摘要
目的探讨早期妊娠甲状腺激素水平与妊娠期糖尿病(gestational diabetes mellitus,GDM)发病的相关性。方法回顾性选取2016年10月-2018年10月于厦门大学附属妇女儿童医院(厦门市妇幼保健院)建卡并定期产检的孕妇共718名,收集妊娠早期促甲状腺激素(TSH)、游离甲状腺素(FT_(4))及24~28周口服葡萄糖耐量试验(OGTT)等检测指标。根据妇产科学第九版妊娠期糖尿病(GDM)诊断标准进行实验分组,分为GDM组(177例)及非GDM组(541例)。分析早期妊娠甲状腺激素水平与GDM发病的相关性。结果GDM组早期FT4检测水平0.86(0.65,1.34),非GDM组早期FT4检测水平0.93(0.68,1.45),两组比较差异有统计学意义(P<0.05)。GDM组与非GDM组妊娠早期TSH检测水平比较,差异无统计学意义(P=0.688)。妊娠早期TSH与OGTT各项指标之间均无相关性(r=0.100、0.024、0.009,P>0.05);回归分析GDM发病的影响因素,FT_(4)是GDM发病的保护因素β=-1.963,OR(95%CI)=0.140(0.051~0.391);年龄及孕早期空腹血糖是GDM发病的危险因素β=0.072、0.334,OR(95%CI)=1.075(1.037~1.114)、1.397(1.128~1.731)。结论FT_(4)是GDM的保护性因素,妊娠早期FT_(4)越低,发生GDM的概率越高,而孕早期空腹血糖越高、年龄越大,孕中后期发生GDM的可能性越高。
Objective To investigate the correlation between early pregnancy thyroid hormone levels and the onset of gestational diabetes mellitus(GDM).Methods A total of seven hundred and eighteen pregnant women who had their cards established and regular maternity checkups at the Women and Children's Hospital Affiliated to Xiamen University(Xiamen Maternal and Child Health Hospital)from October 2016 to October 2018 were regressibilit selected.Thyroid stimulating hormone(TSH),free thyroxine(FT_(4))and oral glucose tolerance test(OGTT)at 24-28 weeks were collected in early pregnancy.They were divided into GDM group(one hundred and seventy-seven cases)and non-GDM group(five hundred and forty-one cases)according to the diagnostic criteria of gestational diabetes mellitus(GDM)in the 9th edition of obstetrics and gynecology.The correlation between early pregnancy thyroid hormone levels and the onset of GDM was analyzed.Results The early FT4 detection level in the GDM group was 0.86(0.65,1.34),while the early FT4 detection level in the non-GDM group was 0.93(0.68,1.45),the difference between the two groups was statistically significant(P<0.05).There was no significant difference in TSH detection level between GDM group and non-GDM group in early pregnancy(P=0.688).TThere was no correlation between TSH and OGTT in early pregnancy(r=0.100,0.024,0.009,P>0.05);regression analysis of the influencing factors of GDM incidence.FT_(4) was a protective actor for the onset of GDMβ=-1.963,OR(95%CI)=0.140(0.051~0.391).Age and fasting blood glucose in early pregnancy were risk factors for the onset of GDMβ=0.072,0.334,OR(95%CI)=1.075(1.037~1.114),1.397(1.128~1.731).Conclusion FT_(4) is a protective factor of GDM.The lower the FT_(4) in the early pregnancy,the higher the probability of GDM.The higher the fasting blood glucose in the early pregnancy and the older the age,the higher the probability of GDM in the middle and late pregnancy.
作者
郭琼
GUO Qiong(Department of Obstetrics and Gynecology,Women and Children's Hospital Affiliated to Xiamen University(Xiamen Maternal and Child Health Hospital),Xiamen,Fujian Province,361000 China)
出处
《中外医疗》
2022年第34期24-28,共5页
China & Foreign Medical Treatment
