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| Changes of thyroid function and glucose metabolism of pregnant women with gestational hypothyroidism complicated with gestational diabetes mellitus
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| The First Hospital of Qinhuangdao, Hebei Province, 066000 |
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Abstract To analyze the changes between thyroid function of pregnant women with hypothyroidism complicated with gestational diabetes mellitus (GDM). Methods: A total of 45 pregnant women with hypothyroidism complicated with GDM were selected in observation group from March 2018 to October 2020. 45 pregnant women who underwent physical examination were selected in control group during the same time. The levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), triiodothyronine (T3), tetraiodothyronine (T4), fasting blood glucose (FBG), 1 hour postprandial blood glucose (PBG1h)，2 hours postprandial blood glucose (PBG2h), glycosylated hemoglobin (HbAlc), fasting insulin (FINS), 1 hour postprandial insulin (1hINS), insulin, and C-peptide (CP) of the women in the two groups were detected. The value of homeostasis model assessment of insulin resistance (HOMA-IR) of the women in the two groups was calculated. And the adverse pregnancy outcomes of the women in the two groups were counted. Results: The HbAlc level of the women in the observation group was significantly lower than that of the women in the control group, and the levels of FBG, PBG1h, PBG2h, FINS, 1hINS, insulin, and CP, and the HOMA-IR value of the women in the observation group were significantly higher. In the observation group, the levels of TSH, FBG, PBG1h, FINS, and 1hINS of the women during the first, the second ,the third trimester of pregnancy had decreased gradually, and the TSH level of the women was positively correlated with their levels of FBG and PBG1h during pregnancy (all P<0.05). There was no significant difference in the total incidence of adverse pregnancy outcomes (11.1% vs. 4.4%) of the women between the two groups (P>0.05). Conclusion: The thyroid function, glucose metabolism, and islet function of the pregnant women with gestational hypothyroidism combined with GDM are all abnormal, which has some guiding significance in clinical diagnosis and treatment.
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