open access

Ahead of print
Original paper
Published online: 2021-02-22
Submitted: 2020-10-23
Accepted: 2021-02-01
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The relationship between Thyroid dysfunction during pregnancy and Gestational diabetes mellitus

Vesselina Evtimova Yanachkova, Zdravko Kamenov
DOI: 10.5603/EP.a2021.0016
·
Pubmed: 33619713

open access

Ahead of print
Original Paper
Published online: 2021-02-22
Submitted: 2020-10-23
Accepted: 2021-02-01

Abstract

Background: Thyroid dysfunction and gestational diabetes are the two most common endocrine disorders that can be observed during pregnancy. Thyroid function abnormalities could be associated with insulin resistance (IR) and changes in carbohydrate metabolism. In patients with type 1 diabetes, thyroid function is usually evaluated to rule out abnormalities within a second autoimmune disease. Patients with type 2 diabetes are tested for thyroid function in view of the associated weight gain, IR and changes in metabolism. The question arises, should we also look for thyroid dysfunction in patients with gestational diabetes? Aim: To determine whether there are abnormalities in thyroid hormone levels in pregnant women with gestational diabetes. Materials and methods: A monocentric, retrospective study of Dr Shterev Hospital electronic database was performed. We analyzed the medical records of 662 pregnant women, divided in two groups- 412 with GDM and 250 with normal glucose tolerance, who gave birth in the period 2017-2019. GDM in the study group was diagnosed using an oral glucose tolerance test. We analyzed the mean serum levels of thyroid stimulating hormone (TSH); free thyroxine levels (FT4), free triiodothyronine levels (FT3), FT3:FT4 ratio, fasting plasma glucose, age and body mass index in both groups. The groups were compared using Mann-Whitney U-test. Results: In patients who developed GDM significantly higher levels of TSH (p<0.0001) and FT3 (p<0.0001), lower levels of FT4 (p<0.0001) and higher FT3:FT4 ratio (р<0.0001) were found. Conclusion: The results of these pilot retrospective series reveals that high-normal to high levels of TSH and low normal to low levels for FT4 as well as high FT3:Ft4 ratio could indicate increased risk of development of GDM.

Abstract

Background: Thyroid dysfunction and gestational diabetes are the two most common endocrine disorders that can be observed during pregnancy. Thyroid function abnormalities could be associated with insulin resistance (IR) and changes in carbohydrate metabolism. In patients with type 1 diabetes, thyroid function is usually evaluated to rule out abnormalities within a second autoimmune disease. Patients with type 2 diabetes are tested for thyroid function in view of the associated weight gain, IR and changes in metabolism. The question arises, should we also look for thyroid dysfunction in patients with gestational diabetes? Aim: To determine whether there are abnormalities in thyroid hormone levels in pregnant women with gestational diabetes. Materials and methods: A monocentric, retrospective study of Dr Shterev Hospital electronic database was performed. We analyzed the medical records of 662 pregnant women, divided in two groups- 412 with GDM and 250 with normal glucose tolerance, who gave birth in the period 2017-2019. GDM in the study group was diagnosed using an oral glucose tolerance test. We analyzed the mean serum levels of thyroid stimulating hormone (TSH); free thyroxine levels (FT4), free triiodothyronine levels (FT3), FT3:FT4 ratio, fasting plasma glucose, age and body mass index in both groups. The groups were compared using Mann-Whitney U-test. Results: In patients who developed GDM significantly higher levels of TSH (p<0.0001) and FT3 (p<0.0001), lower levels of FT4 (p<0.0001) and higher FT3:FT4 ratio (р<0.0001) were found. Conclusion: The results of these pilot retrospective series reveals that high-normal to high levels of TSH and low normal to low levels for FT4 as well as high FT3:Ft4 ratio could indicate increased risk of development of GDM.

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Keywords

thyroid dysfunction, pregnancy, insulin resistance, gestational diabetes mellitus

About this article
Title

The relationship between Thyroid dysfunction during pregnancy and Gestational diabetes mellitus

Journal

Endokrynologia Polska

Issue

Ahead of print

Article type

Original paper

Published online

2021-02-22

DOI

10.5603/EP.a2021.0016

Pubmed

33619713

Keywords

thyroid dysfunction
pregnancy
insulin resistance
gestational diabetes mellitus

Authors

Vesselina Evtimova Yanachkova
Zdravko Kamenov

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