title: Iron deficiency, an independent risk factor for isolated hypothyroxinemia in pregnant and nonpregnant women of childbearing age in China.
abstract: BACKGROUND
  Isolated hypothyroxinemia during early pregnancy may irreversibly damage the neurodevelopment of offspring. However, the causes are not well clarified.
  
  
  OBJECTIVE
  To explore the association of iron deficiency (ID) with hypothyroid function of women in early pregnancy and nonpregnant women.
  
  
  METHODS
  A total of 7953 pregnant women of ≤ 12 weeks gestation and 2000 childbearing-aged women were recruited. A subpopulation including 3340 pregnant women and 1052 nonpregnant women with sufficient iodine intake and negative thyroid peroxidase antibody were studied. Mild and severe cases of hypothyroxinemia were defined as free T4 levels below the 10th percentile and the 5th percentile, respectively, with normal TSH. Total body iron, serum ferritin, and serum transferrin receptor were used as indicators for iron nutrition.
  
  
  RESULTS
  Serum free T4 levels were significantly lower in both pregnant and nonpregnant women with ID compared with the corresponding groups without ID (both P < .05). The prevalence of mild and severe hypothyroxinemia was markedly higher in women with ID than those without, in both pregnant and nonpregnant women (all P < .01). Logistic regression indicated that ID was an independent risk factor for both mild and severe hypothyroxinemia in pregnancy (odds ratio [OR] = 2.440, 95% confidence interval [CI]: 1.324-4.496, P = .004; and OR = 3.278, 95% CI: 1.443-7.446, P = .005, respectively) and nonpregnancy (OR = 2.662, 95% CI: 1.330-5.329, P = .006; and OR = 3.254, 95% CI: 1.375-7.700, P = .007, respectively).
  
  
  CONCLUSIONS
  An association between ID and isolated hypothyroxinemia was found in both pregnant and nonpregnant childbearing-aged women, independent of the effects of iodine and thyroid autoimmunity. We speculate that ID may be a pathogenic factor for hypothyroxinemia, even in pregnant women during the first trimester.
authors.affiliation: Endocrine Institute and Liaoning Provincial Key Laboratory of Endocrine Diseases (X.Y., Z.S., Chenyan.L., J.M., W.W., X.X., A.L., X.T., C.F., W.T.), Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang 110001, China; Shenyang Women's and Children's Hospital (W.Z., Chenyang.L.), Shenyang 110011, China; Department of Obstetrics and Gynecology (B.X.), No. 202 Hospital of People's Liberation Army, Shenyang 110003, China; Dalian Obstetrics and Gynecology Hospital (L.B.), Dalian 116033, China; Department of Obstetrics and Gynecology (T.M.), The First Hospital of China Medical University, Shenyang 110001, China; Department of Endocrinology (J.D.), The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; Department of Endocrinology (S.Z.), No. 202 Hospital of People's Liberation Army, Shenyang 110003, China; Department of Endocrinology (Z.G.), Dalian Municipal Central Hospital Affiliated of Dalian Medical University, Dalian 116033, China; Department of Endocrinology (X.Z.), The First Hospital of Dandong, Dandong118000, China; and Shenyang Women and Children Health Care Center (L.Y.), Shenyang 110032, China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Yu
authors.forename: Zhongyan
authors.initials: Z
authors.lastname: Shan
authors.forename: Chenyan
authors.initials: C
authors.lastname: Li
authors.forename: Jinyuan
authors.initials: J
authors.lastname: Mao
authors.forename: Weiwei
authors.initials: W
authors.lastname: Wang
authors.forename: Xiaochen
authors.initials: X
authors.lastname: Xie
authors.forename: Aihua
authors.initials: A
authors.lastname: Liu
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Teng
authors.forename: Weiwei
authors.initials: W
authors.lastname: Zhou
authors.forename: Chenyang
authors.initials: C
authors.lastname: Li
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
authors.forename: Lihua
authors.initials: L
authors.lastname: Bi
authors.forename: Tao
authors.initials: T
authors.lastname: Meng
authors.forename: Jianling
authors.initials: J
authors.lastname: Du
authors.forename: Shaowei
authors.initials: S
authors.lastname: Zhang
authors.forename: Zhengnan
authors.initials: Z
authors.lastname: Gao
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Zhang
authors.forename: Liu
authors.initials: L
authors.lastname: Yang
authors.forename: Chenling
authors.initials: C
authors.lastname: Fan
authors.forename: Weiping
authors.initials: W
authors.lastname: Teng
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood* / Q000453:epidemiology* / Q000209:etiology; D000090463:Iron Deficiencies; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000453:epidemiology*; D011261:Pregnancy Trimester, First / Q000097:blood; D012307:Risk Factors; D013960:Thyroid Function Tests; D013974:Thyroxine / Q000097:blood; D055815:Young Adult
chemical_list: D013974:Thyroxine