ETA2023 Poster Presentations Basic Thyroid Gland, Iodine & Autoimmunity Basic (9 abstracts)
Reference range of maternal thyroid hormones from rural himalayan foothills (TEHRI CLUSTER): a cross sectional study
Nikku Yadav 1 , Asha Chandola-Saklani 2 , Jayanti Semwal 3 , Nidhi Yadav 4 & Anita Sharma 5
1Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Clinical Research Under Department of Community Medicine, Dehradhun, India; 2Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Clinical Research Under Department of Community Medicine, Dehradun, India; 3Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Community Medicine, Dehradun, India; 4Swami Rama Himalayan University, Clinical Trial Centre, Dehradun, India; 5Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Biochemistry, Dehradun, India
Background: It is well established that during pregnancy, normal physiological changes occur concomitant with an enhanced metabolic demand for thyroxine/iodine. If dietary iodine intake is sufficient, normal equilibrium is achieved. With deficient iodine intake, the demand not being met, it is believed that pathological alterations occur leading to maternal thyroxineaemia and impaired growth and neurodevelopmental disorders in the offspring. However, there are very few studies with respect to uterine history of thyroid hormones in iodine deficient area. Present study is an attempt in that direction. Trimester wise hormonal profiles have been provided.
Objective: To establish trimester specific reference ranges of Thyrotrophin(TSH) & Free Thyroxine (T4), dietary iodine & Urinary Iodine Excretion(UIE) levels.
Method: This study involved population drawn from tehri cluster viz., District Hospital Tehri(30.3809° N, 78.4374° E), CHC Devprayag (30.1584° N, 78.5989° E) and CHC Belashwar (29.9831° N, 78.5278° E). Blood and urine samples collected from pregnant (n =570) and non pregnant (n =300) subjects. Information on socioeconomic status, maternal thyroid history, dietary-iodine intake, smoking habits and BMI were generated. IEC approval & informed consent were also taken.
Results: All mothers used iodisided salt (26.33± 9.08 ppm) had BMI and BP within normal range. None of then were smokers. Table 1 depicts the results of the study
| Parameter | Status | Range (5-95percentile) | Range (2.5-97.5 percentile) | Mean ± SEM |
| TSH (mIU/l) | NP (n =300) | 0.46-3.74 | 0.36-4.56 | 1.73±0.060 |
| Tri I (n =167) | 0.46-3.26 | 0.32-3.73 | 1.60±0.066 | |
| Tri II (n =274) | 0.47-3.59 | 0.36-4.56 | 1.65±0.079 | |
| Tri III (n =81) | 0.58-3.89 | 0.28-4.94 | 1.73±0.105 | |
| FT4 (ng/dl) | NP (n =300) | 0.48-3.6 | 0.15-4.28 | 4.65±2.830 |
| Tri I (n =167) | 0.63-2.9 | 0.47-3.56 | 1.72±0.055 | |
| Tri II (n =274) | 0.63-2.91 | 0.39-3.67 | 1.64±0.046 | |
| Tri III (n =81) | 0.65-3.38 | 0.34-4.50 | 1.77±0.075 | |
| UIC (µg/l) | NP (n =300) | 106-189 | 104-198 | 100* |
| Tri I (n =167) | 104-191.6 | 103-197.8 | 148* | |
| Tri II (n =274) | 104.8-189 | 102-198 | 155* | |
| Tri III (n =81) | 104-196.6 | 104-198 | 147* | |
| * median | ||||
Conclusion: The UIC values observed in population reflected marginally mild iodine deficiency (ID) as per WHO norms, despite adequate iodisation level. However thyroid hormone profile was near normal indicating an apt handling of marginal ID. Financial assistance from Uttarakhand Council of Science & Technology and research facility from Swami Rama Himalayan University are gratefully acknowledged.
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