Prevalence of thyroid autoimmunity and dysfunction in women with iron deficiency during early pregnancy: is it altered?

Veltri, Flora; Decaillet, Sarah; Kleynen, Pierre; Grabczan, Lidia; Belhomme, Julie; Rozenberg, Serge; Pepersack, Thierry; Poppe, Kris

doi:10.1530/eje-16-0288

Cited by 40 publications

(52 citation statements)

References 42 publications

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“…In most studies in pregnant women, age > 30 years was not associated with increased serum TSH levels [9, 10, 38, 39] or TAI [39, 40]. In contrast, in the study by Veltri et al [40] serum TSH was significantly lower in women > 30 years, and, in a study by Korevaar et al [9], serum FT4 levels were significantly lower. Differences in serum TSH levels observed between studies may be explained by a different iodine and BMI status of the women.…”

Section: Established Variables Contributing To Variation In Thyroid Fmentioning

confidence: 96%

“…In both studies, TAI was not taken into account or an exclusion criterion. In a recent study by Veltri et al [40] in 1,900 pregnant women performed in Belgium (mild ID), TAI was also analyzed in relation to Fe-D. In the Fe-D group (all over 35%), the prevalence of TAI and SCH was higher than in the non-Fe-D group (10 vs. 6 and 20 vs. 16%, respectively; p = 0.011 and 0.049, respectively).…”

Section: New Candidate Variables Contributing To Variation In Thyroidmentioning

confidence: 99%

“…In the logistic regression and after correction for confounding factors, Fe-D remained associated with TAI ( p = 0.017) but not with SCH. Finally, it is important to highlight that in the multivariable analysis, Fe-D explained < 1% of the variability in log TSH [40]. …”

Section: New Candidate Variables Contributing To Variation In Thyroidmentioning

confidence: 99%

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Variables Contributing to Thyroid (Dys)Function in Pregnant Women: More than Thyroid Antibodies?

Veltri

Poppe

2018

Eur Thyroid J

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Variability in thyroid function in pregnant women is the result of 2 main determinants, each accounting for approximately half of it. The first is the genetically determined part of which the knowledge increases fast, but most remains to be discovered. The second determinant is caused by an ensemble of variables of which thyroid autoimmunity is the best known, but also by others such as parity, smoking, age, and BMI. More recently, new candidate variables have been proposed, such as iron, endocrine disruptors, and the ethnicity of the pregnant women. In the future, the diagnosis and treatment of thyroid (dys)function may be optimized by the use of each individual’s pituitary-thyroid set point, corrected with a factor taking into account the impact of nongenetically determined variables.

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Section: Established Variables Contributing To Variation In Thyroid Fmentioning

confidence: 96%

Section: New Candidate Variables Contributing To Variation In Thyroidmentioning

confidence: 99%

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Variables Contributing to Thyroid (Dys)Function in Pregnant Women: More than Thyroid Antibodies?

Veltri

Poppe

2018

Eur Thyroid J

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“…Yu X et al found that serum TSH levels were negatively correlated with total body iron (TBI) levels at 4 to 12 weeks of gestation [18]. Flora Veltri et al found iron deficiency was frequent during the first trimester of pregnancy and was associated with a higher prevalence of thyroid autoimmunity, higher serum TSH and lower FT4 levels [25]. Because the prevalence of low body iron was substantially increased in pregnant women in the second trimesters than in the first trimesters (14.3 ± 2.1% vs. 6.9 ± 2.2%) [21], we investigated pregnant women from 13 to 24 weeks of gestation in the second trimester.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of serum ferritin and thyroid function in the second trimester of pregnancy

Shen

Zhang

et al. 2018

Endocr J

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Abstract. Ferritin is a universal intracellular protein that acts as an iron carrier. Several studies have indicated that iron deficiency affects thyroid function in non-pregnant women. Our objective was to assess the relationship between serum ferritin levels and thyroid function in pregnant women during the second trimester. Pregnant women with sufficient iodine intake and normal antithyroid antibodies during the second trimester were recruited from the obstetric outpatient department of the Fifth People's Hospital of Fudan University. Serum ferritin (SF) levels, thyroid function, anti-thyroid antibodies and vitamin B12 were determined by electrochemiluminescence immunoassay kit. Maternal serum iron (Fe), unsaturated iron binding capacity (UIBC), hemoglobin (Hb), creatinine (Cr), fasting blood glucose (FBG), and alanine aminotransferase (ALT) were also evaluated. Stepwise regressions performed to evaluate the associations between SF and other maternal parameters. In the second trimester, 11.4% pregnant women had a SF concentration less than 12 μg/L, and 7.6% pregnant women were anemic. SF levels were negatively correlated with serum TSH levels (r = -0.219, p < 0.05), and positively correlated with FT4 levels (r = 0.203, p < 0.05). Linear regression analysis showed only SF, age, week of gestation were significant predictors of regression with TSH as the dependent variable (β: -0.007, -0.059, and 0.118 respectively; all p < 0.05). However consistent relation between the SF levels and FT4 was not observed in stepwise linear regression. Maternal iron status is a determinant of TSH concentrations during pregnancy in pregnant women during the second trimester.Key words: Serum ferritin, Thyroid function, Thyroid stimulating hormone, Pregnancy, The second trimester THYROID DISEASE is a common endocrine disorder prevalent in pregnant women. The prevalence of subclinical hypothyroidism and hypothyroxinemia during the second trimester of pregnancy is 5.96% and 2.29%, respectively in China [1]. Maternal thyroid dysfunction has been reportedly associated with gestational hypertension, gestational diabetes, spontaneous abortion, fetal loss, dysplasia, and inadequate neuropsychological development in children [2][3][4][5]. Chronic autoimmune thyroiditis is the main cause of hypothyroidism during pregnancy [6,7]. Iodine deficiency during pregnancy is also

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“…Altogether, a better thyroid function is found when iron stores are sufficient. In 2016 Veltri et al [64] described a similar situation, i.e. increased levels of TSH in conditions of iron deficiency.…”

Section: Magnesium and Iron In A Systems Approach Related To Thyroid mentioning

confidence: 94%

A post-publication analysis of the idealized upper reference value of 2.5 mIU/L for TSH: Time to support the thyroid axis with magnesium and iron especially in the setting of reproduction medicine

Moncayo¹,

Moncayo²

2017

BBA Clinical

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Laboratory medicine approaches the evaluation of thyroid function mostly through the single determination of the blood level of thyroid stimulating hormone (TSH). Some authors have suggested an upper reference value for TSH of 2.5 mIU/L. This suggestion has not been confirmed by recent clinical studies. These studies have delivered a clinically valid reference range going from 0.3 to 3.5 mIU/L. These values are valid for both for the general population as well as in the setting of fertility and pregnancy.Current biochemical evidence about the elements required to maintain thyroid function shows that these not only include dietary iodine but also magnesium, iron, selenium and coenzyme Q10. Iron is important for the synthesis of thyroid peroxidase; magnesium-ATP contributes to the active process of iodine uptake; iodine has to be sufficiently present in the diet; selenium acts through selenoproteins to protect the thyroid cell during hormone synthesis and in deiodination of thyroxine; coenzyme Q10 influences thyroid vascularity. As a consequence, good clinical practice requires additional biochemical information on the blood levels of magnesium, selenium, coenzyme Q10 as well as iron status.Since these elements are also important for the maintenance of reproductive function, we postulate that they constitute the connecting link between both endocrine systems.

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Prevalence of thyroid autoimmunity and dysfunction in women with iron deficiency during early pregnancy: is it altered?

Cited by 40 publications

References 42 publications

Variables Contributing to Thyroid (Dys)Function in Pregnant Women: More than Thyroid Antibodies?

Variables Contributing to Thyroid (Dys)Function in Pregnant Women: More than Thyroid Antibodies?

Evaluation of serum ferritin and thyroid function in the second trimester of pregnancy

A post-publication analysis of the idealized upper reference value of 2.5 mIU/L for TSH: Time to support the thyroid axis with magnesium and iron especially in the setting of reproduction medicine

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