroid disease need further study.
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This study was aimed to evaluate the application of64-slice spiral CT in imaging anatomy of the normal optic canal. The optic canals of 100 healthy subjects were examined by 64-slice spiral CT,and the imaging measurement of the anatomy structures were performed by the multi-planar reconstruction. The longest and the shorzest walls of the optic canal were the medial wall and the inferior wall, respectively.Results indicate that the imaging anatomic measurement of the optic canal can be accurately and easily performed by means of multi-planar reconstruction of 64-slice spiral CT.
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Objective To prospectively observe the effect of levothyroxine treatment on neuropsychological development in offspring of pregnant women with subclinical hypothyroidism. Methods Twenty-three pregnant women with subclinical hypothyroidism received levothyroxine therapy (SCH+LT4 group) and 17 who did not receive levothyroxine ( SCH group) were enrolled; 24 pregnant women with normal thyroid function were referred as controls (C group). All the subjects underwent the planned thyroid tests regularly. Serum TSH, TT4, FT4, TT3,FT3, TPOAb, and TgAb levels were determined. Their 14-30 month-old children underwent the tests relating to intelligence and motor activity with the Bayley scale. Results In SCH group, SCH+LT4 group, and C group, the MDI were 115. 12, 118.56, and 117.63, respectively. And the PDI were 115.47, 120.65, and 117.50,respectively. The MDI and PDI were the highest in SCH+LT4 group and were the lowest in SCH group. Serum TSH levels remained above 2.0 mIU/L during the whole course of pregnancy in SCH group and higher than that in C group at all time points ( P＜0.05 ). Serum TT4 and FT4 levels were lower in SCH group than in C group at all time points except G28 and G32. The baseline TSH level in SCH+LT4 group was the highest ( P＜0.01 ), their TT4 and FT4 levels were the lowest among the three groups. In SCH + LT4 group, serum TSH, TT4, and FT4 levels were similar to C group after L-T4 treatment. Conclusion The prompt L-T4 treatment can maintain normal TSH levels in pregnant women with subclinical hypothyroidism during the whole course of pregnancy, and impairment of neuropsychological development in infants may be avoided.
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Objective To assess the effects of maternal subclinical hypothyroidism (SCH) during the first trimester on neuropsychological development of the offspring by 20-30 months. Methods In this study, 1 761 pregnant women from 10 hospitals with about 8 weeks of gestation were enrolled. Urinary iodine excretion and serum thyrotropin ( TSH ), free thyroxine ( FT4 ), and thyroid peroxidase antibody ( TPOAb ) levels were determined in all subjects. Pregnant women with SCH (TSH≥2.5 mIU/L) were divided into two subgroups using trimester-specific thyroid function reference: group A (2.5 mIU/L≤TSH＜3.93 mIU/L, 18 cases), and group B (TSH ≥3.93 mIU/L, 20 eases). Thirty euthyroid and TPOAb-negative women from the same cohort were selected as controls. Intellectual and motor development score evaluations were performed in the children by 20-30 months of age. Results Children of women with SCH and subgroups A and B had lower mean intelligence scores 6.55,3.39, and 9.40 points compared with those of the control group (P=0. 001, P=0. 125, and P＜0. 001 ); the respective mean motor scores were 6.31,4.35, and 8.07 points being lower than that of the control ( P=0. 003,P=0. 070, and P=0. 001 ). Intelligence scores and motor scores were negatively correlated with TSH levels (r=-0.425, P＜0. 001 and r=-0. 394, P=0. 001 ). Multiple group comparisons revealed that differences of TSH affected intelligence and motor scores (F=9. 277, P＜0. 001 and F=5. 909, P=0. 004). Ordinal logistic regression analysis showed that possibilities for the reduction of filial mental development index ( MDI ) and psychomotor development index ( PDI ) scores in SCH with maternal TSH levels≥3.93 mIU/L were 8.66 and 6.27 times that of controls ( OR = 8.66,95% CI 2.72-27.57, OR =6.27,95% CI 2.03-19.34 ). Conclusion Maternal elevated TSH levels diagnosed by trimester-specific reference during early gestation are independently associated with lowered filial neurodevelopment scores by 20-30 months.
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Objective To establish the gestational month-specific reference intervals for thyrotropin and thyroxine in Han nationality women in iodine sufficient area of China. Methods In iodine sufficient area of China, 120 non-pregnant women and 1 118 pregnant women at gestational ages from 4 to 36 week (4 weeks≈1 month) were collected according to the strict criteria. Urinary iodine excretion and serum thyrotropin (TSH), total thyroxine (TT4), free thyroxine (FT4), thyroid peroxidase antibody (TPOAb) levels were determined in all subjects. Results During pregnancy, serum TSH increased at week 4, and then began to decrease with the lowest level at week 12, which was 35% lower than the non-pregnant level." After that, serum TSH increased gradually and finally became stable during the third-trimester of pregnancy (T3) when the level was 29% higher than that of non-pregnant controls. Serum TT4 elevated dramatically during the first-trimester with peak at week 16, which increased by 70% compared with the non-pregnant level, then slightly decreased, and became steady with 50% increasing compared with non-pregnant level. Serum FT4 initially increased slightly with peak at week 4, and then decreased gradually until the beginning of T3 without obvious fluctuation during T3. Conclusion The gestational month-specific reference intervals for TSH, TT4 and FT4 are necessary for the early diagnosis of maternal subclinical hypothyroidism and hypothyroxinaemia.
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Objective To investigate the prevalence of gestational transient thyrotoxicosis(GTT) and analyze the cause of thyrotoxicosis encountered in this period MethodsAn epidemiologic survey in ten hospitals in Shenyang was performed and 534 pregnant women during the first trimester of pregnancy filled questionaire,received physical examination and had serum thyroid-stimulating hormone(TSH),free T4 (FT4),free T3(FT3),thyroid peroxjdase antibody(TPOAb),thyrotrophin receptor antibody(TRAb),and human chorionic gonadotrophin(hCG)tests.Results(1)The total prevalence of thyrotoxicosis was 9.75%(52/534)in the first trimester and the prevalence of Grrr was 7.86%.which accounted for 80.77%of the thyroxicosis encountered in this period.A total of 88.89%of the overt GTT showed only elevated FT3 level.(2)The level of serum hCG increased gradually in the first trimester.The medians of hCG were 25 300,85 220 and 81 780 IU/L 6,8-10 and 12 weeks after gestation.respectively(P=0.000).The medians of serum TSH were 1.45.1.10 and 0.84 mlU/I,6.8-10 and 12 weeks after gestation,respectively(P＜0.01).(3)When segum hCG was more than 50 000 IU/L,the prevalece of GTT increased obviously.When serum hCG was between 80000 IU/L and 110000 IU/L,subclinical GTT increased significantly.When serum hCG was more than 110000 IU/L,overt GTT increased significantly.Correlation analysis showed that serum hCG was related negatively with TSH(r=-0.402,P=0.000)and positively with FT3(r=0.165,P=0.000),but not related with FT4.Conclusions The prevalence of GTT is 7.86%in the first trimester and it is the main cause of thyrotoxicosis found in the first trimester,accounting for 80.77%of all the causes.The serological characteristic of overt GTT is mainly the elevation of serum FT3 leveL Serum hCG level is related with the severity of GTT.
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Objective To investigate the prevalence of hypothyrodism during the first half of pregnancy in the Han nationality women in iodine-adequate area. Methods TSH, FT4 and thyroid peroxidase antibody (TPOAb) levels were detected in 4 800 pregnant women during the first half of pregnancy. Both gestational age-specific reference intervals and population-based reference intervals of thyroid function were applied and the corresponding prevalences of hypothyroidism were compared with each other. Results Based on the gestational age-specific reference intervals, the prevalences of overt hypothyroidism at 4th and 8th weeks of gestation were 1.03%, 0.37% respectively. At 4th, 8th, 12th, 16th and 20th weeks of gestation, the prevalences of subclinical hypothyroidism were 4.59%, 6.15% , 4.68%, 4.53%, 5.96% respectively, while those of hypothyroxinemia were 3.69%, 1.11%, 2.92% , 1.29%, 2.29%, respectively. According to the pepulation-based reference intervals, the rates of missed diagnosis of subclinical hypothyroidism were 0.18%, 2.85%, 4.10%, 3.24%, 3.21% while those of hypothyroxinemia were 3.45%, 0.66%, 2.34%, 1.29%, 1.83%, respectively. During 4th, 8th, 16th weeks of gestation, the positive rates of TPOAb in the group with subclinical hypothyroidism were significantly higher than those with euthyroidism. The prevalences of subclinical hypothyroidism in TPOAb positive group were obviously higher than those in TPOAb negative group at 4th, 8th, 12th, 16th gestational weeks. Conclusion The rates of missed diagnosis of subclinical hypothyroidism and hypothyroxinemia during the first half of pregnancy were decreased by applying the gestational age-specific reference intervals in this prospective study. Positive TPOAb is a risk factor for subclinical hypothyroidism during the first half of pregnancy.
ABSTRACT
Objective To study the effect of maternal subclinical thyroid abnormalities [including subclinical hypothyroidism, hypothyroxinemia and positive anti-thyroid peroxidase antibody (TPOAb) with normal thyroid function] in women during 16-20 weeks of gestation on offspfing's intellectual development and motor function. Methods Sera from 1 268 women during 16-20 weeks of gestation (collected 2 years ago) were obtained and thyroid stimulating hormone (TSH), total thyroxine (TT4), free thyroxine (FT4) and TPOAb levels were measured. Pregnant specific thyroid function reference ranges were used to screen for subclinical hypothyroidism (18 cases), hypothyroxinemia (19 cases) and positive TPOAb (34 cases). From the same cohort, a total of 142 pregnant women who were euthyroid with negative TPOAb were selected as controls (a case: control ratio of 1 : 2). Intellectual and motor development score evaluations were performed in their children at 25-30 months of age. Results In the group of pregnant women with subclinical hypothyroidism, the offspring' s intelligence score was (109.89±13.81) points, which was 8.88 points lower than in the control group (P < 0.01). Similarly, the motor score of the offspring was (108.11±9.93) points, which was 9.98 points lower than in the control group (P < 0.01). In the pregnant women with hypothyroxinemia, the offspring's intelligence score was (112.32±15.10) points, 9.30 points lower than in the control group (P <0.01); the motor score was (112.21±12.26) points, 7.57 points lower than in the control group (P < 0.01). In the pregnant women with positive TPOAb and euthyroid function, the offspring's intelligence score was (112.70±20.64) points, 10.56 points lower than in the control group (P < 0.01); the motor score was (110.64±12.49) points, 9.03 points lower than in the control group (P < 0.01). Conclusion Maternal subclinical thyroid abnormality between 16-20 weeks of gestation adversely may affect offspring intellectual and motor development, suggesting the necessity for screening and treatment of maternal subclinical thyroid abnormality in the early stages of pregnancy.