The impact of insulin resistance on thyroid function and the prevalence of thyroid follicular nodular disease in pregnant women.

IF 3.5 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

European Thyroid Journal Pub Date : 2025-04-03 Print Date: 2025-04-01 DOI:10.1530/ETJ-24-0317

Andrzej Nowak, Jacek Podlewski, Alicja Hubalewska-Dydejczyk, Małgorzata Trofimiuk-Müldner

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Abstract

Introduction: Insulin resistance (IR) is a phenomenon commonly observed in pregnancy. Increased insulin concentrations might impact thyroid function and structure during gestation.

Objectives: This study investigates the bidirectional relationship between IR indices and thyroid function and morphology in pregnant women.

Methods: In 1,069 gravid participants of the Polish National Programme for Elimination of Iodine Deficiency (2007-2017), blood samples were analyzed for thyroid-stimulating hormone (TSH), FT3, FT4, aTPO, fasting glucose and insulin concentrations, and the thyroid structure was assessed with ultrasound (in 1,065 subjects). Based on calculated homeostatic model assessment of insulin resistance (HOMA-IR) values, participants were stratified into two subgroups: HOMA-nl (HOMA-IR <2.5) and HOMA-h (HOMA-IR ≥2.5), comprising 894 and 175 women, respectively.

Results: Significant difference in mean TSH (1.77 ± 1.17 vs 1.96 ± 1.04; P = 0.008) and mean FT4 (12.65 ± 2.3 vs 11.47 ± 1.9; P = 0.001) concentrations between HOMA-nl and HOMA-h groups was found. The subgroups did not differ in thyroid nodularity or multinodular goiter prevalence. HOMA-IR positively correlated with TSH concentrations, BMI and thyroid volume. Serum FT3 and FT4 concentrations showed negative correlations with HOMA-IR.

Conclusions: IR seems to affect the thyroid function of gravid women by diminishing the ability to respond to increased thyroid hormone demand. Thyroid volume increase during pregnancy may be influenced by IR; however, its short-term effect on thyroid nodularity appears to be negligible.

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胰岛素抵抗对孕妇甲状腺功能和甲状腺滤泡结节病患病率的影响

胰岛素抵抗（Insulin resistance， IR）是妊娠期常见的一种现象。妊娠期胰岛素浓度升高可能影响甲状腺功能和结构。目的：探讨IR指数与孕妇甲状腺功能及形态的双向关系。方法：对波兰国家消除碘缺乏症计划（2007-2017）的1069名孕妇进行血液样本分析，检测TSH、FT3、FT4、aTPO、空腹血糖和胰岛素浓度，并对1065名受试者进行甲状腺结构超声评估。根据计算的胰岛素抵抗稳态模型评估（HOMA-IR）值，参与者被分为两个亚组：HOMA-nl (HOMA-IR结果：平均TSH有显著差异(1.77±1.17 vs 1.96±1.04；P=0.008)，平均FT4(12.65±2.3 vs 11.47±1.9；P=0.001)， HOMA-nl组和HOMA-h组之间存在差异。亚组在甲状腺结节性或多结节性甲状腺肿患病率上没有差异。HOMA-IR与TSH浓度、BMI和甲状腺体积呈正相关。血清FT3和FT4浓度与HOMA-IR呈负相关。结论：IR似乎通过降低对甲状腺激素（TH）需求增加的反应能力来影响妊娠妇女的甲状腺功能。妊娠期间甲状腺体积的增加可能受到IR的影响，然而，其对甲状腺结节的短期影响似乎可以忽略不计。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.