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第42卷第10期                                                                          ILDR1  TUBB2B
               ·1420 ·                           南 京    医 科 大 学 学         报                        2022年10月                                                                     EYA4          DACH1
                                                                                                                                                                                      SORCS1
                                                                                                                                                                       NTRK2
                                                                                                                                                                                           MAN1C1
              摄取和有机化活性,造成甲状腺激素合成和释放功                                 al. Prevention and control of iodine deficiency in pregnant                                             GALNT3              WNT9B
                                                                                                                                                                      BMP3
              能障碍,并反馈引起TSH分泌增多               [22] 。碘过量还可             and lactating women and in children less than 2⁃years⁃                                    MOXD1              hsa⁃miR⁃885⁃5p  CLDN16
                                                                                                                                                          CLDN8      OLFM3
              能抑制脱碘酶活性,使 T4 向 T3 转化减少              [23] 。另有          old:conclusions and recommendations of the Technical                                                   ATP12A               ABHD17C
              研究显示碘过量可能影响甲状腺形态与超微结构,                                 Consultation[J]. Public Heal Nutr,2007,10(12A):                                  GRM1  SLC5A7  C7   ZNF728             KHDRBS2
                                                                                                                                                                     CADM2        KSR2  FAM81A
                                                                     1606-1611                                                                                              SEMA6D
              促使甲状腺细胞凋亡增多等             [24] 。在本研究中,可能                                                                                               LPA  BTG2                                 SOWAHA
                                                                [8] SHI X G,HAN C,LI C Y,et al. Optimal and safe upper                                                   NIPAL1      SIX4
              由于妊娠女性补碘意识较强,甲减孕妇的碘缺乏比                                                                                                                                                     TFAP2B
                                                                     limits of iodine intake for early pregnancy in iodine⁃suffi⁃                 CPNE4 COBLL1
              例并不高,并且妊娠中后期 FT4 随着 UIC/UCr 的升                                                                                                                                        GJC1
                                                                     cient regions:a cross ⁃ sectional study of 7190 pregnant                                            CLIC5            PSMB9
              高而降低,当 UIC/UCr 超足量时,TSH 明显升高,提                                                                                                        MRAP2  ALX1
                                                                     women in China[J]. J Clin Endocrinol Metab,2015,100                                              FGF1    NETO1           MARCH4
              示在碘充足地区,碘过量较碘缺乏更应引起重视,                                (4):1630-1638                                                                       PLP1    TCF21
              需根据 UIC/UCr 的检测结果慎重补碘,使得孕妇的                       [9] 阎玉芹,陈祖培. 尿样浓度对尿碘含量的影响[J]. 中国                                                            AIF1L  KCNJ10 ST6GAL1  TMEM92  hsa⁃miR⁃1251⁃5p  CXCL11
              碘摄入量维持在合理的范围内,保证孕妇最合适、                                 地方病学杂志,1997,16(4):239-241
              安全的碘状态。                                           [10] LI C Y,PENG S Q,ZHANG X M,et al. The urine iodine                                                        TENM1           FCGR1B
                  本研究也有一定的局限性:首先,样本量少,我                              to creatinine as an optimal index of iodine during pregnan⁃                                                   FCGR1A  NPTX2
              们正在纳入更多的人群;第二,未采集患者的饮食                                 cy in an iodine adequate area in China[J]. J Clin Endocri⁃                       红色代表上调,绿色代表下调;三角形代表miRNA,圆形代表mRNA。
              碘营养信息。另外,本研究未采集同步血白蛋白信                                 nol Metab,2016,101(3):1290-1298                                                           图6   miRNA与靶基因的调控网络
                                                                [11]《妊娠和产后甲状腺疾病诊治指南》(第2版)编撰委员
              息,因为对于低蛋白饮食的孕妇,其低肌酐排泄可                                                                                                              Figure 6  The regulatory network between miRNA and target genes
                                                                     会,中华医学会内分泌学分会,中华医学会围产医学
              能会掩盖碘缺乏状态。
                                                                     分会. 妊娠和产后甲状腺疾病诊治指南(第 2 版)[J].
                  综上,在碘充足地区,以 UIC/UCr 替代 UIC 评
                                                                     中华围产医学杂志,2019,22(8):505-506
              价孕期碘营养状态,碘缺乏比例明显减少,妊娠中
                                                                [12] LUO J Y,LI C Y,ZHANG X M,et al. Reference intervals
              后期 FT4 随着 UIC/UCr 的升高而降低,甲状腺功能                         of the ratio of urine iodine to creatinine in pregnant wom⁃
              减退人群碘营养充足或超足量比例高,应结合                                   en in an iodine⁃replete area of China[J]. Biol Trace Elem
              UIC/UCr值慎重补碘。                                          Res,2021,199(1):62-69
                                                                [13] JI C L,BU Y,TIAN C Y,et al. Determination of reference
             [参考文献]
                                                                     intervals of ratios of concentrations of urinary iodine to
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