Department of Endocrinology, The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China.
The Savaid School of Medicine, University of Chinese Academy of Sciences, Beijing, PR China.
Endocrine. 2021 Sep;73(3):550-560. doi: 10.1007/s12020-021-02712-2. Epub 2021 May 13.
The current meta-analysis aimed to evaluate the association of thyroid dysfunction and autoimmunity with gestational diabetes mellitus (GDM).
A comprehensive search from PubMed, Embase, MEDLINE, and Cochrane databases until November 2020 was conducted. Fixed-effect model was used to combine the results when I was <50%. Random-effect model was used to summarize the results when I was >50%.
A total of 44 studies were included in the meta-analysis. Low FT4 levels were closely related with GDM in the first and second trimesters of gestation. Hypothyroxinemia (OR: 1.45; 95% CI: 1.25, 1.68; P < 0.00001), overt (OR: 1.80; 95% CI: 1.73, 1.86; P < 0.00001), and subclinical (OR: 1.54; 95% CI: 1.03, 2.30; P = 0.03) hypothyroidism, overt hyperthyroidism (OR: 1.49; 95% CI: 1.09, 2.04; P = 0.01), and positive thyroid antibodies (OR: 1.49; 95% CI: 1.07, 2.07; P < 0.00001) were observed significantly associated with the risk of GDM. Pregnant women with subclinical hyperthyroidism were less likely to develop GDM (OR: 0.62; 95% CI: 0.39, 0.97; P = 0.04).
Thyroid dysfunction and positive thyroid antibodies were associated with the risk of GDM. Our findings suggest that pregnant women with these thyroid diseases may be offered screening for GDM comprehensively.
本荟萃分析旨在评估甲状腺功能障碍和自身免疫与妊娠糖尿病（GDM）的关联。
对PubMed、Embase、MEDLINE 和 Cochrane 数据库进行了全面检索，检索时间截至 2020 年 11 月。当 I²<50%时采用固定效应模型合并结果；当 I²>50%时采用随机效应模型合并结果。
共有 44 项研究纳入荟萃分析。在妊娠前三个月和后三个月，低游离甲状腺素（FT4）水平与 GDM 密切相关。亚临床甲状腺功能减退症（OR：1.45；95%CI：1.25，1.68；P<0.00001）、显性（OR：1.80；95%CI：1.73，1.86；P<0.00001）和亚临床（OR：1.54；95%CI：1.03，2.30；P=0.03）甲状腺功能减退症、显性甲状腺功能亢进症（OR：1.49；95%CI：1.09，2.04；P=0.01）和阳性甲状腺抗体（OR：1.49；95%CI：1.07，2.07；P<0.00001）与 GDM 风险显著相关。亚临床甲状腺功能亢进症孕妇发生 GDM 的可能性较低（OR：0.62；95%CI：0.39，0.97；P=0.04）。
甲状腺功能障碍和阳性甲状腺抗体与 GDM 风险相关。我们的研究结果表明，患有这些甲状腺疾病的孕妇可能需要全面筛查 GDM。
