实用医学杂志 ›› 2026, Vol. 42 ›› Issue (15): 2779-2785.doi: 10.3969/j.issn.1006-5725.2026.15.014

• 论著·机制与实践 • 上一篇    

甲状腺功能异常孕妇补铁与甲状腺功能及自身抗体之间的关联

王海又1,刘雪婷2,廖文欢2,汪晓语2,3,程志宝2,徐裕杰2,高伊星4,熊静远1,5,龚云辉6,成果1,2,3()   

  1. 1.四川大学华西公共卫生学院/华西第四医院 (四川成都 610041);四川大学华西第二医院2华西妇儿营养中心
    3.出生缺陷与相关妇儿疾病教育部重点实验室
    6.产科 (四川 成都 610041 )
    4.陆军军医大学第二附属医院肿瘤科 (重庆 400038 )
    5.主动健康与食品营养安全四川省重点实验室 (四川 成都 610041 )
    7.儿童药物四川省重点实验室 (四川 成都 610041 )
  • 收稿日期:2026-05-19 修回日期:2026-06-17 接受日期:2026-06-18 出版日期:2026-08-10 发布日期:2026-08-13
  • 通讯作者: 成果 E-mail:ehw_cheng@126.com
  • 基金资助:
    国家自然科学基金资助项目(U25A20154);临床营养工作高质量发展研究项目(2025-2-Z-04)

Effects of iron supplementation on thyroid function and autoantibodies in pregnant women with thyroid dysfunction

Haiyou WANG1,Xueting LIU2,Wenhuan LIAO2,Xiaoyu WANG2,3,Zhibao CHENG2,Yujie XU2,Yixing GAO4,Jingyuan XIONG1,5,Yunhui GONG6,Guo CHENG1,2,3()   

  1. 1.West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu 610041,Sichuan,China
    2.West China Women and Children Nutrition Center,West China Second Hospital,Sichuan University,Chengdu 610041,Sichuan,China
    3.Key Laboratory of Birth Defects and Related Diseases of Women and Children,Sichuan University,Ministry of Education,Chengdu 610041,Sichuan,China
    4.Department of Oncology,the Second Affiliated Hospital of Army Medical University,Chongqing 400038,Chongqing,China
    5.Key Laboratory of Active Health and Food Nutrition Safety of Sichuan Province,Chengdu 610041,Sichuan,China
    6.Department of Obstetrics,West China Second University Hospital,Sichuan University,Chengdu 610041,Sichuan,China
    7.Key Laboratory of Children's Drugs of Sichuan Province,Chengdu 610041,Sichuan,China
  • Received:2026-05-19 Revised:2026-06-17 Accepted:2026-06-18 Online:2026-08-10 Published:2026-08-13
  • Contact: Guo CHENG E-mail:ehw_cheng@126.com

摘要:

目的 探讨甲状腺功能异常的孕妇不同铁营养状况下补铁对甲状腺功能指标及甲状腺相关自身抗体的影响。 方法 采用回顾性队列研究方法,共纳入2024年11月至2025年8月在四川大学华西第二医院建档的甲状腺功能异常孕妇353例,根据基线铁营养状况(铁缺乏/铁充足)及是否暴露于补铁自然分为4组,比较各组甲状腺功能指标及自身抗体水平在补铁前后的变化。采用多元线性回归模型分析在不同铁营养状况下补铁与甲状腺功能指标及自身抗体水平变化的关系。 结果 在铁缺乏的甲状腺功能异常孕妇中,补铁组与未补铁组的游离甲状腺素(FT4)[β(95%CI):-4.75(-7.73 ~ -1.76),P = 0.002]、促甲状腺素(TSH)[β(95%CI):-1.84(-3.49 ~ -0.18),P = 0.030]和抗甲状腺过氧化物酶抗体(TPOAb)[β(95%CI):-271.33(-423.84 ~ -118.82),P < 0.001]水平差异有统计学意义。在铁充足的甲状腺功能异常孕妇中,补铁与抗甲状腺球蛋白抗体(TGAb)[β(95%CI):-41.74(-75.69 ~ -7.79),P = 0.016]水平下降相关。未发现补铁与三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)之间的关联。 结论 在甲状腺功能异常孕妇中,补铁与部分甲状腺功能及自身抗体指标变化存在关联。另外,对铁充足者进行预防性补铁可改善甲状腺自身免疫反应。

关键词: 甲状腺功能异常, 妊娠, 铁剂补充, 甲状腺自身抗体, 铁营养状况

Abstract:

Objective To investigate the effects of iron supplementation on thyroid function indices and thyroid-related autoantibodies in pregnant women with thyroid dysfunction under different iron nutritional statuses. Methods This retrospective cohort study recruited 353 pregnant women with thyroid dysfunction who registered for antenatal care at a tertiary Grade-A maternal and child health hospital in Chengdu, China, from November 2024 to August 2025. Based on the baseline iron nutritional status (iron deficiency vs. iron sufficiency) and exposure to iron supplementation, the participants were naturally divided into four groups. The changes in thyroid function indices and autoantibody levels before and after iron supplementation were compared among the groups. Multiple linear regression models were used to analyze the associations between iron supplementation and changes in thyroid function indices and autoantibody levels under different iron nutritional statuses. Results Among iron-deficient pregnant women with thyroid dysfunction, statistically significant differences were detected between the iron-supplemented and non-supplemented groups in free thyroxine (FT4) [β(95%CI): -4.75 (-7.73 - -1.76), P = 0.002], thyroid-stimulating hormone (TSH) [β(95%CI): -1.84 (-3.49 - -0.18), P = 0.030], and anti-thyroid peroxidase antibody (TPOAb) [β(95%CI): -271.33 (-423.84 - -118.82), P < 0.001]. Among iron-sufficient pregnant women with thyroid dysfunction, iron supplementation was linked to a reduction in anti-thyroglobulin antibody (TGAb) levels [β(95%CI): -41.74 (-75.69 - -7.79), P = 0.016]. No associations were identified between iron supplementation and triiodothyronine (T3), thyroxine (T4), or free triiodothyronine (FT3). Conclusions In pregnant women with thyroid dysfunction, iron supplementation is associated with specific changes in thyroid function parameters and autoantibody levels. Moreover, prophylactic iron supplementation effectively mitigates thyroid autoimmune responses in iron-sufficient pregnant women.

Key words: thyroid dysfunction, pregnancy, iron supplementation, thyroid autoantibodies, iron nutritional status

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