促甲状腺激素水平与妊娠期代谢综合征的相关性分析

The correlative analysis analysis between thyroid-stimulating hormone levels and metabolic syndrome during pregnancy

目的：研究血清促甲状腺激素（TSH）水平与妊娠期代谢综合征及其组分的相关性。方法：选取在温州市人民医院定期产检并住院分娩的甲状腺激素正常、资料完整的911例单胎妊娠孕妇,根据TSH水平分为研究组及对照组。其中149例TSH〉3.0 m IU/L孕妇为亚临床甲状腺功能减退组（研究组）;762例TSH〈3.0 m IU/L孕妇为对照组。记录各组孕期身高、年龄、孕前体质量、孕24～28周糖耐量试验（OGTT）、孕晚期临近分娩的甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、总胆固醇（CHOL）、TSH、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）水平。比较研究组与对照组的血脂水平,2组单纯妊娠期高血压病、单纯妊娠期糖尿病、妊娠期代谢综合征的患病率。比较TSH在妊娠期糖尿病、妊娠期高血压疾病、妊娠期代谢综合征3组与正常组的高低。结果：研究组TG水平高于对照组,差异有统计学意义（P〈0.05）。研究组妊娠期高血压疾病患病率高于正常组,差异有统计学意义（P〈0.05）。TSH与妊娠期代谢综合征患病率关系不显著（P〉0.05）。TSH值在妊娠期高血压疾病组高于正常组,差异有统计学意义（P〈0.05）。结论：血清TSH水平与血脂组分TG、妊娠期高血压疾病存在相关,与妊娠期高血压疾病患病亦相关,与妊娠期代谢综合征关系不显著。

Objective： To investigate the relationship between thyroid-stimulating hormone（TSH） levels and metabolic syndrome during pregnancy. Methods： Nine hundred and eleven single pregnant women who accepted regular obstetrical inspection and delivered in Wenzhou People＇s Hospital were enrolled. One hundred and forty-nine cases with subclinical hypothyroidism（TSH〉3.0 m IU/L） were divided into study group and other 762 pregnant women with TSH〈3.0 m IU/L were as controls. Information Including age, gestational weeks, body weight before pregnancy and biochemical indicators, including total cholesterol（CHOL）, triglyceride（TG）, high density lipoprotein cholesterol（HDL-C）, low density lipoprotein cholesterol（LDL-C） and thyroid-stimulating hormone levels were recorded. The levels of serum lipid, the prevalence of pregnancy induced hypertension, gestational diabetes mellitus and pregnancy metabolic syndrome were compared between the two group. Results： The levels of triglyceride in the subclinical hypothyroidism group were much higher than that in the controls. The difference was statistically significant（P〈0.05）. The incidence of GMS and pregnancy induced hypertension was much higher than that in the controls. There was no correlation between TSH and GMS（P〉0.05）. The TSH seemed to have relationship in the morbidity between pregnancy induced hypertension and normal（P〈0.05）. Conclusion： There is a significant correlation between TSH levels and triglyceride and pregnancy induced hypertension.The levels of TSH is also associated with pregnancy hypertension, but not related to GMS.