关注妊娠期母体甲状腺功能和糖代谢水平，探究二者是否存在双向关联

Are there bidirectional associations between maternal thyroid function and glucose metabolism in singleton live births? A birth cohort study

在单胎活产中，母体甲状腺功能和葡萄糖代谢之间是否存在双向关联？一项出生队列研究

Authors：Lu J, Zhu L, Guo Y, Hao X, Yan S, Tao F, Huang K.

Source： Diabetes Res Clin Pract. 2024 Feb 8:209:111569. 

DOI: 10.1016/j.diabres.2024.111569.

Abstract

Aims: To examine the associations between maternal thyroid function and glucose metabolism during pregnancy.

Methods: This study was based on Ma’ anshan Birth Cohort in China. Totally 2375 pregnant women were included in data analysis. Maternal thyroid-stimulating hormone (TSH), free thyroxine (FT₄), thyroid peroxidase antibody (TPOAb) and fasting plasma glucose (FPG) levels during the first, second and third trimesters of pregnancy were measured retrospectively. Mplus 8.0 was used to construct a cross-lagged panel model to examine the potential bidirectional association between thyroid function and FPG levels throughout pregnancy.

Results: FT₄ levels were positively correlated with FPG levels in the first trimester and negatively correlated with FPG levels in the second trimester. TSH levels were negatively associated with FPG levels in the second trimester, and in the first trimester, it could positively predict FPG levels in the second trimester. No significant association was found between TPOAb levels and FPG levels during pregnancy.

Conclusions: There was a non-bidirectional association between maternal thyroid function and glucose metabolism during pregnancy. FT₄ and TSH levels influence FPG concentrations in the first and second trimesters of pregnancy.

Keywords: Pregnant women; Thyroid function; Fasting plasma glucose; Cross-lagged panel models

摘要

背景：研究妊娠期母体甲状腺功能与糖代谢之间的关联。

方法：本研究以中国马鞍山出生队列为基础。共有2375名孕妇被纳入数据分析。研究人员回顾性测定孕妇在孕早、中、晚期母体促甲状腺激素（TSH）、游离甲状腺素（FT₄）、甲状腺过氧化物酶抗体（TPOAb）和空腹血浆葡萄糖（FPG）水平。Mplus 8.0用于构建交叉滞后面板模型，以检查整个妊娠期甲状腺功能和FPG水平之间的潜在双向关联。

结果：在妊娠早期，FT₄水平与FPG水平呈正相关；在妊娠中期与FPG水平呈负相关。在妊娠中期，TSH水平与FPG水平呈负相关；在妊娠早期，它可以积极预测妊娠中期的FPG水平。未发现妊娠期TPOAb水平和FPG水平存在显著相关性。

结论：妊娠期孕妇甲状腺功能与糖代谢之间存在非双向关联。FT₄和TSH水平影响妊娠早期和中期FPG浓度。

关键词：孕妇；甲状腺功能；空腹血浆血糖；交叉滞后面板模型