妊娠期糖尿病与妊娠期甲状腺功能状态的相关性分析

发布时间：2018-11-07 14:39

【摘要】：目的观察妊娠期血糖水平与甲状腺功能的相关性,探讨GDM是否与妊娠期甲状腺功能异常相关。方法选取在我院产检的孕妇514名,分为GDM组与非GDM组。收集妊娠期血清游离甲状腺激素(FT_4)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TpoAb)、75 g OGTT结果,统计GDM、甲状腺功能异常的发病率,比较两组甲状腺功能异常的差异,分析FT4、TSH与血糖水平的相关性。结果总甲状腺功能异常发病率为21.2%,其中临床甲状腺功能亢进、亚临床甲状腺功能亢进、临床甲状腺功能减退、亚临床甲状腺功能减退发病率分别为3.7%、1.9%、0.2%、15.4%,TpoAb阳性率为9.7%,GDM的发病率为16.3%;GDM组与非GDM组甲状腺功能异常、TpoAb阳性率比较,差异均无统计学意义(x~2=0.407、1.051,P=0.523、0.305);妊娠早期TpoAb阳性组与阴性组的GDM发病率比较,差异有统计学意义(x~2=6.362,P=0.012),而中晚期则差异无统计学意义;FT4仅与FPG呈负相关(r=-0.148,P=0.001),TSH与FPG、1 hPG及2 hPG无相关性。结论 GDM与甲状腺功能异常无相关性,但妊娠早期TpoAb阳性与GDM发病可能存在一定的相关性。
[Abstract]:Objective to investigate the correlation between serum glucose level and thyroid function in pregnancy and whether GDM is correlated with thyroid dysfunction in pregnancy. Methods 514 pregnant women were divided into GDM group and non-GDM group. The results of serum free thyroid hormone (FT_4) and thyroid peroxidase antibody (TpoAb), 75 g OGTT) of thyroid stimulating hormone (TSH),) in pregnancy were collected and the incidence of thyroid dysfunction in GDM, was analyzed. To compare the difference of thyroid dysfunction between the two groups, and analyze the correlation between FT4,TSH and blood glucose level. Results the incidence of total thyroid dysfunction was 21.2. The incidence of clinical hyperthyroidism, subclinical hyperthyroidism, clinical hypothyroidism and subclinical hypothyroidism were 3.7, respectively. The positive rate of TpoAb was 9. 7 and the incidence of GDM was 16. 3. There was no significant difference in the positive rate of thyroid function and TpoAb between the GDM group and the non-GDM group. The incidence of GDM in TpoAb positive group was significantly higher than that in negative group in the first trimester of pregnancy (x2 + 6.362P0. 012), but there was no significant difference in the middle and late stage of pregnancy. There was only negative correlation between FT4 and FPG (r = -0.148), TSH). There was no correlation between), TSH and FPG,1 hPG and 2 hPG. Conclusion there is no correlation between GDM and thyroid dysfunction, but there may be some correlation between TpoAb positive and GDM in early pregnancy.
【作者单位】：南方医科大学第三附属医院内分泌代谢科;
【分类号】：R714.256

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