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孕期甲状腺功能和甲状腺自身免疫与孕期糖尿病的关联:系统性审查和个人参与者分析
Joris A J Osinga1, Arash Derakhshan1, Marianna Karachaliou2
1Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands.
The lancet. Diabetes & endocrinology
|July 3, 2025
概括
较低的自由T4水平和妊娠中孤立的低甲状腺血与妊娠期糖尿病风险增加有关. 这项研究挑战了关于甲状腺自身免疫和妊娠糖尿病的先前假设,突出了新的风险概况.
科学领域:
- 内分泌学 在内分泌学.
- 代谢健康 代谢健康
- 生殖健康 生殖健康
背景情况:
- 怀孕涉及显著的代谢和内分泌变化.
- 孕期甲状腺功能障碍和孕期糖尿病是常见的,经常同时发生的疾病.
- 甲状腺激素在怀孕期间对葡萄糖代谢的确切影响需要进一步阐明.
研究的目的:
- 进行一项元分析,评估甲状腺功能测试与妊娠糖尿病之间的关联.
- 评估怀孕期间甲状腺功能和葡萄糖代谢标志物之间的关系.
主要方法:
- 对前性队列研究的系统审查和个人参与者数据元分析.
- 在Ovid MEDLINE,EMBASE和科学网络中搜索到2024年12月.
- 包括25个队列 (63,548名参与者),分析母亲的甲状腺功能测试 (TSH,FT4,FT3) 和妊娠糖尿病状态.
主要成果:
- 隔离性低甲状腺血与妊娠糖尿病风险增加1.52倍有关.
- 较低的自由T4度与更高的妊娠糖尿病风险相关.
- 更高的自由T3度和FT3对FT4比率也显示出与妊娠糖尿病风险增加的关联.
结论:
- 较低的FT4和孤立的低甲状腺血与妊娠糖尿病风险增加有关.
- 这些发现挑战了亚临床甲状腺功能低下症和甲状腺自身免疫作为妊娠糖尿病风险因素的作用.
- 支持精制妊娠时甲状腺功能障碍的风险概况,并优化利沃西治疗目标.
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