Changes and clinical significance of serum TSH,Hcy and 25(OH)D3 levels in pregnant patients with hypothyroidism
Objective To explore the changes and clinical significance of serum levels of thyroid stimulating hormone(TSH),homocysteine(Hcy)and 25-hydroxyvitamin D3[25(OH)D3]in pregnant pa-tients with hypothyroidism.Methods 102 pregnant patients with hypothyroidism at Anhui Wannan Rehabilita-tion Hospital,the Fifth People's Hospital of Wuhu from March 2020 to March 2023 were selected as the study subjects(case group),and 80 healthy pregnant women during the same period were included in the control group.Serum levels of TSH,free thyroxine(FT4),Hcy and 25(OH)D3 were compared between the two groups.The correlation between thyroid hormones and Hcy and 25(OH)D3 was analyzed.The patients were di-vided into the controlled group and the uncontrolled group based on the treatment objectives for pregnancy with hypothyroidism.Additionally,the patients were classified into a normal outcome group and adverse outcome group based on the pregnancy outcomes.The relationship of serum thyroid hormones,Hcy and 25(OH)D3 with disease control effect and pregnancy outcomes was explored.Results The levels of serum TSH and Hcy in the case group were significantly higher than those in the control group while the 25(OH)D3 level was sig-nificantly lower than that in the control group(P<0.05).However,there was no statistically significant differ-ence in serum FT4 levels between the two groups(P>0.05).Pearson correlation analysis results showed that se-rum TSH in pregnant patients with hypothyroidism was positively correlated with Hcy and negatively correlat-ed with 25(OH)D3(P<0.05).Before treatment,serum TSH and Hcy levels in the controlled group were sig-nificantly lower than those in the uncontrolled group(P<0.05),while serum 25(OH)D3 levels wwere signifi-cantly higher than those in the uncontrolled group(P<0.05).The total incidence rate of adverse pregnancy out-comes in the case group was significantly higher than that in the control group,and the incidence rate in the un-controlled group was significantly higher than that in the controlled group(P<0.05).Before treatment,serum TSH and Hcy levels in the normal outcome group were significantly lower than those in the adverse outcome group(P<0.05),while serum 25(OH)D3 levels were significantly higher than those in the adverse outcome group(P<0.05).Conclusion Serum TSH and Hcy levels are significantly increased,while 25(OH)D3 is significantly decreased in pregnant patients with hypothyroidism.These three indicators are related to the dis-ease control effect and pregnancy outcomes.Monitoring changes in the these indicators can provide references for diagnosing,treating,and evaluating the prognosis of pregnancy with hypothyroidism.
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