孕早期TPO-Ab与糖代谢及妊娠期糖尿病的关系

The relationship between TPO-Ab and glucose metabolism and gestational diabetes mellitus in early pregnancy

目的探讨孕早期抗甲状腺过氧化物酶抗体(TPO-Ab)与糖代谢及妊娠期糖尿病(GDM)的关系。方法选取于该院产检的孕妇300例,检测TPO-Ab、促甲状腺素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)及抗甲状腺球蛋白抗体(Tg-Ab),根据TPO-Ab阳性及阴性分为两组,收集两组孕妇空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、糖化血红蛋白(HbA1c)数据,以及口服糖耐量结果并进行比较。结果与TPO-Ab阴性组比较,TPO-Ab阳性组HbA1c[(5.73±0.92)%]及Tg-Ab[(7.38±6.44)ng/mL]增高,且组间比较差异有统计学意义(P<0.05)。TPO-Ab阳性组FBG、TSH、TC及TG水平较TPO-Ab阴性组增高(P>0.05),FT3、FT4较TPO-Ab阴性组降低(P>0.05)。HbA1c与TSH呈正相关(r=0.089、Beta=0.202,P<0.05)。TPO-Ab阳性组GDM发病率明显高于TPO-Ab阴性组(68.53%vs.38.85%,P<0.05)。孕早期TPO-Ab阳性孕妇后期患GDM风险升高(OR=3.43,P=0.015 7)。结论 TPO-Ab阳性孕妇出现糖代谢异常较TPO-Ab阴性孕妇的风险升高。

Objective To explore the relationship between the early stages of pregnancy thyroid peroxidase antibodies(TPO-Ab)and glucose metabolism or gestational diabetes mellitus(GDM).Methods 300 pregnant women were selected for obstetric examination in the hospital,whose TPO-Ab,thyroid stimulating hormone(TSH)and free thyroxine(FT4),free triiodothyronine(FT3)and antithyroglobulin antibody(TGAb)were recorded.According to the nature of TPO-Ab,those women were divided into two groups,TPO-Ab negative group and TPO-Ab positive group.The data of fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),glycosylated hemoglobin(HbA1 c),as well as the oral glucose tolerance results,were compared between the two groups.Results Compared with the TPO-Ab negative group,HbA1 c [(5.73±0.92)%]and Tg-Ab[(7.38±6.44)ng/mL]increased in TPO-Ab positive group,and the difference was statistically significant(P<0.05).The level of FBG,TSH,TC and TG in the TPO-Ab positive group were higher than those in the negative group(P>0.05),and those of FT3 and FT4 were lower(P>0.05).HbA1 cwas positively correlated with TSH(r=0.089,Beta=0.202,P<0.05).The incidence of GDM in TPO-Ab positive group was significantly higher than that in the TPO-Ab negative group(68.53%vs.38.85%,P<0.05).The risk of GDM increased(OR=3.43,P=0.015 7)during the late pregnancy of TPO-Ab positive pregnant women.Conclusion The risk of abnormal glucose metabolism increased in TPO-Ab positive pregnant women than that in the TPO-Ab negative pregnant women.