Correlation Between Levothyroxine and Blood Th17/Treg in Pregnant Women With Normal-high TSH and Positive TPOAb
NCT ID: NCT06527859
Last Updated: 2024-07-30
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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TERMINATED
64 participants
OBSERVATIONAL
2022-04-06
2024-06-05
Brief Summary
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Are there differences in immune inflammation between normal pregnant women and those in the disease group? Can different doses of levothyroxine improve the Th17/Treg ratio and cytokine levels in the disease group? Researchers first compared the differences between normal pregnant women and those in the disease group, and then administered two different doses of levothyroxine to the disease group to observe whether different doses of levothyroxine can improve the immune inflammation in this group.
pregnant women in the disease group will: Take the same dose of levothyroxine (25/50ug) every day Return for a follow-up visit after 4 weeks of medication
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Detailed Description
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Conditions
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Study Design
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CASE_CONTROL
CROSS_SECTIONAL
Study Groups
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control group
healthy pregnancy women
No interventions assigned to this group
disease group
pregnant women with normal-high TSH and positive TPOAb in the first half of pregnancy
Levothyroxin
The disease group were divided into two groups ,25ugLT4 (HA group, n=17) and 50ugLT4 (HB group, n=17) respectively.
Interventions
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Levothyroxin
The disease group were divided into two groups ,25ugLT4 (HA group, n=17) and 50ugLT4 (HB group, n=17) respectively.
Eligibility Criteria
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Inclusion Criteria
* All pregnant women are in the first half of pregnancy (gestational age≤20 weeks).
Exclusion Criteria
* Assisted reproduction;
* Multiple pregnancy;
* Combined with other autoimmune diseases such as antiphospholipid syndrome and thrombophilia;
* Severe intestinal diseases or intestinal surgery history, or the use of probiotics, prebiotics and other drugs that affect intestinal flora;
* Obesity, pre-pregnancy hyperlipidemia;
* Adverse reactions to LT4
FEMALE
Yes
Sponsors
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Third Affiliated Hospital of Zhengzhou University
OTHER
Responsible Party
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Xin Tian
Resident Physician
Principal Investigators
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Xin Tian
Role: PRINCIPAL_INVESTIGATOR
Third Affiliated Hospital of Zhengzhou University
Yanjie Ban
Role: PRINCIPAL_INVESTIGATOR
Third Affiliated Hospital of Zhengzhou University
Locations
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The Third Affiliated Hospital of Zhengzhou University
Zhengzhou, Henan, China
Countries
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References
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Michalopoulou G, Alevizaki M, Piperingos G, Mitsibounas D, Mantzos E, Adamopoulos P, Koutras DA. High serum cholesterol levels in persons with 'high-normal' TSH levels: should one extend the definition of subclinical hypothyroidism? Eur J Endocrinol. 1998 Feb;138(2):141-5. doi: 10.1530/eje.0.1380141.
Cayres LCF, de Salis LVV, Rodrigues GSP, Lengert AVH, Biondi APC, Sargentini LDB, Brisotti JL, Gomes E, de Oliveira GLV. Detection of Alterations in the Gut Microbiota and Intestinal Permeability in Patients With Hashimoto Thyroiditis. Front Immunol. 2021 Mar 5;12:579140. doi: 10.3389/fimmu.2021.579140. eCollection 2021.
Xue H, Yu X, Ma L, Song S, Li Y, Zhang L, Yang T, Liu H. The possible role of CD4(+)CD25(high)Foxp3(+)/CD4(+)IL-17A(+) cell imbalance in the autoimmunity of patients with Hashimoto thyroiditis. Endocrine. 2015 Dec;50(3):665-73. doi: 10.1007/s12020-015-0569-y. Epub 2015 Mar 13.
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Xue H, Yang Y, Zhang Y, Song S, Zhang L, Ma L, Yang T, Liu H. Macrophage migration inhibitory factor interacting with Th17 cells may be involved in the pathogenesis of autoimmune damage in Hashimoto's thyroiditis. Mediators Inflamm. 2015;2015:621072. doi: 10.1155/2015/621072. Epub 2015 Mar 15.
Lee SY, Pearce EN. Assessment and treatment of thyroid disorders in pregnancy and the postpartum period. Nat Rev Endocrinol. 2022 Mar;18(3):158-171. doi: 10.1038/s41574-021-00604-z. Epub 2022 Jan 4.
Yetkin DO, Dogantekin B. The Lipid Parameters and Lipoprotein(a) Excess in Hashimoto Thyroiditis. Int J Endocrinol. 2015;2015:952729. doi: 10.1155/2015/952729. Epub 2015 May 3.
Sinha RA, Singh BK, Yen PM. Direct effects of thyroid hormones on hepatic lipid metabolism. Nat Rev Endocrinol. 2018 May;14(5):259-269. doi: 10.1038/nrendo.2018.10. Epub 2018 Feb 23.
Kim HJ, Park SJ, Park HK, Byun DW, Suh K, Yoo MH. Thyroid autoimmunity and metabolic syndrome: a nationwide population-based study. Eur J Endocrinol. 2021 Oct 11;185(5):707-715. doi: 10.1530/EJE-21-0634.
Ru X, Yang M, Teng Y, Han Y, Hu Y, Wang J, Tao F, Huang K. Association of maternal thyroid peroxidase antibody during pregnancy with placental morphology and inflammatory and oxidative stress responses. Front Endocrinol (Lausanne). 2023 Sep 22;14:1182049. doi: 10.3389/fendo.2023.1182049. eCollection 2023.
Mahto M, Chakraborthy B, Gowda SH, Kaur H, Vishnoi G, Lali P. Are hsCRP Levels and LDL/HDL Ratio Better and Early Markers to Unmask Onset of Dyslipidemia and Inflammation in Asymptomatic Subclinical Hypothyroidism? Indian J Clin Biochem. 2012 Jul;27(3):284-9. doi: 10.1007/s12291-012-0206-y. Epub 2012 Apr 18.
Cao Y, Jin X, Sun Y, Wen W. Therapeutic effect of mesenchymal stem cell on Hashimoto's thyroiditis in a rat model by modulating Th17/Treg cell balance. Autoimmunity. 2020 Feb;53(1):35-45. doi: 10.1080/08916934.2019.1697689. Epub 2019 Dec 3.
Vaivode I, Zake T, Strele I, Upmale-Engela S, Gogins D, Gersone G, Skesters A, Dambrova M, Konrade I. Stress-Related Immune Response and Selenium Status in Autoimmune Thyroid Disease Patients. Int J Mol Sci. 2023 Jan 26;24(3):2440. doi: 10.3390/ijms24032440.
Mazzieri A, Montanucci P, Basta G, Calafiore R. The role behind the scenes of Tregs and Th17s in Hashimoto's thyroiditis: Toward a pivotal role of FOXP3 and BACH2. Front Immunol. 2022 Dec 12;13:1098243. doi: 10.3389/fimmu.2022.1098243. eCollection 2022.
Xu Y, Zhao Y, Xu X, Yan Q, Yang L. Serum lipid profile in relation to free thyroxine and the effect of levothyroxine treatment on lipids in patients with isolated hypothyroxinemia during pregnancy: a single-center retrospective study. Lipids Health Dis. 2022 Dec 19;21(1):142. doi: 10.1186/s12944-022-01744-5.
Yu M, Long Y, Wang Y, Zhang R, Tao L. Effect of levothyroxine on the pregnancy outcomes in recurrent pregnancy loss women with subclinical hypothyroidism and thyroperoxidase antibody positivity: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2023 Dec;36(2):2233039. doi: 10.1080/14767058.2023.2233039.
Fenneman AC, Bruinstroop E, Nieuwdorp M, van der Spek AH, Boelen A. A Comprehensive Review of Thyroid Hormone Metabolism in the Gut and Its Clinical Implications. Thyroid. 2023 Jan;33(1):32-44. doi: 10.1089/thy.2022.0491. Epub 2023 Jan 6.
Provided Documents
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Document Type: Study Protocol and Statistical Analysis Plan
Document Type: Informed Consent Form
Other Identifiers
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ThirdZhengzhouU
Identifier Type: -
Identifier Source: org_study_id
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