亚临床甲状腺功能减退对妊娠期糖尿病母儿的影响

The Influence of Subclinical Hypothyroidism on Mothers and Children with Gestational Diabetes

目的探讨亚临床甲状腺功能减退对妊娠期糖尿病母儿的影响。方法选取2018年3月—2020年3月于该院检查并分娩的妊娠期糖尿病孕妇100例和非糖尿病合并亚临床甲减的孕妇60例作为研究对象,按甲状腺功能将妊娠期糖尿病孕妇分为妊娠期糖尿病亚临床甲减组42例、妊娠期糖尿病非甲减组58例和非妊娠期糖尿病亚临床甲减组60例,对3组指标、母儿结局进行比较分析。结果妊娠期糖尿病亚临床甲减组的空腹血糖(FPG)、糖化血红蛋白(HbA1c)水平分别为(5.22±0.71)mmol/L、(5.69±0.93)%较妊娠期糖尿病非甲减组(5.89±0.94)mmol/L、(6.42±1.27)%明显更低,较非妊娠期糖尿病亚临床甲减组(4.21±0.37)mmol/L、(5.14±0.78)%则明显更高,差异有统计学意义(P<0.05)。同时,三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、促甲状腺激素(TSH)水平及高血压发生率、早产率较其他两组明显更高,差异有统计学意义(P<0.05)。结论亚临床甲状腺功能减退合并妊娠期糖尿病往往会伴随明显糖脂代谢异常和甲状腺功能异常,两种疾病可相互影响,使患者病情发展加重,从而增加妊娠期糖尿病母儿不良结局发生率。

Objective To investigate the effect of subclinical hypothyroidism on mothers and children with gestational diabetes.Methods 100 pregnant women with gestational diabetes who were examined and delivered in the hospital from March 2018 to March 2020 and 60 pregnant women with non-diabetic and subclinical hypothyroidism were selected as the research objects.According to the thyroid function,the pregnant women with gestational diabetes were divided into 42 cases of gestational diabetes subclinical hypothyroidism group,58 cases of gestational diabetes non-hypothyroidism group and 60 cases of non-gestational diabetes subclinical hypothyroidism group.The three groups of indicators and maternal and child outcomes were compared and analyzed.Results The fasting blood glucose(FPG)and glycosylated hemoglobin(HbA1c)levels of the subclinical hypothyroidism group of gestational diabetes were(5.22±0.71)mmol/L and(5.69±0.93)%respectively compared with those of the non-hypothyroid group of gestational diabetes(5.89±0.94)mmol/L and(6.42±1.27)%were significantly lower than those in the non-gestational diabetes subclinical hypothyroidism group(4.21±0.37)mmol/L and(5.14±0.78)%were significantly higher,the difference was statistically significant(P<0.05).At the same time,triacylglycerol(TG),total cholesterol(TC),low-density lipoprotein(LDL-C),thyroid-stimulating hormone(TSH)levels and the incidence of hypertension,premature delivery were more significant than those of the other two groups,the difference was statistically significant(P<0.05).Conclusion Subclinical hypothyroidism combined with gestational diabetes is often accompanied by obvious abnormal glucose and lipid metabolism and thyroid dysfunction.The two diseases can affect each other and make the patient's condition worse,thereby increasing the incidence of adverse maternal and child outcomes of gestational diabetes.