Association of serum TPO-Ab,IGF-1 and obestatin with adverse pregnancy outcomes in pregnant women with subclinical hypothyroidism
Objective:To investigate the relationship between serum thyroid peroxidase antibody(TPO-Ab),insulin-like growth factor-1(IGF-1)and obestatin and adverse pregnancy outcomes in pregnant women with subclinical hypothyroidism(SC H).Methods:A total of 213 pregnant women with SCH who delivered and 102 normal pregnant women who conducted physical examinations in Zhangjiakou Maternal and Child Health Hospital from February 2019 to April 2022 were recruited as the SCH group and the control group,respectively.Serum TPO-Ab,IGF-1 and obestatin were detected in the two groups.According to the pregnancy outcome,the study group was divided into normal pregnancy group and adverse pregnancy group.The logistic regression analysis was used to screen the influencing factors of adverse pregnancy outcomes in SCH patients,and Pearson correlation analysis was used to explore the correlation between serum TPO-Ab,IGF-1 and obestatin and adverse pregnancy outcomes in SCH patients.The receiver operating characteristic(ROC)curve of serum TPO-Ab,IGF-1 and obestatin was plotted to predict adverse pregnancy outcome in SCH patients.Results:The serum TPO-Ab positive rate of the SCH group was higher than that of the control group(35.21％vs.6.86％).The serum levels of IGF-1[(30.11±4.76)μg/L vs.(32.86±5.12)μg/L],obestatin[(19.30±4.15)ng/L vs.(22.37±4.29)ng/L]of the SCH group were lower than those of the control group(P＜0.05).The serum TPO-Ab positive rate in adverse pregnancy group was significantly higher than that of normal pregnancy group(72.55％vs.23.46％),and the levels of IGF-1[(25.83±3.51)μg/L vs.(31.47±4.29)μg/L]and obestatin[(15.23±2.75)ng/L vs.(20.58±3.67)ng/L]in adverse pregnancy group were significantly lower than those of normal pregnancy group(P＜0.05).Logistic regression analysis showed that TPO-Ab was a risk factor for adverse pregnancy outcomes in SCH patients,while both IGF-1 and obestatin were protective factors(P＜0.001).Correlation analysis results showed that TPO-Ab was positively correlated with adverse pregnancy outcomes in SCH patients(r=0.439,P＜0.001),while both IGF-1 and obestatin were negatively correlated with adverse pregnancy outcomes in SCH patients(r=-0.507,P＜0.001;r=-0.551,P＜0.001).The AUC of serum TPO-Ab,IGF-1 and obestatin in predicting adverse pregnancy outcomes in SCH patients was 0.745,0.845 and 0.877,respectively.The AUC of TPO-Ab combined with IGF-1,TPO-Ab combined with obestatin and IGF-1 combined with obestatin in predicting adverse pregnancy outcomes of SCH patients were 0.897,0.925 and 0.945,respectively.While the AUC of the combination of serum TPO-Ab,IGF-1 and obestatin in predicting adverse pregnancy outcomes in SCH patients was 0.963,which was higher than those of serum TPO-Ab,IGF-1 as well as obestatin alone and combined in pairs(P＜0.05).Conclusions:Serum TPO-Ab,IGF-1 and obestatin in SCH patients should be monitored clinically,and timely targeted intervention should be given to SCH patients to reduce the incidence of adverse pregnancy outcomes.
万方数据
维普
