摘要
目的探讨孕早期甲状腺功能与妊娠期糖尿病(Gestational diabetes mellitus,GDM)的相关性。方法回顾性分析2021年8月至2022年7月在深圳市宝安区妇幼保健院就诊的单胎孕妇,根据葡萄糖耐量试验(OGTT)结果,分为GDM组和正常糖耐量组(NGT)。收集孕妇年龄、孕次、产次等一般资料,血糖等生化指标以及游离甲状腺素4(FT4)、促甲状腺激素(TSH)和甲状腺过氧化物酶抗体(TPOAb)。结果共纳入7023例单胎孕妇,其中GDM 1714例,发生率为24.4%。与NGT组相比,GDM组孕妇年龄大,孕次产次多和FT4降低差异有统计学意义(P<0.05)。孕早期FT4水平与OGTT血糖水平负相关(P<0.05),而TSH和TPOAb与OGTT血糖水平的相关性分析无统计学意义(P>0.05)。多因素logistic回归分析结果显示,妊娠年龄和FT4水平是GDM的独立危险因素(P<0.05),可预测GDM的发生。结论高龄妊娠和孕早期低水平的FT4是GDM的独立危险因素,加强对孕早期FT4水平监测和年龄管理,有助于降低GDM发生率。
Objective To investigate the relationship between thyroid function in early pregnancy and gestational diabetes mellitus(GDM).Methods The single pregnant women in Baoan District Maternal and Child Health Hospital of Shenzhen from August 2021 to July 2022 were retrospectively analyzed and divided into GDM group and normal glucose tolerance(NGT)group,according to the results of glucose tolerance test(OGTT).General information such as age,second pregnancy,blood glucose and other biochemical indicators,free thyroxine 4(FT4),thyroid stimulating hormone(TSH)and thyroid peroxidase antibody(TPOAb)were collected.Results 7023single pregnant women were included,including 1714 cases of GDM(24.4%).Compared with the NGT group,the pregnant women in the GDM group were older,more pregnancy times and lower FT4had statistical significance(P<0.05).FT4level in the first trimester was negatively correlated with OGTT level(P<0.05),while the correlation analysis of TSH and TPOAb with OGTT level was not statistically significant(P>0.05).Multivariate logistic regression analysis showed that gestational age and FT4 level were independent risk factors for GDM(P<0.05),which could predict the occurrence of GDM.Conclusion Low levels of FT4in advanced pregnancy and early pregnancy are independent risk factors for GDM.Strengthening FT4level monitoring and age management in early pregnancy is helpful to reduce the incidence of GDM.
作者
袁博
陈献
王丰
YUAN Bo;CHEN Xian;WANG Feng(Shantou University Medical College,Shantou,Guangdong 515041,China;Department of Clinical Laboratory,Southern University of Science and Technology Hospital,Shenzhen,Guangdong 518055,China;Department of Clinical Laboratory,Shenzhen Baoan Women’s and Children’s Hospital,Shenzhen,Guangdong 518102,China)
出处
《中国实验诊断学》
2023年第9期1039-1043,共5页
Chinese Journal of Laboratory Diagnosis
关键词
妊娠期糖尿病
孕早期
游离甲状腺素
高龄
gestational diabetes mellitus
first trimester
free thyroxine 4
advanced age
作者简介
袁博(1988-),男,湖南汨罗人,主管检验师,学士,主要从事妊娠期糖尿病研究;通讯作者:王丰
