PDF(Pubmed)
Abstract：
Pregnant women are at high risk of developing subclinical hypothyroidism (SCH), and anti-thyroid peroxidase antibody (TPOAb) positivity can further inhibit thyroxine synthesis. Emerging evidence indicates that intestinal flora can modulate metabolic and immune homeostasis. The characteristics of intestinal flora of TPOAb-positive women with SCH in their second trimester of pregnancy have not been reported. This single-center prospective observational cohort study investigated gut microbial composition and metabolic function using sequencing of the 16S rRNA gene in fecal samples from 75 TPOAb-positive women with SCH and 90 TPOAb-negative women with SCH during their second trimester of pregnancy. Women were treated with no levothyroxine (LT4), low-dose LT4 (≤50ug/d), or high-dose LT4 (>50ug/d). Taxonomic analysis showed Firmicutes and Bacteroidetes were the dominant phyla, followed by Actinobacteria and Proteobacteria. Faecalibacterium, Bacteroides, Prevotella 9, Bifidobacterium, Subdoligranulum, Lachnospira, and Megamonas were the predominant genera. The intestinal flora of TPOAb-positive women with SCH who received no LT4 was characterized by bacterial amplicon sequence variants (ASVs)/operational taxonomic units (OTUs) enriched in the genus Subdoligranulum. The intestinal flora of TPOAb-positive women with SCH who received low-dose or high-dose LT4 were characterized by bacterial ASVs/OTUs depleted of the species Ruminococcus sp._or Bacteroides massiliensis, respectively. A total of 19 metabolic functions of intestinal flora, mainly involving lipid and amino acid metabolism, discriminated TPOAb-positive and TPOAb-negative women with SCH. Our study suggests that there are differences in the composition and metabolic function of intestinal flora of TPOAb-positive and TPOAb-negative women with SCH treated with different doses of LT4 in the second trimester of pregnancy. The findings provide insight into intestinal flora as novel targets for the treatment of TPOAb-positive women with SCH during pregnancy.
摘要：
孕妇发生亚临床甲状腺功能减退症（SCH）的风险很高，抗甲状腺过氧化物酶抗体(TPOAb)阳性可进一步抑制甲状腺素的合成。新的证据表明，肠道菌群可以调节代谢和免疫稳态。TPOAb阳性孕妇妊娠中期的肠道菌群特征尚未见报道。这项单中心前瞻性观察队列研究使用16SrRNA基因测序研究了75名TPOAb阳性SCH女性和90名TPOAb阴性SCH女性在妊娠中期的粪便样本中的肠道微生物组成和代谢功能。妇女不接受左甲状腺素（LT4）治疗，低剂量LT4（≤50ug/d），或高剂量LT4（>50ug/d）。分类分析表明，厚壁菌和拟杆菌是主要的门，其次是放线菌和变形菌。粪杆菌,拟杆菌,普雷沃氏菌9号，双歧杆菌，下颗粒,落叶螺旋体,Megamonas是主要的属。未接受LT4的TPOAb阳性SCH女性的肠道菌群的特征在于富含下颗粒属的细菌扩增子序列变体（ASV）/操作分类单位（OTU）。接受低剂量或高剂量LT4的TPOAb阳性SCH女性的肠道菌群的特征是细菌ASV/OTU耗尽了Ruminococussp。_或拟南芥，分别。肠道菌群共有19种代谢功能，主要涉及脂质和氨基酸代谢，区分TPOAb阳性和TPOAb阴性的SCH女性。我们的研究表明，在妊娠中期，接受不同剂量LT4治疗的TPOAb阳性和TPOAb阴性的SCH女性的肠道菌群组成和代谢功能存在差异。这些发现提供了对肠道菌群作为治疗妊娠期TPOAb阳性SCH女性的新靶标的见解。
