Abstract
Aims: Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus.
Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Methods: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Results: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.Keywords: Thyroid diseases, gestational, diabetes, pregnant women, glucose tolerance test, thyroid peroxidase.
[1]
Schneider S, Bock C, Wetzel M, Maul H, Loerbrock A. The prevalence of gestational diabetes in advanced economies. 2012.
[http://dx.doi.org/10.1515/jpm-2012-0015]
[http://dx.doi.org/10.1515/jpm-2012-0015]
[2]
Tutino GE, Tam WH, Yang X, Chan JC, Lao TT, Ma RC. Diabetes and pregnancy: perspectives from Asia. Diabet Med 2014; 31(3): 302-18.
[http://dx.doi.org/10.1111/dme.12396] [PMID: 24417604]
[http://dx.doi.org/10.1111/dme.12396] [PMID: 24417604]
[3]
Shahbazian HB, Shahbazian N, Yarahmadi M, Saiedi S. Prevalence of gestational diabetes mellitus in pregnant women referring to gynecology and obstetrics clinics 2012.
[4]
Larijani B, Hossein-nezhad A, Rizvi SW, Munir S, Vassigh A-R. Cost analysis of different screening strategies for gestational diabetes mellitus. Endocr Pract 2003; 9(6): 504-9.
[http://dx.doi.org/10.4158/EP.9.6.504] [PMID: 14715477]
[http://dx.doi.org/10.4158/EP.9.6.504] [PMID: 14715477]
[5]
Hadaegh F, Kheyr AM, Rahimi S, Touhidi M. Prevalence of gestational diabetes in pregnant women of Bandar Abbas. 2004.
[7]
Philips JC, Emonts P, Pintiaux A, Kirkpatrick C, Scheen AJ. [Management of gestational diabetes]. Rev Med Liege 2013; 68(9): 489-96.
[PMID: 24180206]
[PMID: 24180206]
[8]
Bellamy L, Casas J-P, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet 2009; 373(9677): 1773-9.
[http://dx.doi.org/10.1016/S0140-6736(09)60731-5] [PMID: 19465232]
[http://dx.doi.org/10.1016/S0140-6736(09)60731-5] [PMID: 19465232]
[9]
Nerenberg K, Daskalopoulou SS, Dasgupta K. Gestational diabetes and hypertensive disorders of pregnancy as vascular risk signals: an overview and grading of the evidence. Can J Cardiol 2014; 30(7): 765-73.
[http://dx.doi.org/10.1016/j.cjca.2013.12.030] [PMID: 24726053]
[http://dx.doi.org/10.1016/j.cjca.2013.12.030] [PMID: 24726053]
[10]
Vandana Kumar A, Khatuja R, Mehta S. Thyroid dysfunction during pregnancy and in postpartum period: treatment and latest recommendations. Arch Gynecol Obstet 2014; 289(5): 1137-44.
[http://dx.doi.org/10.1007/s00404-014-3159-y] [PMID: 24510157]
[http://dx.doi.org/10.1007/s00404-014-3159-y] [PMID: 24510157]
[11]
Ong GS, Hadlow NC, Brown SJ, Lim EM, Walsh JP. Does the thyroid-stimulating hormone measured concurrently with first trimester biochemical screening tests predict adverse pregnancy outcomes occurring after 20 weeks gestation? J Clin Endocrinol Metab 2014; 99(12): E2668-72.
[http://dx.doi.org/10.1210/jc.2014-1918] [PMID: 25226292]
[http://dx.doi.org/10.1210/jc.2014-1918] [PMID: 25226292]
[12]
Bloomgarden ZT. Abnormal thyroid function during pregnancy. 2003. Available from:. http://www.medscape.com/viewarticle/458428
[13]
Catalano PM. Trying to understand gestational diabetes. Diabet Med 2014; 31(3): 273-81.
[http://dx.doi.org/10.1111/dme.12381] [PMID: 24341419]
[http://dx.doi.org/10.1111/dme.12381] [PMID: 24341419]
[14]
Bitterman O, Bongiovanni M, Giuliani C, Roma G, Toscano V, Napoli A. Anti thyroperoxidase and anti thyroglobulin antibodies in diabetic pregnancies. J Endocrinol Invest 2014; 37(10): 911-5.
[http://dx.doi.org/10.1007/s40618-014-0087-4] [PMID: 24947178]
[http://dx.doi.org/10.1007/s40618-014-0087-4] [PMID: 24947178]
[15]
Wang C, Luo LF, Zhou GD. Calculation of the equivalent circuit of a rectifier transformer with additional filtering and power-compensating winding Hunan Daxue Xuebao/ J Hunan University. Natural Sciences 2014; 41(10): 67-70.
[16]
Kang SY, Wang Y, Wu L. The study of thyroid function and pregnancy outcomes in pregnant women with gestational diabetes mellitus. Prog Obstet Gynecol 2014; 23: 50-2.
[17]
Oguz A, Tuzun D, Sahin M, et al. Frequency of isolated maternal hypothyroxinemia in women with gestational diabetes mellitus in a moderately iodine-deficient area. Gynecol Endocrinol 2015; 31(10): 792-5.
[http://dx.doi.org/10.3109/09513590.2015.1054801] [PMID: 26190538]
[http://dx.doi.org/10.3109/09513590.2015.1054801] [PMID: 26190538]
[18]
Care D. American Diabetes Association. 8. Obesity management for the treatment of type 2 diabetes: standards of medical care in diabetes-2019. Diabetes Care 2019; 42(Suppl. 1): S81-9.
[http://dx.doi.org/10.2337/dc19-S008] [PMID: 30559234]
[http://dx.doi.org/10.2337/dc19-S008] [PMID: 30559234]
[19]
Alexander EK, Pearce EN, Brent GA, et al. Guidelines for the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2017; 27(3): 315-89.
[http://dx.doi.org/10.1089/thy.2016.0457] [PMID: 28056690]
[http://dx.doi.org/10.1089/thy.2016.0457] [PMID: 28056690]
[20]
Soldin OP. Thyroid function testing in pregnancy and thyroid disease: trimester-specific reference intervals. Ther Drug Monit 2006; 28(1): 8-11.
[http://dx.doi.org/10.1097/01.ftd.0000194498.32398.7b] [PMID: 16418685]
[http://dx.doi.org/10.1097/01.ftd.0000194498.32398.7b] [PMID: 16418685]
[21]
Agarwal MM, Dhatt GS, Punnose J, Bishawi B, Zayed R. Thyroid function abnormalities and antithyroid antibody prevalence in pregnant women at high risk for gestational diabetes mellitus. Gynecol Endocrinol 2006; 22(5): 261-6.
[http://dx.doi.org/10.1080/09513590600630470] [PMID: 16785147]
[http://dx.doi.org/10.1080/09513590600630470] [PMID: 16785147]
[22]
Velkoska Nakova V, Krstevska B, Dimitrovsky C, Simeonova S, Hadzi-Lega M, Serafimoski V. Prevalence of thyroid dysfunction and autoimmunity in pregnant women with gestational and diabetic type 1. Contributions Sec Biol Med Sci, MASA, XXXI, 2 p 51-59 (2010) 2010; 31(2): 51-9.
.
[23]
Iranparvar M, Ghorbani H, Azami A, Darvishkhah H. Thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus: a cross-sectional study. Int J Adv Med 2015; 2(4): 350.
[http://dx.doi.org/10.18203/2349-3933.ijam20151007]
[http://dx.doi.org/10.18203/2349-3933.ijam20151007]
[24]
Shahbazian H, Shahbazian N, Rahimi Baniani M, Yazdanpanah L, Latifi SM. Evaluation of thyroid dysfunction in pregnant women with gestational and pre-gestational diabetes. Pak J Med Sci 2013; 29(2): 638-41.
[http://dx.doi.org/10.12669/pjms.292.2862] [PMID: 24353594]
[http://dx.doi.org/10.12669/pjms.292.2862] [PMID: 24353594]
[25]
Maleki N, Tavosi Z. Evaluation of thyroid dysfunction and autoimmunity in gestational diabetes mellitus and its relationship with postpartum thyroiditis. Diabet Med 2015; 32(2): 206-12.
[http://dx.doi.org/10.1111/dme.12580] [PMID: 25186500]
[http://dx.doi.org/10.1111/dme.12580] [PMID: 25186500]
[26]
Werner SC, Ingbar SH, Braverman LE, Utiger RD. Werner & Ingbar’s thyroid: a fundamental and clinical text. Lippincott Williams & Wilkins 2005.
[27]
van den Boogaard E, Vissenberg R, Land JA, et al. Significance of (sub)clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: a systematic review. Hum Reprod Update 2011; 17(5): 605-19.
[http://dx.doi.org/10.1093/humupd/dmr024] [PMID: 21622978]
[http://dx.doi.org/10.1093/humupd/dmr024] [PMID: 21622978]
[28]
Glinoer D. Thyroid function during pregnancy, ‘The thyroid’ 9thedition. Philadelphia: Lippincott Williams & Wilkins 2004; pp 1086-100.
[29]
Montaner P, Juan L, Campos R, Gil L, Corcoy R. Is thyroid autoimmunity associated with gestational diabetes mellitus? Metabolism 2008; 57(4): 522-5.
[http://dx.doi.org/10.1016/j.metabol.2007.11.015] [PMID: 18328355]
[http://dx.doi.org/10.1016/j.metabol.2007.11.015] [PMID: 18328355]
[30]
Olivieri A, Magnani F, Valensise H, et al. Thyroid autoimmunity in pregnant women at risk for GDM. Ann Ist Super Sanita 1997; 33(3): 447-50.
[PMID: 9542280]
[PMID: 9542280]
Article Metrics
25