| 余蓓蓓,武培,周婷婷,等.孕早期甲状腺功能指标对孕妇发生妊娠期糖尿病风险的临床价值分析[J].安徽医药,2026,30(1):92-95. |
| 孕早期甲状腺功能指标对孕妇发生妊娠期糖尿病风险的临床价值分析 |
| Clinic value of thyroid function indicators in early pregnancy for risk of gestational diabetes mellitus |
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| DOI：10.3969/j.issn.1009-6469.2026.01.019 |
| 中文关键词: 糖尿病，妊娠 甲状腺球蛋白抗体(TG-Ab) 甲状腺过氧化物酶抗体( TPO-Ab) 孕早期 危险因素 预测 |
| 英文关键词: Diabetes,gestational Thyroglobulin antibody(TgAb) Thyroid peroxidase antibody(TPO-Ab) First trimester Risk factor Forecasting |
| 基金项目:河南省医学科技攻关计划联合共建项目( LHGJ20200456) |
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| 中文摘要: |
| 目的探讨孕早期甲状腺功能指标对孕妇妊娠期糖尿病(GDM)的临床价值。方法选取 2021年 3月至 2022年 9月周口市妇幼保健院孕检孕妇 195例为研究对象，于妊娠 8～12周行甲状腺功能检查，于妊娠 24～25周行 75 g葡萄糖耐量测试(OGTT)检查，依据 OGTT结果分为 GDM组、对照组(孕妇糖耐量正常)。收集孕妇一般资料，检测血清甲状腺功能指标［促甲状腺素(TSH)、游离三碘甲状腺原氨酸( FT3)、游离甲状腺素( FT4)、甲状腺球蛋白抗体( TG-Ab)、甲状腺过氧化物酶抗体( TPO-Ab)］水平。对上述临床资料进行单因素分析，将差异有统计学意义的指标纳入 logistic回归模型，分析孕妇发生 GDM风险的影响因素，采用受试者操作特征曲线(ROC曲线)评估甲状腺功能指标对 GDM的临床效能。结果 GDM组血清 FT3(3.60±0.87)pmol/L、FT4(5.02±1.53)pmol/L低于对照组［( 4.54±1.02)pmol/L、(9.37±2.24)pmol/L］，血清 TSH(3.36±1.04)mU/L、TPO-Ab(4 892.52±1 221.62)IU/L、TG-Ab(3 841.65±1 011.54)IU/L及糖尿病家族史比例 45.95%(17/37)高于对照组［( 2.41±0.74)mU/L、(3 308.98±1 942.65)IU/L、(2 764.58±1 804.57)IU/L、24.05%(38/158)］。回归结果显示血清 TPO-Ab、TG-Ab、糖尿病家族史是 GDM发生的影响因素( P<0.05)； ROC曲线显示孕早期血清 TPO-Ab、TG-Ab及联合检测 GDM的 AUC 95%CI分别为 0.84(0.78，0.89)、 0.80(0.74， 0.86)、0.91(0.86，0.95)联合检测 GDM的价值更高。结论孕早期血清 TPO-Ab、TG-Ab是 GDM发生的影响因素，血清 TPO-Ab、 TG-Ab及联合检测一定程，度上可判断孕妇 GDM发生风险，联合检测 GDM的临床效能更高。 |
| 英文摘要: |
| Objective To investigate the clinic value of thyroid function indicators in early pregnancy for gestational diabetes melli-tus (GDM). Methods A total of 195 pregnant women, having a prenatal check-up in Zhoukou Maternal and Child Health Hospitalfrom March 2021 to September 2022, were selected as research subjects. Thyroid function test was performed at 8-12 weeks of gesta-tion and oral glucose (75 g) tolerance test (OGTT) was performed at 24-25 weeks of gestation. According to the OGTT results, they wereassigned to GDM group or control group (pregnant women with normal glucose tolerance). General data of pregnant women were collect-ed and serum thyroid function indicators [thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyro-globulin antibody (TG-Ab) and thyroid peroxidase antibody (TPO-Ab)] levels were detected. Univariate analysis was performed on theabove clinical data, and statistically significant indicators were incorporated into the Logistic regression model to analyze the influenc-ing factors for the risk of GDM in pregnant women. ROC curve was used to evaluate the clinic value of thyroid function indicators forGDM.Results In the GDM group, serum FT3 and FT4 levels were lower than those in the control group [serum FT3 level: (3.60±0.87) pmol/ L vs. (4.54±1.02) pmol/L, FT4 level: (5.02±1.53) pmol/L vs. (9.37±2.24) pmol/L]. Serum TSH, TPO-Ab, TG-Ab, and the proportion of patients with a family history of diabetes were higher than those in the control group [(3.36±1.04) mU/L vs. (2.41±0.74) mU/L, (4 892.52±1 221.62) IU/L vs. (3 308.98±1 942.65) IU/L, (3 841.65±1 011.54) IU/L vs. (2 764.58±1 804.57) IU/L, (45.95%, 17/37) vs. (24.05%, 38/158), re-spectively] (P < 0.05). Logistic regression results showed that serum TPO-Ab, TG-Ab, and family history of diabetes were the factors in-fluencing the occurrence of GDM (P < 0.05). ROC curve showed that the AUC 95%CI of serum TPO-Ab, TG-Ab and combined detec-tion of GDM in early pregnancy were 0.84 (0.78, 0.89), 0.80 (0.74, 0.86) and 0.91 (0.86, 0.95), respectively. The combined detectionvalue of GDM was higher.Conclusions Serum TPO-Ab and TG-Ab in early pregnancy are influencing factors for the occurrence of GDM. Serum TPO-Ab, TG-Ab and combined detection can judge the risk of GDM in pregnant women to a certain extent, and combineddetection of GDM has higher clinic efficacy. |
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