苏丹孕妇的甲状腺功能和胰岛素抵抗。
Thyroid functions and insulin resistance in pregnant Sudanese women.
机构信息
Faculty of Medicine, Kordofan University, Elobeid, Sudan.
Faculty of Medicine, El Imam El Mahdi University, Kosti, Sudan.
出版信息
BMC Endocr Disord. 2024 Sep 27;24(1):200. doi: 10.1186/s12902-024-01739-6.
BACKGROUND
The thyroid function test (free triiodothyronine [FT3], free thyroxine [FT4], and thyroid-stimulating hormone [TSH]) is one of the key determinant of glucose homeostasis by regulating the balance of insulin. Thyroid dysfunction alters glucose metabolism, leading to insulin resistance (IR). This study aimed to assess the association between thyroid function and IR in pregnant Sudanese women.
METHOD
A cross-sectional study was conducted in Saad Abuelela Hospital, Khartoum-Sudan, from January to April 2021. Obstetric/sociodemographic characteristics were gathered through questionnaires. Serum TSH, FT3, FT4, fasting plasma glucose (FPG), and fasting insulin levels were measured and evaluated, and IR was estimated using the homeostatic model assessment for insulin resistance (HOMA-IR) equation.
RESULTS
In total, the study included 127 pregnant women with a median age of 27.0 years (interquartile range [IQR] 23.0‒31.2) and a median gestational (IQR) age of 25.0 (IQR 25.0‒27.0) weeks. The medians (IQRs) of the TSH, FT3, and FT4 were 1.600 (1.162‒2.092) IU/ml, 2.020(1.772‒2.240) nmol/l, and 10.70 (9.60‒11.90) pmol/l, respectively. The median (IQR) of the FPG and fasting blood insulin level was [69.0 (62.00‒78.00) mg/dl] and [5.68(2.99‒11.66) IU/ml], respectively. The median (IQR) of the HOMA-IR level was 0.9407 (0.4356‒2.1410). There was a positive correlation between HOMA -IR and FT3 levels (r = 0.375; P < 0.001) and a negative correlation with FT4 levels (r= -0.312; P < 0.001). Also, a significant positive correlation was found between fasting insulin levels and FT3 levels (r = 0.438; P < 0.001) and a negative correlation with FT4 levels (r= -0.305; P < 0.001).
CONCLUSIONS
This study indicated that FT3 has positive correlation with HOMA-IR, while FT4 has negative correlation among healthy pregnant women without a history of thyroid dysfunction. This may indicate screening of euthyroid pregnant women for thyroid dysfunction and IR. Further studies are needed.
背景
甲状腺功能测试（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]）是通过调节胰岛素平衡来调节葡萄糖稳态的关键决定因素之一。甲状腺功能障碍会改变葡萄糖代谢，导致胰岛素抵抗（IR）。本研究旨在评估苏丹孕妇甲状腺功能与 IR 之间的关系。
方法
这是一项于 2021 年 1 月至 4 月在苏丹喀土穆的 Saad Abuelela 医院进行的横断面研究。通过问卷收集产科/社会人口统计学特征。测量并评估血清 TSH、FT3、FT4、空腹血糖（FPG）和空腹胰岛素水平，并使用稳态模型评估胰岛素抵抗（HOMA-IR）方程估计 IR。
结果
共有 127 名孕妇入组，中位年龄为 27.0 岁（四分位距 [IQR] 23.0-31.2），中位妊娠（IQR）年龄为 25.0（IQR 25.0-27.0）周。TSH、FT3 和 FT4 的中位数（IQR）分别为 1.600（1.162-2.092）IU/ml、2.020（1.772-2.240）nmol/L 和 10.70（9.60-11.90）pmol/L。FPG 和空腹胰岛素水平的中位数（IQR）分别为[69.0（62.00-78.00）mg/dl]和[5.68（2.99-11.66）IU/ml]。HOMA-IR 水平的中位数（IQR）为 0.9407（0.4356-2.1410）。HOMA-IR 与 FT3 水平呈正相关（r=0.375；P<0.001），与 FT4 水平呈负相关（r=-0.312；P<0.001）。此外，空腹胰岛素水平与 FT3 水平呈显著正相关（r=0.438；P<0.001），与 FT4 水平呈负相关（r=-0.305；P<0.001）。
结论
本研究表明，FT3 与 HOMA-IR 呈正相关，而 FT4 与无甲状腺功能障碍病史的健康孕妇呈负相关。这可能表明需要对甲状腺功能正常的孕妇进行甲状腺功能障碍和 IR 的筛查。还需要进一步的研究。
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