Higher prevalence of gestational diabetes in euthyroid women with thyroid autoimmunity who were expecting a female foetus.

IF 3.5 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

European Thyroid Journal Pub Date : 2025-01-01 DOI:10.1530/ETJ-24-0339

Madhu Prasai, Manon Lomré, Emna Jelloul, Pierre Kleynen, Flora Veltri, Georgiana Sitoris, Lidia Grabczan, Serge Rozenberg, Kris G Poppe

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Abstract

Objective: In the general population, women pregnant with a male foetus (MF) have a higher prevalence of gestational diabetes mellitus (GDM) compared with those pregnant with a female foetus (FF). Some studies suggest a higher prevalence of GDM in euthyroid pregnant women with thyroid autoimmunity (TAI+) compared with women without TAI (TAI-). However, whether the impact of TAI on GDM correlates with foetal gender has not been documented.

Design/methods: A single centre cohort study including 1201 women screened at median 12 (11-14) weeks of pregnancy for thyroid disorders (TSH, free T4 (FT4), TPOAb,) and at 24-28 weeks for GDM with an oral glucose tolerance test. Exclusion criteria were pre-pregnancy diabetes or hypertension, thyroid dysfunction (treated or untreated) before and after screening, thyroid screening after 20 weeks of pregnancy, and assisted pregnancies. The diagnosis of GDM was based diagnosed according on the 2013 WHO criteria, and that of TAI by increased TPOAb levels (≥ 60 kIU/L).

Results: Overall, 622 women were expecting a FF (51.8%) and 579 a MF (48.2%). Seventy-five women were TAI+ (6.2%). The overall prevalence of GDM was 19.6%, 28% in TAI+ women and 19% in TAI- women (p = 0.008 after adjustment for confounders). In women who were expecting a FF, the prevalence of GDM was 34.4% in TAI+ women vs 19.2 % in TAI- women; p = 0.002.

Conclusions: The prevalence of GDM was increased in euthyroid TAI+ women, but only in the case of pregnancies with a FF. This is opposite to the result observed in the general population and deserves more research to explore the underlying mechanisms.

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目的：在普通人群中，怀有男胎（MF）的妇女与怀有女胎（FF）的妇女相比，妊娠糖尿病（GDM）的发病率更高。一些研究表明，与无甲状腺自身免疫（TAI-）的孕妇相比，甲状腺自身免疫（TAI+）的甲状腺功能正常孕妇的妊娠糖尿病发病率更高。然而，TAI对GDM的影响是否与胎儿性别相关尚未有文献记载：单中心队列研究，包括在妊娠中位 12（11-14）周筛查甲状腺疾病（TSH、游离 T4 (FT4)、TPOAb）和在妊娠 24-28 周通过口服葡萄糖耐量试验筛查 GDM 的 1201 名妇女。排除标准包括孕前糖尿病或高血压、筛查前后的甲状腺功能障碍（治疗或未治疗）、怀孕 20 周后的甲状腺筛查以及助孕。GDM的诊断依据是2013年世界卫生组织标准，TAI的诊断依据是TPOAb水平升高（≥ 60 kIU/L）：总计有 622 名女性（51.8%）和 579 名女性（48.2%）怀有先兆流产（FF）。75名妇女为TAI+（6.2%）。GDM的总发病率为19.6%，TAI+妇女为28%，TAI-妇女为19%（调整混杂因素后，P = 0.008）。在怀有 FF 的妇女中，TAI+ 妇女的 GDM 患病率为 34.4%，而 TAI- 妇女的患病率为 19.2%；P = 0.002：甲状腺功能正常的TAI+女性的GDM患病率增加，但仅限于妊娠FF的情况。这与在普通人群中观察到的结果相反，值得进行更多的研究来探索其背后的机制。

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来源期刊

European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.70

自引率

2.10%

发文量

156

期刊介绍： The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.