Agarwal Mukesh M, Dhatt Gurdeep S, Punnose John, Bishawi Bassam, Zayed Reem
Department of Pathology, Faculty of Medicine, UAE University, Al Ain, United Arab Emirates.
Gynecol Endocrinol. 2006 May;22(5):261-6. doi: 10.1080/09513590600630470.
Both gestational diabetes mellitus (GDM) and thyroid dysfunction in pregnancy compromise maternal and fetal health. The aim of the present study was to determine the prevalence of abnormal thyroid function and antithyroid antibodies during early pregnancy in a population at high risk for GDM. Serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were measured in 301 pregnant women who underwent routine 'universal screening' for GDM. The antithyroid peroxidase antibody (antiTPOAb) was also quantified in 255 of these women. GDM was confirmed by a 75-g oral glucose tolerance test using World Health Organization criteria. No statistically significant difference was found between the 80 (26.6%) women with GDM and the 221 (73.4%) women without GDM for any of the thyroid function tests. In the cohort tested for antiTPOAb, the 51 (20.0%) women who were positive for antiTPOAb had higher mean TSH (1.57 +/- 2.49 mIU/l; p < 0.001) than the women negative for antiTPOAb. Seventeen (5.6%) women had low FT4 while 12 (4.0%) women had high TSH; 28 (9.3%) women had low serum TSH, among whom three (1.0%) also had high FT4. The significantly higher prevalence of hypothyroxinemia and antiTPOAb titers than generally reported warrants routine screening for thyroid abnormalities. This screening, which can be effectively and easily incorporated into screening practices already in place for GDM, would result in improved obstetric care.
妊娠期糖尿病（GDM）和妊娠期甲状腺功能障碍均会危及母婴健康。本研究旨在确定GDM高危人群孕早期甲状腺功能异常及抗甲状腺抗体的患病率。对301名接受GDM常规“普遍筛查”的孕妇测定了血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）和促甲状腺激素（TSH）。其中255名孕妇还进行了抗甲状腺过氧化物酶抗体（antiTPOAb）定量检测。采用世界卫生组织标准通过75克口服葡萄糖耐量试验确诊GDM。在任何甲状腺功能检查中，80名（26.6%）GDM孕妇与221名（73.4%）非GDM孕妇之间均未发现统计学上的显著差异。在检测antiTPOAb的队列中，antiTPOAb呈阳性的51名（20.0%）孕妇的平均TSH水平（1.57±2.49 mIU/l；p<0.001）高于antiTPOAb呈阴性的孕妇。17名（5.6%）孕妇FT4水平低，12名（4.0%）孕妇TSH水平高；28名（9.3%）孕妇血清TSH水平低，其中3名（1.0%）孕妇FT4水平也高。甲状腺素血症和antiTPOAb滴度的患病率显著高于一般报道，因此有必要对甲状腺异常进行常规筛查。这种筛查可以有效且轻松地纳入现有的GDM筛查流程中，从而改善产科护理。
