Association of gestational diabetes mellitus and thyroid status during pregnancy: a cross-sectional study in a tertiary health care center of Bangladesh

Abstract

Objective

To find out any association between gestational diabetes mellitus (GDM) and thyroid status (TS) throughout pregnancy in Bangladesh.

Methodology

This study, designed as a cross-sectional study, was performed on randomly chosen 628 patients attending the Ad-Din Women's Medical College antenatal service from January 1 2019 to December 31 2019. After taking a detailed history, oral glucose tolerance test was done for all the participants. If eligible, then thyroid-stimulating hormone (TSH) and free thyroxine (F.T4) tests were done. t-test and Chi-square test were used to compare variables between various classes as necessary.

Results

The mean gestational age in GDM and non-GDM groups was 20.5 ± 9.1 years and 17.5 ± 9.2 years, which were significantly different (p<.001). There was a substantial (p<.001) high incidence of thyroid disorder (TD) in the non-GDM community. Mean F.T4 of the GDM group was lower in all three trimesters. The mean TSH of the GDM group was more deficient in the early stage of pregnancy but higher in the later stage (3rd trimester). Euthyroid cases were significantly higher (83.8%; p<.001) while subclinical hypothyroidism (9.5%; p<.001) and transient hyperthyroidism (2.4%; p<.001) cases were significantly lower in GDM group.

Conclusions

Even though GDM and TD are the most prevalent endocrine disorders during pregnancy, neither TS during pregnancy nor any risk factors for TD have been associated with the development of GDM.

摘要

目的：了解孟加拉国女性整个孕期妊娠期糖尿病(GDM)和甲状腺状况(TS)之间的关系。

方法：本研究为横断面研究, 随机选择2019年1月1日至2019年12月31日在Ad-Din女子医学院进行产前检查的628例患者。在详细记录病史后, 对所有参与者进行口服葡萄糖耐量试验。符合入组条件的女性进行促甲状腺激素(TSH)和游离甲状腺素(F.T4)检测。根据需要应用t检验和卡方检验对各种类别之间的变量进行比较。

结果：GDM组和非GDM组的平均妊娠年龄分别为20.5±9.1岁和17.5±9.2岁, 差异有统计学意义（p <.001）。在非妊娠期糖尿病人群中, 甲状腺疾病(TD)的发病率显著升高(p<0.001)。妊娠期糖尿病组的平均F.T4在孕期三个时段中都较低。GDM组的平均TSH在妊娠早期较低, 而在妊娠晚期（第3个妊娠时段）较高。GDM组甲状腺功能正常病例显著升高 (83.8%；p<0.001), 亚临床甲状腺功能减退(9.5%；p<0.001)和一过性甲状腺功能亢进(2.4%；p<0.001)明显降低。

结论：尽管妊娠期糖尿病和TD是妊娠期最常见的内分泌疾病, 但妊娠期TS和TD的任何危险因素都与GDM的发生无关。

Keywords:

• Gestational diabetes mellitus
• thyroid status
• thyroid diseases
• pregnancy
• bangladesh

Disclosure statement

The authors declare no conflict of interest regarding the publication of this article.