孕期尿碘、TPOAB、FT_4、TSH与妊娠期糖尿病的相关性分析

Correlation analysis between urinary iodine, TPOAB, FT_4, TSH and gestational diabetes mellitus during pregnancy

目的分析孕期尿碘、抗甲状腺过氧化物酶抗体(TPOAB)、血清游离甲状腺素(FT4)、促甲状腺激素(TSH)与妊娠期糖尿病的相关性。方法 824例孕妇,首次产前分别检测其尿碘、TPOAB、FT4、TSH水平,持续随访至孕24~28周,再依次对其开展口服葡萄糖耐量试验(OGTT),观察不同甲状腺功能表现孕妇的妊娠期糖尿病发病率。结果 824例孕妇中,确诊亚临床甲状腺功能减退症148例,发生率为18.0%。亚临床甲状腺功能减退症孕妇的碘适量率明显低于非亚临床甲状腺功能减退症孕妇,亚临床甲状腺功能减退症孕妇的碘缺乏率明显高于非亚临床甲状腺功能减退症孕妇,差异均具有统计学意义(P<0.05)。亚临床甲状腺功能减退症孕妇的妊娠期糖尿病发病率为68.9%,明显高于非亚临床甲状腺功能减退症孕妇的5.8%,差异具有统计学意义(P<0.05)。结论孕期甲状腺功能减退症与妊娠期糖尿病具有相关性,存在甲状腺功能异常的孕妇更易发生妊娠期糖尿病,在孕早期及时给予甲状腺功能与糖尿病筛查有助于改善妊娠结局。

Objective To analyze the correlation between urinary iodine,thyroid peroxidase antibody(TPOAB),serum free thyroxine(FT4),thyroid stimulating hormone(TSH)and gestational diabetes mellitus during pregnancy.Methods The levels of urinary iodine,TPOAB,FT4and TSH in824pregnant women were measured in the first prenatal period.The patients were followed up for24to28weeks,followed by oral glucose tolerance test(OGTT).The incidence of gestational diabetes mellitus in pregnant women with different thyroid function was observed.Results Among the824pregnant women,148cases were diagnosed subclinical hypothyroidism,with the incidence rate of18%.Pregnant women with subclinical hypothyroidism had lower iodine sufficient rate than non subclinical hypothyroidism pregnant women,and obviously higher iodine deficiency rate than non subclinical hypothyroidism pregnant women.Their difference was statistically significant(P<0.05).Pregnant women with subclinical hypothyroidism had obviously higher incidence of gestational diabetes mellitus as68.9%than5.8%in non subclinical hypothyroidism pregnant women,and the difference was statistically significant(P<0.05).Conclusion Hypothyroidism during pregnancy is correlated to gestational diabetes mellitus,and pregnant women with abnormal thyroid function are more likely to develop gestational diabetes mellitus.Timely screening of thyroid function and diabetes in early pregnancy can improve pregnancy outcome.