孕早期甲状腺功能异常与妊娠期糖尿病的关系研究  

Study on correlation of thyroid dysfunction in early pregnancy with gestational diabetes mellitus

作　　者：段崇强 DUAN Chong-qiang(Department of Clinical Laboratory,Shandong Yiyang Health Care Group Laiwu Central Hospital,Jinan 271100,China)

机构地区：[1]山东颐养健康集团莱芜中心医院检验科,271100

出　　处：《中国实用医药》2024年第19期25-28,共4页China Practical Medicine

摘　　要：目的 探讨孕早期甲状腺功能异常与妊娠期糖尿病(GDM)的关系。方法 100例孕早期孕妇,根据是否发生GDM分成GDM组(n=24)与非GDM组(n=76),对所有孕妇进行甲状腺功能检测,并收集所有孕妇一般资料调查问卷,包括年龄、体质量指数(BMI)、孕次、产次、甲状腺功能指标[甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、FT_(3)/FT_(4)]。比较两组孕妇一般资料,分析GDM发生的影响因素以及甲状腺功能对GDM的预测价值。结果 与非GDM组的(21.84±2.15)kg/m^(2)、43.42%、(3.24±0.62)IU/ml、(2.18±0.59)mU/L、(4.57±0.69)pmol/L、(0.28±0.05)比较,GDM组的BMI(22.94±2.37)kg/m^(2)、TgAb阳性率66.67%、TPOAb(4.39±0.75)IU/ml、TSH(3.36±0.71)mU/L、FT_(3)(5.19±0.76)pmol/L、FT_(3)/FT_(4)(0.33±0.07)水平更高(P<0.05)。以单因素分析差异有统计学意义的因素作为自变量,以GDM作为因变量,分别进行0与1赋值。建立多因素Logistic回归模型,发现TPOAb(OR=3.725)、TSH(OR=2.965)、FT_(3)/FT_(4)(OR=4.137)是GDM发生的独立影响因素(P<0.05)。绘制受试者工作特征曲线(ROC曲线)显示,TPOAb、TSH、FT_(3)/FT_(4)的曲线下面积分别为0.698、0.709、0.759。结论 GDM的发生受到孕早期甲状腺功能异常的影响,TPOAb、TSH、FT_(3)/FT_(4)是其独立影响因素,对GDM有较高的预测价值。Objective To explore the correlation of thyroid dysfunction in early pregnancy with gestational diabetes mellitus(GDM).Methods A total of 100 pregnant women in early pregnancy were divided into GDM group(n=24)and non-GDM group(n=76)based on the occurrence of GDM.Thyroid function tests were performed on all patients,and questionnaires were collected on general information of all patients,including age,body mass index(BMI),number of pregnancies,number of deliveries,thyroid function indicators[thyroglobulin antibody(TgAb),thyroid peroxidase antibody(TPOAb),thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),FT3/FT4].The general data of the two groups were compared,and the factors affecting the occurrence of GDM and the predictive value of thyroid function on GDM were analyzed.Results GDM group had BMI of(22.94±2.37)kg/m^(2),TgAb positive rate of 66.67%,TPOAb of(4.39±0.75)IU/ml,TSH of(3.36±0.71)mU/L,FT3 of(5.19±0.76)pmol/L,and FT3/FT4 of(0.33±0.07),which were higher than(21.84±2.15)kg/m^(2),43.42%,(3.24±0.62)IU/ml,(2.18±0.59)mU/L,(4.57±0.69)pmol/L,and(0.28±0.05)in the non-GDM group(P<0.05).The factors with statistically significant differences were taken as independent variables by univariate analysis,and GDM was taken as dependent variable to assign values of 0 and 1 respectively.Multivariate Logistic regression model was established,and it was found that TPOAb(OR=3.725),TSH(OR=2.965)and FT3/FT4(OR=4.137)were independent influencing factors of GDM occurrence(P<0.05).The receiver operating characteristic(ROC)curve was drawn to show that the area under the curve of TPOAb,TSH and FT3/FT4 were 0.698,0.709 and 0.759,respectively.Conclusion The occurrence of GDM is related to thyroid dysfunction in early pregnancy,and TPOAb,TSH and FT3/FT4 are independent influencing factors,which has high predictive value for GDM.

关 键 词：孕早期 甲状腺功能异常 妊娠期糖尿病 影响因素 

分 类 号：R714.256[医药卫生—妇产科学]