妊娠早期甲状腺功能异常与妊娠期糖尿病及糖代谢指标的关联性分析  

Analysis on the correlations between thyroid dysfunction and gestational diabetes mellitus,glucose metabolism indexes during the first trimester of pregnancy

作　　者：陈晓琴[1] 刘康 高林琳[1] 郑彩虹[1] CHEN Xiao-Qin, LIU Kang, GAO Lin-Lin, et al.(Shanxi Big Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi 031000, Chin)

机构地区：[1]山西医学科学院山西大医院,山西太原031000

出　　处：《中国妇幼保健》2018年第7期1472-1475,共4页Maternal and Child Health Care of China

摘　　要：目的分析妊娠早期甲状腺功能异常与妊娠期糖尿病及糖代谢指标的关联性,为临床妊娠期糖尿病的防治提供理论参考。方法选取2015年1月-2017年5月期间在该院接受常规体检的孕妇206例为研究对象,按照甲状腺功能分为甲状腺功能正常组(145例)、甲减组(10例)、亚临床甲减组(44例)、甲状腺功能亢进组(7例)。对孕妇的年龄、甲状腺功能、妊娠期糖尿病发生率、孕前体重指数及糖代谢指标情况进行记录,分析妊娠早期甲状腺功能异常与妊娠期糖尿病、糖代谢指标的关联性,应用Logistic回归分析法分析妊娠期糖尿病发生危险因素。结果经药物干预治疗后,甲减组、亚临床甲减组孕妇患妊娠期糖尿病的风险与甲状腺功能正常组比较差异无统计学意义(P>0.05);甲减组、亚临床甲减组孕妇的GLU、Hb A1C、2h PG、HOMA-IR水平均高于甲状腺功能正常组和甲亢组,差异有统计学意义(均P<0.05);Logistic回归分析显示,TSH升高0.1 ng/ml、FT4减少0.2 ng/ml、BMI水平>26.7 kg/m2是妊娠期糖尿病独立危险因素。结论妊娠早期甲状腺功能异常和妊娠期糖尿病、糖代谢指标存在密切关联性,妊娠早期甲状腺功能异常能导致妊娠期糖尿病发生风险增加,妊娠早期积极检测孕妇甲状腺功能具有重要意义。Objective To analyze the correlations between thyroid dysfunction and gestational diabetes mellitus （GDM）, glucose metabolism indexes during the first trimester of pregnancy, provide a theoretical reference for prevention and treatment of GDM. Methods A total of 206 pregnant women receiving routine physical examination in Shanxi Big Hospital from January 2015 to May 2017 were selected and divided into normal thyroid function group （145 cases） , hypothyroidism group （10 cases ） , subclinical hypothyroidism group （44 cases ） , and hyperthyroidism group （7 cases） according to thyroid function. Maternal age, thyroid function, incidence rate of GDM, body mass index before pregnancy, and glucose metabolism indicators were recorded to analyze the con＇elations between thyroid dysfunction and GDM, glucose metabolism indexes during the first trimester of pregnancy. Logistic regression model was used to analyze the risk factors of GDM. Results After drug intervention, there was no statistically significant difference in the risk of GDM between normal thyroid function group and hypothyroidism group, subclinical hypothyroidism group （P〉0. 05） . The levels of GLU, HbA1C, 2hPG, and HOMA-IR in hypothyroidism group and subclinical hypothyroidism group were statistically significantly higher than those in normal thyroid function group and hyperthyroidism group （P〈0. 05） . Logistic regression analysis showed that TSH elevation by 0. 1 ng/ml, FT4 reduction by 0. 2 ng/ml, BMI〉 26.7 kg/m^2 were independent risk factors of GDM. Conclusion Thyroid dysfunction during the first trimester of pregnancy is closely correlated with GDM and glucose metabolism indicators, which can increase the risk of GDM, so active detection of thyroid function in pregnant women during the first trimester of pregnancy is of great significance.

关 键 词：妊娠早期 甲状腺功能异常 妊娠期糖尿病 糖代谢指标 关联性 

分 类 号：R714.256[医药卫生—妇产科学]