[1]乔艳花,张丹丹,王倩.妊娠糖尿病与甲状腺自身免疫的相关性研究[J].国际内分泌代谢杂志,2015,(04):242-245.[doi:10.3760/cma.j.issn.1673-4157.2015.04.007]
　Qiao Yanhua,Zhang Dandan,Wang Qian..Relationship between gestational diabetes and thyroid autoimmunity[J].International Journal of Endocrinology and Metabolism,2015,(04):242-245.[doi:10.3760/cma.j.issn.1673-4157.2015.04.007]
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妊娠糖尿病与甲状腺自身免疫的相关性研究()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
期数:
2015年04
页码:
242-245
栏目:
短篇论著
出版日期:
2015-07-20

文章信息/Info

Title:
Relationship between gestational diabetes and thyroid autoimmunity
作者:
乔艳花; 张丹丹; 王倩
510630　广州，南方医科大学第三附属医院内分泌代谢科
Author(s):
Qiao Yanhua; Zhang Dandan;  Wang Qian.
Department of Obstetrics，Tianjin Hexi Gynecology and Obstetrics Hospital，Tianjin 300202，China
关键词:
妊娠糖尿病; 甲状腺功能; 自身免疫; 抗体
Keywords:
Gestational diabetes mellitus; Thyroid function; Autoimmunity; Antibody
DOI:
10.3760/cma.j.issn.1673-4157.2015.04.007
摘要:
目的　研究妊娠糖尿病与甲状腺功能异常及甲状腺自身抗体阳性的相关性。方法　选取妊娠糖尿病患者共80例作为妊娠糖尿病组，另外选择糖耐量正常孕妇36名作为正常对照组。同时选择产后18～120个月曾诊断为妊娠糖尿病者作为曾患妊娠糖尿病组（36例），并以产后18~96个月的正常妊娠者28名作为随访对照组。检测4组受试者空腹血糖、餐后 2 h血糖、游离T4、促甲状腺激素（TSH）、血脂水平，以及谷氨酸脱羧酶65（GAD65）抗体、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TgAb）。曾患妊娠糖尿病组根据甲状腺自身抗体情况分为甲状腺自身抗体阳性组与阴性组，统计两个亚组糖代谢异常的发生情况。结果　妊娠糖尿病组空腹血糖、餐后2 h血糖高于其他组（P均 ＜0.05），4组间血脂水平差异没有统计学意义（P均＞0.05）。与正常对照组相比，妊娠糖尿病组游离T4、TSH水平差异均没有统计学意义（P 均＞0.05）。妊娠糖尿病组GAD65抗体阳性者有4例，曾患妊娠糖尿病组有3例。分别与正常对照组及随访对照组相比，妊娠糖尿病组及曾患妊娠糖尿病组TPOAb、TgAb阳性发生率均增加（χ2=7.459，P ＜0.05）。曾患妊娠糖尿病组总体TSH水平异常的发生率、同时存在TSH水平异常及甲状腺自身抗体阳性的发生率显著高于其他3组（χ2=5.925，8.766，P 均＜0.05）。曾患妊娠糖尿病组47.2%（17/36）在随访时发生高血糖，甲状腺抗体阳性组60.0%（6/10）出现糖代谢异常，而甲状腺抗体阴性组42.3%（11/26）有糖代谢异常，但两组间差异没有统计学意义（P ＞0.05）。 结论　产后甲状腺自身免疫与糖代谢受损无关。妊娠糖尿病可能是发生甲状腺自身免疫异常的危险因素。
Abstract:
Objective　To investigate the relationship between thyroid dysfunction，positive thyroid autoimmune antibodies and gestational diabetes. Methods　Eighty patients with gestational diabetes were chosen as gestational diabetes group，while 36 pregnant women with normal glucose tolerance were chosen as normal control group. In addition，36 women who had delivered a baby and diagnosed with gestational diabetes 18-120 months prior to this investigation （previous gestational diabetes group） and 28 women who had delivered a baby 18-96 months prior to this investigation with normal pregnancy （follow-up control group） were chosen. Fasting blood glucose， postprandial 2 h blood glucose，free T4，thyroid-stimulating hormone（TSH），blood lipids，glutamic-acid decarboxylase（GAD）65 antibody，thyroid peroxidase antibody（TPOAb） and thyroid globulin antibody （TgAb） were tested. According to thyroid antibody，previous gestational diabetes group was divided into two sub-groups：positive thyroid antibody group and negative thyroid antibody group，and the incidence of abnormal glucose metabolism in both groups were analyzed. Results　Fasting blood glucose and postprandial 2 h blood glucose in gestational diabetes group were higher than those in other three groups（all P ＜0.05）. Blood lipid level was not different between four groups （all P ＞0.05）. Compared with normal control group， the differences of free T4 and TSH in gestational diabetes group were not significant（all P ＞0.05）. There were 4 patients with positive GAD65 antibody in gestational diabetes group，and 3 patients in previous gestational diabetes group. Compared with normal control group and follow-up control group，positive rates of TPOAb，TgAb in gestational diabetes group and previous gestational group were all increased（χ2=7.459， P＜0.05）. Incidence of abnormal TSH，both abnormal TSH and thyroid autoimmunity in previous gestational diabetes group were higher than those in other three groups （χ2=5.925， 8.766， all P＜0.05）. Hyperglycemia developed in 47.2% （17/36） patients in previous gestational diabetes group and 60.0%（6/10） individuals in positive thyroid antibody group，and 42.3%（11/26） individuals in negative thyroid antibody group had impaired glucose metabolism，but there was no significant difference between both groups（P ＞0.05）. Conclusion　Thyroid autoimmunity is not associated with impaired glucose metabolism after delivery. Gestational diabetes may be a risk factor for the dysfunction of thyroid autoimmunity.

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更新日期/Last Update: 2015-07-20