PURPOSE The association between iodine intake and thyroid autoimmunity has been debated, especially in pregnant women. This study aimed to investigate thyroid autoantibodies and their association with iodine intake and hypothyroidism in early pregnancy. METHODS 7073 early pregnant women from an iodine-sufficient region participated in this study. Urinary iodine concentrations (UICs) were measured using an ammonium persulfate method. Serum thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), thyroid-stimulating hormone (TSH), free thyroxine (FT4), and Tg were determined using an electrochemiluminescence immunoassay. RESULTS Iodine deficiency (UIC < 100 μg/L) was associated with higher risks of TPOAb positivity [adjusted odds ratio (aOR) = 1.64, 95% confidence interval [CI] (1.29-2.08)] and TgAb positivity [aOR = 1.44, 95% CI (1.16-1.80)]. Women with isolated TPOAb positivity, isolated TgAb positivity, or both TPOAb and TgAb positivity had a 14.64-fold, 7.83-fold, and 44.69-fold increased risk of overt hypothyroidism, and a 4.36-fold, 2.86-fold, and 6.26-fold increased risk of subclinical hypothyroidism, respectively. Moreover, the risks of overt and subclinical hypothyroidism in women with a high TPOAb titer were 16.99 and 4.80 times that in TPOAb-negative women, respectively. The risk of overt hypothyroidism in women with a high TgAb titer was 6.97 times that in TgAb-negative women. CONCLUSIONS Our work demonstrates that iodine deficiency during early pregnancy is an independent risk factor for both TPOAb positivity and TgAb positivity. Furthermore, positivity for both autoantibodies and a high thyroid autoantibody titer are associated with significantly higher risks of overt and subclinical hypothyroidism.

中文翻译：

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碘摄入与甲状腺自身抗体之间的关联：在碘充足地区的7073名早期孕妇的横断面研究。

目的碘摄入与甲状腺自身免疫性之间的关系一直存在争议，特别是在孕妇中。本研究旨在调查妊娠早期甲状腺自身抗体及其与碘摄入和甲状腺功能低下的关系。方法来自碘充足地区的7073名早期孕妇参加了这项研究。尿碘浓度（UICs）使用过硫酸铵法测量。使用电化学发光免疫测定法测定血清甲状腺过氧化物酶抗体（TPOAb），甲状腺球蛋白抗体（TgAb），甲状腺刺激激素（TSH），游离甲状腺素（FT4）和Tg。结果碘缺乏（UIC <100μg/ L）与TPOAb阳性的风险较高[校正比值比（aOR）= 1.64，95％置信区间[CI]（1.29-2.08）]和TgAb阳性[aOR = 1.44， 95％CI（1。16-1.80）]。TPOAb阳性，TgAb阳性或TPOAb和TgAb阳性的女性患甲状腺机能减退的风险增加了14.64倍，7.83倍和44.69倍，而甲状腺功能减退的风险增加了4.36倍，2.86倍和6.26倍分别增加亚临床甲状腺功能减退症的风险。而且，TPOAb滴度高的女性的显性和亚临床甲状腺功能减退的风险分别是TPOAb阴性女性的16.99和4.80倍。TgAb滴度高的女性中明显甲状腺功能减退的风险是TgAb阴性女性的6.97倍。结论我们的研究表明，孕早期碘缺乏症是TPOAb阳性和TgAb阳性的独立危险因素。此外，