Zhou Xue, Li Zhihong, Li Ben, Guo Shuqin, Yao Mingyan
Xue Zhou, Department of Endocrinology, Baoding First Central Hospital, Baoding 071000, P.R. China.
Zhihong Li, Department of Endocrinology, Baoding First Central Hospital, Baoding 071000, P.R. China.
Pak J Med Sci. 2018 Sep-Oct;34(5):1278-1282. doi: 10.12669/pjms.345.15719.
To analyze the level and clinical significance of serum 25-hydroxyvitamin D (25-OH-D) levels in pregnant women with subclinical hypothyroidism (SCH) and gestational diabetes mellitus (GDM).
One hundred pregnant women of 24-28 weeks' pregnancy with SCH combined GDM were selected into the observation group, and 100 healthy pregnant women were selected into the control group during the corresponding period. Examined the thyroid stimulating hormone (TSH), free thyroxine (FT4), 25-OH-D, serum calcium (Ca2+), fasting plasma glucose (FPG), and glycosylated hemoglobin (HbAIc) levels and thyroid peroxide antibody (TPOAb), Thyroglobulin antibody (TgAb) status. Examine and compare TSH, FT4, Ca2+, FPG, HbAIc, TPOAb, and TgAb at different levels of serum 25-OH-D in the observation group. Compared the 25-OH-D levels and the ratio of different contents of 25-OH-D of TPOAb-positive and TgAb-positive SCH pregnant women.
The levels of TSH, FPG and HbAIc in the observation group were significantly higher than those in the control group (P<0.01). Through comparison of FT4 levels between the two groups, the difference had no statistical significance (P>0.05). The levels of 25-OH-D and Ca2+ in the observation group was significantly lower than those in the control group, and the difference had statistical significance (P<0.01). Through comparison of TSH, Ca2+, FPG and HbAIc in groups with different serum 25-OH-D levels, the difference had statistical significance (P<0.01). The positive rates of TPOAb and TgAb of pregnant women in the observation group were higher than in the control group (P<0.05). The vitamin D deficiency rate of TPOAb or TgAb positive pregnant women in the observation group was higher than those in the TPOAb or TgAb negative pregnant women, the difference had statistical significance (P < 0.05).
blood glucose level in pregnant women with GDM and SCH increased significantly, blood calcium level decreased significantly. This group of people are more likely to have VitD deficiency. Thyroid stimulating hormone and blood glucose levels in pregnant women are negatively correlated with VitD levels. Therefore, serum 25-OH-D level can be used as an important reference index for gestational diabetes mellitus with subclinical hypothyroidism, and it has great clinical significance to maintain it at a normal level.
分析亚临床甲状腺功能减退症(SCH)合并妊娠期糖尿病(GDM)孕妇血清25-羟维生素D(25-OH-D)水平及其临床意义。
选取100例孕24 - 28周的SCH合并GDM孕妇作为观察组,同期选取100例健康孕妇作为对照组。检测促甲状腺激素(TSH)、游离甲状腺素(FT4)、25-OH-D、血清钙(Ca2+)、空腹血糖(FPG)、糖化血红蛋白(HbAIc)水平及甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)状态。对观察组不同血清25-OH-D水平的TSH、FT4、Ca2+、FPG、HbAIc、TPOAb及TgAb进行检测并比较。比较TPOAb阳性和TgAb阳性的SCH孕妇的25-OH-D水平及不同25-OH-D含量比例。
观察组TSH、FPG及HbAIc水平显著高于对照组(P<0.01)。两组FT4水平比较,差异无统计学意义(P>0.05)。观察组25-OH-D及Ca2+水平显著低于对照组,差异有统计学意义(P<0.01)。对不同血清25-OH-D水平组的TSH、Ca2+、FPG及HbAIc进行比较,差异有统计学意义(P<0.01)。观察组孕妇TPOAb及TgAb阳性率高于对照组(P<0.05)。观察组TPOAb或TgAb阳性孕妇的维生素D缺乏率高于TPOAb或TgAb阴性孕妇,差异有统计学意义(P<0.05)。
GDM合并SCH孕妇血糖水平显著升高,血钙水平显著降低。这组人群更易发生维生素D缺乏。孕妇促甲状腺激素和血糖水平与维生素D水平呈负相关。因此,血清25-OH-D水平可作为亚临床甲状腺功能减退症合并妊娠期糖尿病的重要参考指标,维持其在正常水平具有重要临床意义。