부산대학교 도서관

Objective: The upper limit of thyroid stimulating hormone (TSH) in early pregnancy was changed from 2.5 uIU/mL to 4.0 uIU/mL according to the guidelines of ATA about diagnosis and management of thyroid disease during pregnancy and the postpartum in 2017, compared with that in 2011. The purpose of this study was to investigate the relationship between gestational diabetes mellitus and gestational subclinical hypothyroidism diagnosed with the different TSH cut point 2.5 uIU/mL and 4uIU/mL Methods: A total of 284 single fetus pregnant women were enrolled from October 2015 to July 2016 in Peking University International Hospital, of which 17 pregnant women were excluded because of diabetes mellitus in pregnancy or IGT before pregnancy or abnormal thyroid function before pregnancy. 203 women met the inclusion criteria, including 203 women with normal blood glucose (NBG) and 64 women with gestational diabetes mellitus (GDM) who were diagnosed with the criteria of International Association of Diabetic Pregnancy Study Group. The data of pregnant women such as height, weight, age, thyroid function, etc were collected at 7-12 weeks of gestation Results: In GDM group, fasting blood glucose, body weight, body mass index and uric acid is much higher, high density lipoprotein cholesterol is much lower than that in NBG group, there was a significant difference between the two groups (P < 0.05). Whether GDM or not was used as dependent variable, and age, BMI, fasting blood glucose, uric acid, high density lipoprotein cholesterol, subclinical hypothyroidism were used as independent variables, and then the results of multiple logistic regression showed that the women with TSH > 4 uIU/mL in early pregnancy have a higher risk of GDM (P = 0.03, OR = 3.96, 95%CL:1.13-13.89). However, the women with TSH > 2.5 uIU/mL in early pregnancy did not increase the risk of gestational diabetes mellitus (P = 0.085) Conclusion: The results of this study indicated that pregnant women with TSH > 4 uIU/mL in early pregnancy may have a higher risk of gestational diabetes mellitus.