Influence of subclinical hypothyroidism complicating gestational diabetes mellitus on biochemical parameters and pregnancy outcome

Abstract

Objective To investigate the clinical detection and significance of biochemical markers in pregnant women with subclinical hypothyroidism (SCH) complicating gestational diabetes mellitus (GDM) . Methods 132 pregnant women with SCH were collected. According to whether the women combined with GDM, the women were divided into a simple SCH group (n=78) and an SCH combined with GDM group (n=54). 50 normal pregnant women with the same age and gestational weeks were collected as a control group. The TSH, blood lipid indicators, inflammatory indicators, coagulation indicators, and adverse pregnancy outcomes were compared among the three groups. Results The levels of TSH, TC, TG, LDL-C, hs-CRP, IL-6, TNF-α, and FIB were (6.1±1.7) mIU/L, (5.6±0.6) mmol/L, (3.4±0.3) mmol/L, (3.4±0.4) mmol/L, (1.9±0.2) mmol/L, (5.9±2.2) μg/L, ( 79.5±20.3) μg/L, and (39.2±20.1) μg/L in the simple SCH group and were (10.6±3.4) mIU/L, (6.0±0.9) mmol/L, (3.7±0.4) mmol/L, (3.9±0.5) mmol/L, (2.0±0.4) mmol/L, (9.0±3.6) μg/L, (98.4±15.1) μg/L, and (53.4±21.6) μg/L in the SCH combined with GDM group (P<0.05) , respectively, which were significantly higher than those in control group [ (2.1±1.0) mIU/L, (5.2±0.8) mmol/L, (3.1±0.2) mmol/L, (2.9±0.2) mmol/L, (1.9±0.1) mmol/L, (2.7±1.5) μg/L, (60.2±18.4) μg/L, (27.5±13.8) μg/L] (all P<0.05) . The AT Ⅲ level was (82.0±7.4) % in the simple SCH group, (76.2±6.2) % in the SCH combined with GDM group, and (87.4±8.6) % in control group (all P<0.05) . The incidences of preterm labor, gestational hypertension, preeclampsia, placental abruption, fetal growth restriction, and low birth weight infants were 11.5%, 14.1%, 16.7%, 10.3%, 14.1%, and 15.4% in the simple SCH group, were 18.5%, 22.2%, 27.8%, 22.2%, 29.6%, and 27.8% in the SCH combined with GDM group, and were 2.0%, 4.0%, 2.0%, 4.0%, 2.0%, and 4.0% in the control group (all P<0.05) . Conclusion pregnant women with SCH combining GDM have obvious lipid metabolism, blood clotting, and fibrinolytic system dysfunctions; their body are in state of chronic inflammation; their risk of adverse pregnancy outcomes is higher; so we should strengthen the maternal thyroid function, lipid metabolism and coagulation function monitoring, and targeted intervention, in order to reduce the occurrence of adverse pregnancy outcomes. Key words: Subclinical hypothyroidism; Gestational diabetes mellitus; Pregnancy outcome; Lipid metabolism