妊娠早期甲状腺功能异常与糖代谢的相关性研究

Correlation between thyroid dysfunction and glucose metabolism in early pregnancy

目的探讨妊娠早期甲状腺功能异常与糖代谢的相关性研究。方法选取2018年1月至2019年3月深圳市宝安区松岗人民医院收治的200例妊娠早期亚临床型甲状腺功能减退症患者作为研究对象。将这200例患者设为观察组,同时选取50例健康妊娠早期的健康女性作为对照组。检测并对比观察组患者与对照组健康女性的外周血中测促甲状腺激素(TSH),游离甲状腺素(FT4)和游离三碘甲腺原氨酸(FT3)的表达差异,以及空腹葡萄糖水平(FPG)、糖化血红蛋白(HbA1c)、餐后2h葡萄糖水平(2hPG)及胰岛素抵抗指数(HOMA-IR)等糖代谢指标的情况。结果两组研究对象的TSH水平存在显著性的差异,且观察组患者的TSH的水平高于对照组健康女性,差异具有统计学意义(P<0.05);然而,观察组患者和对照组健康女性的FT3和FT4的水平则无显著性差异(P>0.05);此外,两组的糖代谢指标(FPG、HbA1c和HOMA-IR)存在显著性的差异,观察组的糖代谢指标高于对照组,差异具有统计学意义(P<0.05)。Pearson相关性分析结果显示,妊娠早期亚临床型甲状腺功能减退症患者TSH的水平与糖代谢指标(FPG、HbA1c和HOMA-IR)正相关,差异具有统计学意义(P<0.05)。结论妊娠早期亚临床型甲状腺功能减退症患者的TSH水平与血糖代谢密切相关,有利于进一步提示临床治疗。

Objective To investigate the relationship between thyroid dysfunction and glucose metabolism in early pregnancy. Methods From January 2018 to March 2019, 200 cases of early-stage subclinical hypothyroidism admitted to Bao′an District Songgang People′s Hospital were collected as the observation group. 50 healthy women in early pregnancy were selected as the control group. The expression of thyroid stimulating hormone(TSH), free thyroxine(FT4), free triiodothyronine(FT3), the fasting glucose level(FPG), glycosylated hemoglobin(HbA1 c), postprandial 2 h glucose level(2 hPG) and insulin resistance index(HOMA-IR) in peripheral blood of observation group and control group were detected. Results The TSH level in the observation group was higher than that in the control group, with statistically significant differences(P<0.05). However, there was no significant difference in the levels of FT3 and FT4 between the two groups(P> 0.05). In addition, the glucose metabolism indicators(FPG, HbA1 c and HOMA-IR) in the observation group was significantly higher than that in the control group, with statistically significant differences(P<0.05). Pearson correlation analysis showed that the level of TSH was positively correlated with glucose metabolism indicators(FPG, HbA1 c and HOMA-IR), with statistically significant differences(P<0.05). Conclusions The TSH level in patients with subclinical hypothyroidism in early pregnancy is closely related to blood glucose metabolism, which is helpful for further clinical treatment.