Yang Shuai, Shi Feng-Tao, Leung Peter C K, Huang He-Feng, Fan Jianxia
International Peace Maternity and Child Health Hospital (S.Y., F.-T.S., H.-F.H., J.F.), School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; Institute of Embryo-Fetal Original Adult Disease Affiliated to Shanghai Jiao Tong University School of Medicine (F.-T.S., H.-F.H.), Shanghai 200030, China; and Department of Obstetrics and Gynaecology (P.C.K.L.), Child and Family Research Institute, University of British Columbia, Vancouver, British Columbia, Canada V6H 3V5.
J Clin Endocrinol Metab. 2016 Nov;101(11):4237-4243. doi: 10.1210/jc.2016-1506. Epub 2016 Sep 1.
Although thyroid dysfunction in early pregnancy may have adverse effects on pregnancy outcome and offspring, few prospective studies have evaluated these effects.
Our aim was to evaluate the correlations between different thyroid hormone levels in early pregnancy and the incidence of gestational diabetes mellitus (GDM).
The study comprised 27 513 mothers who provided early pregnancy serum samples for analyses of thyroid function. GDM was diagnosed using a 2 hours, 75-g oral glucose tolerance test, and the mothers were grouped and compared according to the results.
We focused on GDM during the index pregnancy.
The incidence of GDM in pregnant women tended to increase with age (5.83%, 10.18%, 14.95%, and 22.40%; P < .0001). The incidence of GDM increased with increasing prepregnancy body mass index (P < .0001). Pregnant women with a family history of diabetes had a much higher incidence of GDM than those without a family history of diabetes (21.09% vs 12.92%; P < .0001). The level of free T (FT) in early pregnancy in GDM women was lower than that in non GDM women (P < .0001). With increasing early pregnancy FT, the rate of incident GDM was decreasing (P < .0001).
Low thyroid hormone levels in early pregnancy are a risk factor for GDM incidence.
尽管孕早期甲状腺功能异常可能对妊娠结局和后代产生不良影响，但很少有前瞻性研究评估这些影响。
我们的目的是评估孕早期不同甲状腺激素水平与妊娠期糖尿病（GDM）发病率之间的相关性。
该研究纳入了27513名母亲，她们提供了孕早期血清样本用于甲状腺功能分析。采用2小时75克口服葡萄糖耐量试验诊断GDM，并根据结果对母亲进行分组和比较。
我们关注的是本次妊娠期间的GDM。
孕妇GDM的发病率随年龄增长呈上升趋势（5.83%、10.18%、14.95%和22.40%；P<.0001）。GDM的发病率随着孕前体重指数的增加而升高（P<.0001）。有糖尿病家族史的孕妇GDM的发病率比没有糖尿病家族史的孕妇高得多（21.09%对12.92%；P<.0001）。GDM女性孕早期游离T（FT）水平低于非GDM女性（P<.0001）。随着孕早期FT水平的升高，GDM的发病率呈下降趋势（P<.0001）。
孕早期甲状腺激素水平低是GDM发病的一个危险因素。
