妊娠期糖尿病患者甲状腺功能TSH和FT_(4)及TPOAb等指标的变化

The relationship between blood sugar in patients with GDM patients and neonates thyroid function

目的探讨妊娠期糖尿病(GDM)患者血糖与甲状腺功能的关系。方法选取2017年3月至2019年3月在本院就诊的GDM患者118例作为GDM组,并选取同期健康孕妇100名作为对照组,检测两组甲状腺功能指标;根据患者血糖控制情况,再分为血糖控制组(n=87)和未控制组(n=31),比较两组妊娠结局。结果 GDM组三碘甲状腺原氨酸(T3)、总甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)分别为(2.21±0.75)nmol/L、(153.30±29.88)nmol/L、(4.22±0.89)pmol/L和(15.15±3.66)pmol/L,均明显低于对照组(P<0.05),而促甲状腺素(TSH)为(1.87±0.41)mIU/L,明显高于对照组(P<0.05);GDM组和对照组甲状腺过氧化物酶抗体(TPOAb)阳性率比较差异无统计学意义;血糖控制组和未控制组T3、T4、FT3和FT4、TSH和TPOAb比较差异均无统计学意义;GDM组糖化血红蛋白(HbA1c)与FT3呈负相关(r=-0.441,P<0.05);血糖控制组和未控制组分娩孕周、新生儿性别、出生体质量比较差异无统计学意义。结论 GDM患者甲状腺功能异常,血糖水平与甲状腺功能无明显相关性。

Objective To explore the relationship between blood sugar in patients with gestational diabetes mellitus(GDM)and thyroid function in patients.Methods 118 cases of GDM patients(GDM group)were admitted to our hospital from March 2017 to March 2019 were selected as GDM group,and 100 healthy pregnant women were selected as the control group at same time,thyroid function indexes of the two groups were measured;according to the blood sugar control of the patients,they were divided into blood sugar control group(n=87)and uncontrolled group(n=31),the pregnancy outcome of two groups were compared.Results The levels of triiodothyronine(T3),total thyroxine(T4),free triiodothyronine(FT3)and free thyroxine(FT4)in the GDM group were(2.21±0.75)nmol/L,(153.30±29.88)nmol/L,(4.22±0.89)pmol/L and(15.15±3.66)pmol/L,which were significantly lower than those in the control group(P<0.05),thyrotropin(TSH)was(1.87±0.41)mIU/L,which was significantly higher than that of the control group(P<0.05);there was no significant difference in the positive rate of thyroid peroxidase antibody(TPOAb)between blood sugar control group and uncontrolled group;there were no significant difference in T3,T4,FT3 and FT4,TSH and TPOAb between the blood sugar control group and the uncontrolled group;there was negative correlation between HbA1 c and FT3 in the GDM group(r=-0.441,P<0.05);there were no significant difference in gestational weeks,neonatal sex and birth weight between blood sugar control group and uncontrolled group.Conclusion Thyroid function are abnormal in GDM patients,there was no significant correlation between blood sugar level and thyroid function.