妊娠早期单纯低甲状腺素血症与妊娠期糖尿病相关性分析

Relationship of hypothyroxinemia to gestational diabetes mellitus during early pregnancy

目的探讨妊娠早期单纯低甲状腺素血症与妊娠期糖尿病相关性。方法收集重庆市妇幼保健院¨诊早期单胎妊娠妇女11365名，筛查其甲状腺功能，比较单纯低甲状腺素血症妊娠妇女血糖和妊娠期糖尿病患病风险，进一步探讨甲状腺激素与血糖的相关性，分析甲状腺过氧化物酶抗体（TPOAb）与妊娠期糖尿病的相关性。结果单纯低甲状腺素血症组患者葡萄糖负荷后血糖水平明显高于正常组，单纯低甲状腺素血症患者妊娠期糖尿病患病率更高（42．2％对18．4％，P〈0．05），游离甲状腺素（FT4）与葡萄糖负荷后血糖水平早负相关．FT4与妊娠期糖尿病相关，FT4越低则妊娠期糖尿病患病风险越高；TPOAb≥500IU／ml的妊娠妇女妊娠期糖尿病患病率较正常组高（31．2％对18．4％，P〈0．05）。结论妊娠早期单纯低甲状腺素血症及高滴度TPOAb阳性与罹患妊娠期糖尿病相关，FT4降低是妊娠期糖尿病患病风险增加的危险因素．

Objective To investigate the relationship of hypothyroxinemia to gestational diabetes mellitus during early pregnancy. Methods A total of 11 365 cases of women with early singleton pregnancies were collected from Chongqing Health Center for Women and Children. The screening of thyroid thnetion was performed. The postload glucose concentrations and the risks of gestational diabetes melfitus in hypothyroxinemia were investigated. The relationship of thyroid hormones to postload glucose concentration was evaluated. The association between thyroid peroxidase antibodies （TPOAb） and gestational diabetes mellitus was analyzed. Results Early pregnancy women with hypothyroxinemia had a higher postload glucose concentration. Comparing to normal pregnancy women, the prevalence of gestational diabetes mellitus in hypothyroxinemia was higher （42.2% vsl8.4% , P〈0.05 ）. Free thyroxine （FT4 ） was significantly negatively correlated with postload glucose concentration. FT4 was associated with gestational diabetes mellitus. The risk of gestational diabetes mellitus was greater when FT4 was lower. The prevalence of gestational diabetes mellitus in early pregnancy women with TPOAb levels ≥ 500 IU/ml was significantly higher than that in normal pregnancy women （ 31.2% vs 18.4% , P〈0.05 ）. Conclusion Early pregnancy women with hypothyroxinemia and TPOAb≥500 IU/ml were related to the risk of gestational diabetes mellitus. Lower FT4 was the risk factor of gestational diabetes mellitus.