三季度特异性甲状腺功能标志物和妊娠糖尿病风险:来自于甲状腺妊娠的第三次基队列的证据
Erkan Sağlam1, Serenat Eris Yalçın1, Mustafa Raşit Özler1
1Bursa City Hospital, Perinatology Clinic, Bursa, Turkey.
概括
甲状腺激素在孕妇中微妙的变化,特别是第一季度较高的自由三甲状腺素 (fT3) 和fT3/fT4比率,与妊娠糖尿病 (GDM) 风险的增加有关. 相反,较高的甲状腺刺激激素 (TSH) 水平与降低的GDM风险相关.
科学领域:
- 内分泌学 在内分泌学.
- 生殖医学 生殖医学
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 孕期糖尿病 (GDM) 对母亲和胎儿的健康构成风险.
- 甲状腺激素在怀孕期间的代谢调节中发挥作用.
- 甲状腺功能的微妙变化可能会影响怀孕的结果.
研究的目的:
- 调查甲状腺刺激激素 (TSH),自由三甲状腺素 (fT3),自由甲状腺素 (fT4) 和fT3/fT4比率之间的关联,以及甲状腺功能良好的孕妇中GDM的发展.
- 评估这些甲状腺参数对GDM风险的预测值.
主要方法:
- 对200名甲状腺功能良好的孕妇进行了回顾性队列研究.
- 在第一和第二个三个月测量TSH,FT3和FT4.
- 基于Tertile的逻辑回归分析,根据母亲的年龄,BMI,吸烟和糖尿病家族史进行调整.
主要成果:
- 第一季度FT3和FT3/FT4比率升高与GDM风险增加显著相关 (调整后OR分别为9.72和4.05).
- 在两个季度中,较高的TSH水平与显著降低GDM风险相关 (OR=0.32-0.04).
- TSH水平增加,而ft3和ft4水平在三个月内显著下降.
结论:
- 即使在安甲状腺范围内,更高的第一季度ft3和ft3 / fT4比率也与高GDM风险有关.
- 在两个季度中,较高的TSH水平与降低GDM风险有关.
- 早期甲状腺功能评估可能有助于预测妊娠期代谢风险.
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