The changes of Hcy,vitamin B12 and folic acid in Subclinical Hypothyroidism(SCH)during pregnancy and its clinical significance
Objective To investigate the changes of homocysteine(Hcy)and vitamin B12 and fo-lic acid in subclinical hypothyroidism(SCH)during pregnancy and its clinical significance.Methods 58 SCH patients admitted to Chengdu Fifth People's Hospital from July 2021 to February 2023 were selected as the ob-servation group,while another 53 pregnant women with normal thyroid function were selected as the control group.The levels of Hcy,vitamin B12 and TSH were compared between the two groups.Risk factors affecting SCH were analyzed using multiple logistic regression and the relationship between Hcy,vitamin B12,folate levels and thyroid function[thyroid stimulating hormone(TSH),serum free triiodothyronine(FT3),free thy-roxine(FT4)levels]between the two groups were compared.Spearman correlation was used to analyze the rela-tionship between Hcy,vitamin B12 and folic acid and hypothyroidism.The ROC curve was used to analyze the diagnostic efficiency of Hcy,vitamin B12,TSH alone and combined detection of SCH.Results The levels of Hcy and TSH in the observation group were higher than those in the control group,and the levels of vitamin B12 and folic acid were lower than those in the control group,with statistically significant differences(P<0.05).The comparison of the levels of FT3 and FT4 between the two groups did not show any statistically significant dif-ferences P>0.05).Spearman correlation analysis showed that Hcy was positively correlated with TSH levels(r=0.536,P<0.05),and was negatively correlated with FT3,FT4,folate and vitamin B12 levels(r=-0.622,-0.517,-0.662,-0.574,P<0.05).TSH levels were positively correlated with FT3,FT4 and Hcy levels(r=0.682,0.575,0.567),and P<0.05,but had no correlation with folic acid and vitamin B12(P>0.05).Vitamin B12 levels were positively correlated with FT3 and FT4 levels(r=0.624,0.528,P<0.05),and negatively corre-lated with TSH and Hcy(r=-0.643,-0.527,P<0.05),but had no correlation with folate(P>0.05).The ROC curve showed that the AUC value of Hcy,vitamin B12 and folic acid for the diagnosis of SCH was 0.766,0.631 and 0.723,respectively.The AUC value of the combined diagnosis of HCY,vitamin B12 and folic acid was 0.901,with a sensitivity of0.879,specificity of of 0.902,and a 95%CI of 0.833-0.967.The diagnostic efficiency of the combined detection was higher than that of the three indicators alone(P<0.05).Conclusion Patients with subclinical hypothyroidism during pregnancy may have abnormal levels of Hcy,vitamin B12,and folate.Detecting the levels of these indicators can serve as a basis for clinical evaluation and diagnosis of the condition.
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