妊娠期甲状腺功能减退和妊娠期糖尿病的相关性研究  

Study on the correlation between hypothyroidism during pregnancy and gestational diabetes mellitus

作　　者：周兰芳[1] 夏婷[2] 

机构地区：[1]杭州市萧山区第三人民医院妇产科,浙江杭州311251 [2]浙江省肿瘤医院妇科,浙江杭州310022

出　　处：《中国妇幼保健》2016年第9期1822-1824,共3页Maternal and Child Health Care of China

基　　金：浙江省自然科学基金项目(2010Y2100593)

摘　　要：目的探讨妊娠期甲状腺功能减退和妊娠期糖尿病(Gestational diabetes mellitus,GDM)的相关性。方法选择2013年1月-2015年1月浙江省萧山区第三人民医院GDM孕妇138例和妊娠期甲状腺功能减退孕妇45例作为研究对象,将GDM不合并甲状腺功能减退者92例作为A组,GDM合并甲状腺功能减退组46例作为B组,妊娠期甲状腺功能减退组45例作为C组。比较A组和B组的糖代谢情况,比较B组和C组的血清TSH、FT_3和FT_4水平,分析3组孕妇的血清TSH、FT_3和FT_4水平和糖代谢水平的相关性。结果 B组孕妇的空腹血糖、餐后2 h血糖和糖化血红蛋白均高于A组,两组之间空腹血糖比较差异有统计学意义(P<0.05),餐后2 h血糖和糖化血红蛋白比较差异没有统计学意义(P>0.05)。B组孕妇的血清FT_3和FT_4水平均低于C组,血清TSH水平高于C组,两组之间血清FT_4水平比较,差异有统计学意义(P<0.05),血清FT_3水平比较差异无统计学意义(P>0.05),血清TSH水平比较差异没有统计学意义(P>0.05)。孕妇血清FT_3、FT_4水平和血清空腹血糖、餐后2h血糖、糖化血红蛋白比较,差异无统计学意义(P>0.05),血清TSH水平和血清空腹血糖、餐后2h血糖之间比较,差异无统计学意义(P>0.05),血清TSH和糖化血红蛋白之间呈负相关(P<0.05)。结论 GDM和妊娠期甲状腺功能减退之间存在一定联系,妊娠期甲状腺功能减退影响GDM的糖代谢,GDM影响妊娠期甲状腺功能减退的甲状腺功能。Objective To explore the correlation between hypothyroidism during pregnancy and gestational diabetes mellitus（ GDM）.Methods A total of 138 GDM pregnant women and 45 pregnant women with hypothyroidism were selected from the hospital from January2013 to January 2015,then the women were divided into group A（ simple GDM）,group B（ GDM combined with hypothyroidism）,and group C（ simple hypothyroidism）. Glucose metabolism situations in group A and group B were compared; the levels of serum thyroid stimulating hormone（ TSH）,free triiodothyronine（FT3）,and free thyroxin（ FT4） in group B and group C were compared; the correlations between serum TSH,FT3,FT4 levels and glucose metabolism levels in the three groups were compared. Results The fasting blood glucose,2-hour postprandial blood glucose,and glycated hemoglobin levels in group B were higher than those in group A,there was statistically significant difference in fasting blood glucose level between the two groups（ P〈0. 05）,there was no statistically significant difference in 2-hour postprandial blood glucose and glycated hemoglobin levels between the two groups（ P〈0. 05）. The levels of serum FT3 and FT4 in group B were statistically significantly lower than those in group C,serum TSH level was higher than that in group C,there was statistically significant difference in serum FT4 level between the two groups（ P〈0. 05）,there was no statistically significant difference in serum FT3 and TSH levels between the two groups（ P〉0. 05）. Serum FT3 and FT4were not correlated with serum fasting blood glucose,2-hour postprandial blood glucose,and glycated hemoglobin levels（ P〉0. 05）; serum TSH level was not correlated with serum fasting blood glucose and 2-hour postprandial blood glucose levels（ P〉0. 05）; serum TSH level was negatively correlated with glycated hemoglobin level（ P〈0. 05）. Conclusion There is a certain correlataion between GDM and hypothyroidism during pregnancy,hypothyroidism during pregnancy affec

关 键 词：妊娠期甲状腺功能减退 妊娠期糖尿病 糖代谢 甲状腺功能 

分 类 号：R714.14[医药卫生—妇产科学]