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
Andrzej Nowak, Jacek Podlewski, Alicja Hubalewska-Dydejczyk, Małgorzata Trofimiuk-Müldner
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引用次数: 0

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 1069 gravid participants of the Polish National Programme for Elimination of Iodine Deficiency (2007-2017), blood samples were analyzed for TSH, FT3, FT4, aTPO, fasting glucose, and insulin concentrations, and the thyroid structure was assessed with ultrasound (in 1065 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 hormones (TH) 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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来源期刊
European Thyroid Journal
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.
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