关键词: 桥本病, 妊娠, 维生素D, 影响因素分析

Abstract:

Objective　To investigate the levels of 25-hydroxyvitamin D〔25（OH）D〕in pregnant women with Hashimoto thyroiditis（HT） and to analyze factors influencing those levels.Methods　One hundred and two pregnant women with HT who met the study criteria and were treated in the Sichuan Academy of Medical Sciences＆Sichuan Provincial People's Hospital between January 2013 and July 2013 were selected as the HT group.To assess the influence of sunshine exposure，80 pregnant women without HT who were admitted during the same seasons were selected as a control group.The general data，thyroid-related indicators，and 25（OH）D levels of the patients were collected.To analyze the relationship between Vitamin D nutritional status and age，gestational week thyroid related indexes in pregnant women with HT and influencing factors of 25（OH）D level.Results　The levels of TT4，TT3，FT4，FT3 and 25（OH） D in HT group were lower than those in control group，while the levels of TSH，TPOAb and TgAb in HT group were higher than those in control group（P<0.05）. In HT group，FT4 level of vitamin D deficiency patients was lower than that of vitamin D deficiency patients，TSH and TPOAb levels were higher than those of vitamin D deficiency patients（P<0.05）.Spearman rank correlation analysis showed that Vitamin D nutritional status levels were positively correlated with FT4 levels in HT patients（rs=0.24，P<0.05） and negatively correlated with the levels of TSH and TPOAb（rs=-0.21 and -0.27，P<0.05）.Multivariate linear regression showed that FT4（t=2.002，P=0.042） and TPOAb（t=-2.981，P=0.004） were independent predictive factors for 25（OH）D level in pregnant HT patients.Conclusion　25（OH）D levels in pregnant HT patients were significantly lower than those in controls and were closely related to the levels of FT4 and TPOAb，thus suggesting that vitamin D may be involved in the pathogenesis of HT in pregnant women.

Key words: Hashimoto disease, Pregnancy, Vitamin D, Root cause analysis