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Thyroid hormone levels in diabetic mothers and their neonates
Insights
Maternal diabetes impacts neonatal thyroid hormone levels, specifically reducing triiodothyronine (T3) in infants. This suggests maternal diabetes affects fetal T3 regulation and conversion from thyroxine (T4).
Area of Science:
- Endocrinology
- Neonatal Medicine
- Reproductive Biology
Background:
- Thyroid hormone is crucial for metabolic pathway regulation in neonates.
- Infants born to diabetic mothers (IDMs) exhibit altered metabolic activity.
- The role of thyroid hormone in IDMs requires further investigation.
Purpose of the Study:
- To investigate thyroid hormone levels (TSH, T4, T3, reverse T3) in infants of diabetic mothers (IDMs) and normal neonates.
- To assess the impact of maternal diabetes on fetal and neonatal thyroid hormone status.
- To explore potential alterations in thyroid hormone secretion or conversion in IDMs.
Main Methods:
- Serum samples collected from 22 IDMs and 9 normal infants at 2, 12, 24, and 72 hours of age.
- Maternal and cord sera thyroid hormone levels were also measured.
- Thyroxine (T4) binding index and free T4 levels assessed in a subset of mothers and infants.
Main Results:
- No significant difference in TSH levels between IDMs and normal infants or their mothers.
- Significantly lower mean T4 levels in diabetic mothers compared to normal mothers.
- Neonatal T4 levels were consistently lower in IDMs, reaching statistical significance at 12 hours.
- Significantly lower mean T3 levels in diabetic mothers and consistently lower T3 concentrations in IDMs compared to controls.
- Reverse T3 levels did not differ significantly between groups.
Conclusions:
- Maternal diabetes is associated with altered thyroid hormone profiles in neonates.
- Evidence suggests a potential impact of maternal diabetes on fetal and neonatal T3 secretion or T4 to T3 conversion.
- Further research is needed to elucidate the mechanisms and clinical implications of these thyroid hormone alterations in IDMs.
Abstract:
Infants born to diabetic mothers have decreased activity of many metabolic pathways which might be regulated by thyroid hormone. Serum TSH, T4, T3, and reverse T3 levels were measured in 22 term infants of diabetic mothers and in 9 normal term babies at 2, 12, 24, and 72 hours of age, as well as in maternal and cord sera. T4 binding index and free T4 levels were measured in 11 diabetic mothers and their babies and 5 normal mothers and babies. Mean TSH levels did not differ between diabetic and normal mothers or their infants. Mean T4 of the diabetic mothers (9.6 micrograms/dl) was significantly (p less than 0.005) less than the mean T4 of the normal mothers (12.8 micrograms/dl). Mean T4 of neonatal specimens was lower in infants of diabetic mothers for each determination, but this difference achieved statistical significance at the 12-hour sample only (p less than 0.001). Mean serum T4 binding index was similar in the neonatal specimens at each time period studied. Mean T3 of diabetic mothers (149 ng/dl) was significantly (p less than 0.001) less than that of normal mothers (217 ng/dl). At each time interval, mean T3 concentration in infants of diabetic mothers was significantly lower than that of normal infants. Levels of reverse T3 were not significantly different between normal and diabetic mothers or their neonates. These data suggest that there is an effect of maternal diabetes on T3 secretion or conversion of T4 to the more active hormone, T3, in the fetus and early newborn.(ABSTRACT TRUNCATED AT 250 WORDS)