Study on the changes in TSH, TPO-Ab and other indicators due to Vitamin D deficiency in Pregnant Women with subclinical hypothyroidism in the first trimester.

Xue Zhou,Chao Wang,Ben Li,Zhihong Li

doi:10.12669/pjms.36.6.1982

Abstract

Objective:To investigate the effect of vitamin D deficiency on the levels of thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPO-Ab), interleukin-1 (IL-1) and high-sensitivity C-reactive protein (hs-CRP) in pregnant women with early pregnancy complicated by subclinical hypothyroidism.Methods:A total of 172 pregnant women with subclinical hypothyroidism in the first trimester diagnosed and treated in a given hospital from August 2014 to May 2018 were selected, and their levels of vitamin D were determined. Depending on the abnormality of their vitamin D levels, the study participants were divided into two groups: the study group (vitamin D≤20 ng/L) and the control group (vitamin D>20 ng/L). The levels of TSH, TPO-Ab, IL-1 and hsCRP in the two groups were measured.Results:The levels of TSH, hsCRP and TPO-Ab in the study group were significantly higher than those in the control group (P<0.05). The comparison between the two groups in terms of IL-1 showed no statistically significant difference.Conclusion:Vitamin D deficiency in the first trimester is associated with in an increased level of TSH in the first trimester, thereby aggravating subclinical hypothyroidism. The mechanism may be associated with the impact of vitamin D deficiency on hs-CRP and other body inflammation indicators, as well as on thyroid autoantibodies and other immune indicators, but has no effect on IL-1 levels.

Highlights

The inclusion criteria for the study were as follows: those who met the diagnostic criteria for subclinical hypothyroidism in the first trimester set forth by the Endocrine Society of the Chinese Medical Association in Guidelines for the Diagnosis and Management of Thyroid Disease during Pregnancy and Postpartum; those for whom the gestational age was less than 13 weeks; those with no personal or family history of genetic diseases; those with no reproductive disease history; and those with a singleton pregnancy
The results of this study show that the thyroid stimulating hormone (TSH) of the study group was higher than that of the control group, with statistically significant differences, implying that vitamin D deficiency affects the level of TSH in vivo and may be involved in the occurrence of subclinical hypothyroidism in the first trimester
The results of this study suggest that the level of hs-CRP in the study group with vitamin D deficiency was higher than that of the control group, and the difference was statistically significant, implying that vitamin D deficiency could increase the inflammatory reaction of the body and may be involved in the occurrence of subclinical hypothyroidism

Summary

INTRODUCTION

The thyroid is an important endocrine organ that controls human metabolism, and the abnormal secretion of hormones by the thyroid can result in hypothyroidism or hyperthyroidism.[1]. The thyroid volume would increase by approximately 10% during pregnancy, making triiodothyronine (T3) and thyroxine (T4) levels increase by approximately 50%, manifested as the increase in daily iodine demand and the decrease in the level of thyroid stimulating hormone (TSH) in the first trimester.[2,3] Subclinical hypothyroidism occurring in the first trimester. Pak J Med Sci September - October 2020 Vol 36 No 6 www.pjms.org.pk 1313 can raise the risk of poor outcome in the second and third trimesters, such as placental abruption, preeclampsia, diabetes and anemia.[4,5] In addition, thyroid hormone is vital to the development of the fetal central nervous system, and subclinical hypothyroidism in the first trimester could induce irreversible damage to the fetal cranial nerve.[6] In recent years, studies have shown that vitamin D can play an important role in the occurrence and development of thyroid diseases in the first trimester by becoming involved in the regulation of IL-1, hsCRP, leptin and other cytokines.[7,8]. The objective of the present study was to investigates the effect of vitamin D deficiency on the changes in the levels of TSH, TPO-Ab, IL-1 and hsCRP in pregnant women with subclinical hypothyroidism (hereinafter referred to as SCH) in the first trimester

METHODS

RESULTS

DISCUSSION

CONCLUSION