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JCEM:妊娠期母体甲状腺功能紊乱或自身抗体阳性是否会影响后代的心血管代谢风险?

2017-09-30 MedSci MedSci原创

胎儿生长发育与多种因素有密切关系,如孕妇外环境、孕妇身体的生理病理条件、胎盘和脐带、胎儿本身的内环境等,还与妊娠前的精子质量也有关。 妊娠期母体甲状腺功能紊乱或自身抗体阳性对儿童心血管代谢危险因素的影响是未知的,这就是本研究的研究对象及目的。

背景及目的:胎儿生长发育与多种因素有密切关系,如孕妇外环境、孕妇身体的生理病理条件、胎盘和脐带、胎儿本身的内环境等,还与妊娠前的精子质量也有关。

妊娠期母体甲状腺功能紊乱或自身抗体阳性对儿童心血管代谢危险因素的影响是未知的,这就是本研究的研究对象及目的。

方法:这是一项前瞻性人群队列研究,主要研究对象为1986年芬兰北部出生队列,该队列包括在该地区一年内所有的妊娠情况的数据。研究人员收集了孕妇妊娠前20周的血清样本,并分析了TSH、游离T4、甲状腺过氧化物酶抗体(TPO-Ab)和甲状腺球蛋白抗体(Tg-Ab)水平。研究人员通过采血和临床检查,评估了上述队列中出生的16岁儿童的心血管代谢危险因素。数据共包括了3229-4176对母子。

主要观察指标:腰围、血压、血脂和脂蛋白、以及胰岛素抵抗。调整协变量后,研究人员使用logistic回归计算了母亲出现/未表现出妊娠期甲状腺功能紊乱或自身抗体的儿童的心血管代谢危险因素的比值比(OR)和95%可信区间(CI)。

结果:TPO-Ab阳性的母亲的孩子有较高的代谢综合征风险(OR 2.57;95% CI 1.26-5.25)和腰围(预示着代谢综合征)风险(OR 1.69;95% CI 1.14-2.50)。他们也更可能超重或肥胖(OR 1.56;95% CI 1.04-2.34)。

孕妇甲状腺功能异常或Tg-Ab阳性与儿童心血管代谢危险因素没有关联。

结论:代谢综合征、腰围较大和较高的体重指数在孕期TPO-Ab的母亲生下的儿童中更为常见,这表明这些儿童的心血管健康状况不良。

原始出处:

Heikkinen AL, P?kkil? F,et al.Maternal Thyroid Antibodies Associates with Cardiometabolic Risk Factors in Children at the Age of 16.J Clin Endocrinol Metab. 2017 Sep 11. doi: 10.1210/jc.2017-01137. [Epub ahead of print]

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    2017-10-04 smallant2015
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    2018-04-01 achengzhao
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1777676, encodeId=58331e77676bc, content=<a href='/topic/show?id=eb9610265ed' target=_blank style='color:#2F92EE;'>#JCEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10265, encryptionId=eb9610265ed, topicName=JCEM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a4439169927, createdName=smallant2015, createdTime=Wed Oct 04 23:59:00 CST 2017, time=2017-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2063058, encodeId=9754206305834, content=<a href='/topic/show?id=14fb10264d7' target=_blank style='color:#2F92EE;'>#JCE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10264, encryptionId=14fb10264d7, topicName=JCE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Sun Apr 01 21:59:00 CST 2018, time=2018-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1948100, encodeId=e7051948100e7, content=<a href='/topic/show?id=3aae55212db' target=_blank style='color:#2F92EE;'>#抗体阳性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55212, encryptionId=3aae55212db, topicName=抗体阳性)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/3239AC2A9C7E6019A0BC3C0489A21F7A/100, createdBy=c6a52500178, createdName=41514487@qq.com, createdTime=Tue Oct 10 02:59:00 CST 2017, time=2017-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1934415, encodeId=0f771934415d3, content=<a href='/topic/show?id=333851e5032' target=_blank style='color:#2F92EE;'>#心血管代谢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51750, encryptionId=333851e5032, topicName=心血管代谢)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bcd469, createdName=fengting3, createdTime=Fri Mar 16 14:59:00 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=273749, encodeId=df5a2e374964, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=150, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=29d12087071, createdName=1371f3708cm, createdTime=Sat Dec 30 07:19:01 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=252802, encodeId=8c8325280288, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=188, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Sat Oct 14 07:53:08 CST 2017, time=2017-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251077, encodeId=4b0612510e7c7, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Mon Oct 02 14:59:00 CST 2017, time=2017-10-02, status=1, ipAttribution=)]
    2017-12-30 1371f3708cm

    谢谢

    0

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    2017-10-14 大爰

    学习了谢谢分享!!

    0

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西地那非是治疗胎儿生长受限(FGR)和先兆子痫的新方法。近期,一项发表在杂志Hypertension上的研究进行了系统的荟萃分析来评估西地那非的疗效。此项研究搜索确定了22项动物研究(小鼠、大鼠、兔、绵羊和豚鼠)以及2项人类随机对照试验。使用胎儿生长和母亲血压平均值差异和95%置信区间的数据进行汇总。对可能影响西地那非疗效的相关因素进行Meta回归分析,包括使用模型(健康怀孕与FGR /先兆子痫)

Lancet:I型糖尿病孕妇动态血糖监测可显著改善新生儿结局

研究认为,对于I型糖尿病孕产妇,有效性的动态血糖监测可显著改善新生儿结局

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