A Prospective Study of Early-pregnancy Thyroid Markers, Lipid Species, and Risk of Gestational Diabetes Mellitus

被引:21
|
作者
Wang, Yi [1 ]
Sun, Fengjiang [2 ,3 ]
Wu, Ping [1 ]
Huang, Yichao [2 ,3 ,4 ]
Ye, Yi [1 ]
Yang, Xue [5 ,6 ]
Yuan, Jiaying [7 ]
Liu, Yan [8 ]
Zeng, Huayan [9 ]
Wen, Ying [10 ]
Qi, Xiaorong [11 ]
Yang, Chun-Xia [5 ,6 ]
Wang, Yixin [1 ]
Liu, Gang [12 ]
Chen, Da [2 ,3 ]
Li, Liangzhong [13 ]
Pan, Xiong-Fei [1 ,14 ]
Pan, An [1 ]
机构
[1] Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Epidemiol & Biostat, Sch Publ Hlth,Minist Educ,Key Lab Environm & Hlth, Wuhan 430030, Peoples R China
[2] Jinan Univ, Sch Environm, Guangzhou 511436, Peoples R China
[3] Jinan Univ, Guangdong Key Lab Environm Pollut & Hlth, Guangzhou 511436, Peoples R China
[4] Anhui Med Univ, Sch Publ Hlth, Dept Toxicol, Hefei 230032, Peoples R China
[5] Sichuan Univ, West China Sch Publ Hlth, Dept Epidemiol & Biostat, Chengdu 610041, Peoples R China
[6] Sichuan Univ, West China Hosp 4, Chengdu 610041, Peoples R China
[7] Shuangliu Maternal & Child Hlth Hosp, Dept Sci & Educ, Chengdu 610200, Peoples R China
[8] Shuangliu Maternal & Child Hlth Hosp, Dept Obstet & Gynecol, Chengdu 610200, Peoples R China
[9] Shuangliu Maternal & Child Hlth Hosp, Nutr Dept, Chengdu 610200, Peoples R China
[10] Shenzhen Ctr Dis Control & Prevent, Dept Communicable Dis Control & Prevent, Shenzhen 518055, Peoples R China
[11] Sichuan Univ, West China Hosp 2, Dept Gynecol & Obstet, State Key Lab Biotherapy, Chengdu 610041, Peoples R China
[12] Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Nutr & Food Hyg, Sch Publ Hlth,Hubei Key Lab Food Nutr & Safety, Wuhan 430030, Peoples R China
[13] South China Inst Environm Sci, State Environm Protect Key Lab Environm Pollut Hl, Minist Ecol & Environm, 7 West St, Guangzhou 510655, Guangdong, Peoples R China
[14] Vanderbilt Univ, Dept Med, Div Epidemiol, Med Ctr, Nashville, TN 37232 USA
来源
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM | 2022年 / 107卷 / 02期
基金
中国国家自然科学基金; 中国博士后科学基金;
关键词
Birth cohort; gestational diabetes mellitus; lipidome; mediation; thyroid markers; INSULIN-RESISTANCE; MATERNAL HYPOTHYROXINEMIA; TYPE-2; DEIODINASE; HORMONE; PREVALENCE; ASSOCIATION; GLUCOSE; OBESITY; WOMEN;
D O I
10.1210/clinem/dgab637
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context: While the associations between thyroid markers and gestational diabetes mellitus (GDM) have been extensively studied, the results are inconclusive and the mechanisms remain unclear. Objective: We aimed to investigate the prospective associations of thyroid markers in early gestation with GDM risk, and examine the mediating effects through lipid species. Methods: This study included 6068 pregnant women from the Tongji-Shuangliu Birth Cohort. Maternal serum thyroid markers (free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone, thyroid peroxidase antibody, and thyroglobulin antibody) were measured before 15 weeks. Deiodinase activity was assessed by fT3/fT4 ratio. Plasma lipidome were quantified in a subset of 883 participants. Results: Mean age of the participants was 26.6 +/- 3.7 years, and mean gestational age was 10.3 +/- 2.0 weeks. Higher levels of fT4 were associated with a decreased risk of GDM (OR = 0.73 comparing the extreme quartiles; 95% CI 0.54, 0.98, P-trend = .043), while higher fT3/fT4 ratio was associated with an increased risk of GDM (OR = 1.43 comparing the extreme quartiles; 95% CI 1.06, 1.93, P-trend = .010) after adjusting for potential confounders. Multiple linear regression suggested that fT3/fT4 ratio was positively associated with alkylphosphatidylcholine 36:1, phosphatidylethanolamine plasmalogen 38:6, diacylglyceride 18:0/18:1, sphingomyelin 34:1, and phosphatidylcholine 40:7 (false discovery rate [FDR] adjusted P < .05). Mediation analysis indicated 67.9% of the association between fT3/fT4 ratio and GDM might be mediated through the composite effect of these lipids. Conclusion: Lower concentration of serum fT4 or higher fT3/fT4 ratio in early pregnancy was associated with an increased risk of GDM.The association of fT3/fT4 ratio with GDM was largely mediated by specific lipid species.
引用
收藏
页码:E804 / E814
页数:11
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