Research Article
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Year 2023, Volume: 36 Issue: 2, 230 - 234, 31.05.2023
https://doi.org/10.5472/marumj.1302525

Abstract

References

  • [1] Mack LR, Tomich PG. Gestational Diabetes: Diagnosis, Classification, and Clinical Care. Obstet Gynecol Clin North Am 2017;44:207-17. doi: 10.1016/j.ogc.2017.02.002
  • [2] Alfadhli EM. Gestational diabetes mellitus. Saudi Med J 2015;36:399-406. doi: 10.15537/smj.2015.4.10307
  • [3] Zhang C, Rawal S, Chong YS. Risk factors for gestational diabetes: is prevention possible? Diabetologia 2016;59:1385- 90. doi: 10.1007/s00125.016.3979-3
  • [4] Giannakou K, Evangelou E, Yiallouros P, et al. Risk factors for gestational diabetes: An umbrella review of meta-analyses of observational studies. PLoS One 2019 ;14:e0215372. doi: 10.1371/journal.pone.0215372
  • [5] Maraka S, Ospina NM, O’Keeffe DT, et al. Subclinical hypothyroidism in pregnancy: a systematic review and metaanalysis. Thyroid 2016;26:580-90. doi: 10.1089/thy.2015.0418
  • [6] Tudela CM, Casey BM, McIntire DD, Cunningham FG. Relationship of subclinical thyroid disease to the incidence of gestational diabetes. Obstet Gynecol 2012 ;119:983-8. doi: 10.1097/AOG.0b013e318250aeeb.
  • [7] Chen LM, Du WJ, Dai J, et al. Effects of subclinical hypothyroidism on maternal and perinatal outcomes during pregnancy: a single-center cohort study of a Chinese population. PloS One 2014;9:e109364. doi:10.1371/journal. pone.0109364
  • [8] Nelson DB, Casey BM, McIntire DD, Cunningham FG. Subsequent pregnancy outcomes in women previously diagnosed with subclinical hypothyroidism. Am J Perinatol. 2014;31:77-84. doi: 10.1055/s-0033.133.4457.
  • [9] [Guideline] American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020;43 (Suppl 1): S14-S31.
  • [10] Cleary-Goldman J, Malone FD, Lambert-Messerlian G, et al. Maternal thyroid hypofunction, and pregnancy outcome. Obstet. Gynecol 2008;112:85-92. doi:10.1097/ AOG.0b013e3181788dd7
  • [11] Stagnaro-Green A, Abalovich M, Alexander E, et al. American Thyroid Association Taskforce on Thyroid Disease During Pregnancy and Postpartum. Guidelines of the American Thyroid Association for diagnosing and managing thyroid disease during pregnancy and postpartum. Thyroid 2011;21:1081-125. doi: 10.1089/thy.2011.0087
  • [12] Alexander EK, Pearce EN, Brent GA, et al. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid 2017;27:315-89. doi: 10.1089/ thy.2016.0457
  • [13] Veltri F, Belhomme J, Kleynen P, et al. Maternal thyroid parameters in pregnant women with different ethnic backgrounds: Do ethnicity-specific reference ranges improve the diagnosis of subclinical hypothyroidism? Clin Endocrinol (Oxf) 2017 ;86:830-6. doi: 10.1111/ cen.13340
  • [14] Bestwick JP, John R, Maina A, et al. Thyroid stimulating hormone and free thyroxine in pregnancy: expressing concentrations as multiples of the median (MoMs). Clin Chim Acta 2014;430:33-7. doi: 10.1016/j.cca.2013.12.030
  • [15] Cotzias C, Wong SJ, Taylor E, Seed P, Girling J. A. A study to establish gestation-specific reference intervals for thyroid function tests in normal singleton pregnancy. Eur J Obstet Gynecol Reprod Biol 2008;137:61-6. doi: 10.1016/j. ejogrb.2007.10.007
  • [16] Springer D, Bartos V, Zima T. Reference intervals for thyroid markers in early pregnancy determined by 7 different analytical systems. Scand J Clin Lab Invest 2014;74:95-101. doi: 10.3109/00365.513.2013.860617
  • [17] Lambadiari V, Mitrou P, Maratou E, et al. Thyroid hormones are positively associated with insulin resistance early in the development of type 2 diabetes. Endocrine 2011;39:28-32. https://doi: 10.1007/s12020.010.9408-3
  • [18] Toulis KA, Stagnaro-Green A, Negro R. Maternal subclinical hypothyroidism and gestational diabetes mellitus: a metaanalysis. Endocr Pract 2014;20:703-14. doi: 10.4158/EP13440. RA
  • [19] Agarwal MM, Dhatt GS, Punnose J, Bishawi B, Zayed R. Thyroid function abnormalities and antithyroid antibody prevalence in pregnant women at high risk for gestational diabetes mellitus. Gynecol Endocrinol 2006;22:261-6. doi: 10.1080/095.135.90600630470
  • [20] Shahbazian H, Shahbazian N, Rahimi Baniani M, Yazdanpanah L, Latifi SM. Evaluation of thyroid dysfunction in pregnant women with gestational and pre-gestational diabetes. Pak J Med Sci 2013;29:638-41. doi: 10.12669/pjms.292.2862
  • [21] Ying H, Tang YP, Bao YR, et al. Maternal TSH level and TPOAb status in early pregnancy and their relationship to the risk of gestational diabetes mellitus. Endocrine 2016 ;54:742- 50. doi: 10.1007/s12020.016.1022-6
  • [22] Gong LL, Liu H, Liu LH. Relationship between hypothyroidism and the incidence of gestational diabetes: A meta-analysis. Taiwan J Obstet Gynecol 2016 ;55:171-5. doi: 10.1016/j. tjog.2016.02.004
  • [23] Yang S, Shi FT, Leung PC, Huang HF, Fan J. Low thyroid hormone in early pregnancy is associated with an increased risk of gestational diabetes mellitus. J Clin Endocrinol Metab 2016;101:4237-43. doi: 10.1210/jc.2016-1506
  • [24] Lee SY, Pearce EN. Assessment and treatment of thyroid disorders in pregnancy and the postpartum period. Nat Rev Endocrinol 2022;18:158-71. doi: 10.1038/s41574.021.00604-z.
  • [25] Gietka-Czernel M, Glinicki P. Subclinical hypothyroidism in pregnancy: controversies on diagnosis and treatment. Pol Arch Intern Med 2021; 131: 266-75. doi:10.20452/pamw.4482

Is subclinical hypothyroidism a risk factor for gestational diabetes mellitus?

Year 2023, Volume: 36 Issue: 2, 230 - 234, 31.05.2023
https://doi.org/10.5472/marumj.1302525

Abstract

Objective: Gestational diabetes mellitus is characterized by increased blood sugar that first appears during pregnancy. Multiple articles
have described a relationship between hypothyroidism/subclinical hypothyroidism (SCH) and a rise in the risk of concomitant
pregnancy complications, including gestational diabetes mellitus (GDM), but the effect of SCH on pregnancy is uncertain in the
literature. We clarified the contribution of SCH to GDM development.
Patients and Methods: We conducted a retrospective study. From the patient records, the first 250 pregnant women who applied to our
hospital for screening at 20-24 weeks and had glucose tolerance tests were included in our study. Retrospectively, all these pregnant
women’s first-trimester thyroid-stimulating hormone (TSH) levels were recorded. We created two groups according to the oral glucose
tolerance test (OGTT) results: a case group diagnosed with GDM and a control group with average blood glucose. Their first-trimester
TSH levels were compared between the two groups and defined whether they had euthyroid, subclinical hypothyroidism (TSH=2.5-
5.5mIU/L) or overt hypothyroidism (TSH >5.5).
Results: We diagnosed 37 of 191 patients (19.4%) with GDM. When we checked the case and control groups, the mean TSH of the
GDM group was 1.8 mIU/L, and the control group was 1.7 mIU/L, but the difference was not statistically significant (p=0.121). 24.32%
(n=9) of 37 pregnant women with GDM were diagnosed with subclinical hypothyroidism/hypothyroidism; this rate was as low as
14.93% (n=28) in the non-GDM group, but no statistical difference was found (p=0.21).
Conclusion: It can be predicted that other accompanying factors may be the primary determinant in the development of GDM rather
than subclinical hypothyroidism. Risk scales that include the first trimester TSH level should be established for the development of
GDM.

References

  • [1] Mack LR, Tomich PG. Gestational Diabetes: Diagnosis, Classification, and Clinical Care. Obstet Gynecol Clin North Am 2017;44:207-17. doi: 10.1016/j.ogc.2017.02.002
  • [2] Alfadhli EM. Gestational diabetes mellitus. Saudi Med J 2015;36:399-406. doi: 10.15537/smj.2015.4.10307
  • [3] Zhang C, Rawal S, Chong YS. Risk factors for gestational diabetes: is prevention possible? Diabetologia 2016;59:1385- 90. doi: 10.1007/s00125.016.3979-3
  • [4] Giannakou K, Evangelou E, Yiallouros P, et al. Risk factors for gestational diabetes: An umbrella review of meta-analyses of observational studies. PLoS One 2019 ;14:e0215372. doi: 10.1371/journal.pone.0215372
  • [5] Maraka S, Ospina NM, O’Keeffe DT, et al. Subclinical hypothyroidism in pregnancy: a systematic review and metaanalysis. Thyroid 2016;26:580-90. doi: 10.1089/thy.2015.0418
  • [6] Tudela CM, Casey BM, McIntire DD, Cunningham FG. Relationship of subclinical thyroid disease to the incidence of gestational diabetes. Obstet Gynecol 2012 ;119:983-8. doi: 10.1097/AOG.0b013e318250aeeb.
  • [7] Chen LM, Du WJ, Dai J, et al. Effects of subclinical hypothyroidism on maternal and perinatal outcomes during pregnancy: a single-center cohort study of a Chinese population. PloS One 2014;9:e109364. doi:10.1371/journal. pone.0109364
  • [8] Nelson DB, Casey BM, McIntire DD, Cunningham FG. Subsequent pregnancy outcomes in women previously diagnosed with subclinical hypothyroidism. Am J Perinatol. 2014;31:77-84. doi: 10.1055/s-0033.133.4457.
  • [9] [Guideline] American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020;43 (Suppl 1): S14-S31.
  • [10] Cleary-Goldman J, Malone FD, Lambert-Messerlian G, et al. Maternal thyroid hypofunction, and pregnancy outcome. Obstet. Gynecol 2008;112:85-92. doi:10.1097/ AOG.0b013e3181788dd7
  • [11] Stagnaro-Green A, Abalovich M, Alexander E, et al. American Thyroid Association Taskforce on Thyroid Disease During Pregnancy and Postpartum. Guidelines of the American Thyroid Association for diagnosing and managing thyroid disease during pregnancy and postpartum. Thyroid 2011;21:1081-125. doi: 10.1089/thy.2011.0087
  • [12] Alexander EK, Pearce EN, Brent GA, et al. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid 2017;27:315-89. doi: 10.1089/ thy.2016.0457
  • [13] Veltri F, Belhomme J, Kleynen P, et al. Maternal thyroid parameters in pregnant women with different ethnic backgrounds: Do ethnicity-specific reference ranges improve the diagnosis of subclinical hypothyroidism? Clin Endocrinol (Oxf) 2017 ;86:830-6. doi: 10.1111/ cen.13340
  • [14] Bestwick JP, John R, Maina A, et al. Thyroid stimulating hormone and free thyroxine in pregnancy: expressing concentrations as multiples of the median (MoMs). Clin Chim Acta 2014;430:33-7. doi: 10.1016/j.cca.2013.12.030
  • [15] Cotzias C, Wong SJ, Taylor E, Seed P, Girling J. A. A study to establish gestation-specific reference intervals for thyroid function tests in normal singleton pregnancy. Eur J Obstet Gynecol Reprod Biol 2008;137:61-6. doi: 10.1016/j. ejogrb.2007.10.007
  • [16] Springer D, Bartos V, Zima T. Reference intervals for thyroid markers in early pregnancy determined by 7 different analytical systems. Scand J Clin Lab Invest 2014;74:95-101. doi: 10.3109/00365.513.2013.860617
  • [17] Lambadiari V, Mitrou P, Maratou E, et al. Thyroid hormones are positively associated with insulin resistance early in the development of type 2 diabetes. Endocrine 2011;39:28-32. https://doi: 10.1007/s12020.010.9408-3
  • [18] Toulis KA, Stagnaro-Green A, Negro R. Maternal subclinical hypothyroidism and gestational diabetes mellitus: a metaanalysis. Endocr Pract 2014;20:703-14. doi: 10.4158/EP13440. RA
  • [19] Agarwal MM, Dhatt GS, Punnose J, Bishawi B, Zayed R. Thyroid function abnormalities and antithyroid antibody prevalence in pregnant women at high risk for gestational diabetes mellitus. Gynecol Endocrinol 2006;22:261-6. doi: 10.1080/095.135.90600630470
  • [20] Shahbazian H, Shahbazian N, Rahimi Baniani M, Yazdanpanah L, Latifi SM. Evaluation of thyroid dysfunction in pregnant women with gestational and pre-gestational diabetes. Pak J Med Sci 2013;29:638-41. doi: 10.12669/pjms.292.2862
  • [21] Ying H, Tang YP, Bao YR, et al. Maternal TSH level and TPOAb status in early pregnancy and their relationship to the risk of gestational diabetes mellitus. Endocrine 2016 ;54:742- 50. doi: 10.1007/s12020.016.1022-6
  • [22] Gong LL, Liu H, Liu LH. Relationship between hypothyroidism and the incidence of gestational diabetes: A meta-analysis. Taiwan J Obstet Gynecol 2016 ;55:171-5. doi: 10.1016/j. tjog.2016.02.004
  • [23] Yang S, Shi FT, Leung PC, Huang HF, Fan J. Low thyroid hormone in early pregnancy is associated with an increased risk of gestational diabetes mellitus. J Clin Endocrinol Metab 2016;101:4237-43. doi: 10.1210/jc.2016-1506
  • [24] Lee SY, Pearce EN. Assessment and treatment of thyroid disorders in pregnancy and the postpartum period. Nat Rev Endocrinol 2022;18:158-71. doi: 10.1038/s41574.021.00604-z.
  • [25] Gietka-Czernel M, Glinicki P. Subclinical hypothyroidism in pregnancy: controversies on diagnosis and treatment. Pol Arch Intern Med 2021; 131: 266-75. doi:10.20452/pamw.4482
There are 25 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Research
Authors

Halime Sen Selım 0000-0002-9545-6873

Mustafa Sengul 0000-0002-9129-4336

Publication Date May 31, 2023
Published in Issue Year 2023 Volume: 36 Issue: 2

Cite

APA Sen Selım, H., & Sengul, M. (2023). Is subclinical hypothyroidism a risk factor for gestational diabetes mellitus?. Marmara Medical Journal, 36(2), 230-234. https://doi.org/10.5472/marumj.1302525
AMA Sen Selım H, Sengul M. Is subclinical hypothyroidism a risk factor for gestational diabetes mellitus?. Marmara Med J. May 2023;36(2):230-234. doi:10.5472/marumj.1302525
Chicago Sen Selım, Halime, and Mustafa Sengul. “Is Subclinical Hypothyroidism a Risk Factor for Gestational Diabetes Mellitus?”. Marmara Medical Journal 36, no. 2 (May 2023): 230-34. https://doi.org/10.5472/marumj.1302525.
EndNote Sen Selım H, Sengul M (May 1, 2023) Is subclinical hypothyroidism a risk factor for gestational diabetes mellitus?. Marmara Medical Journal 36 2 230–234.
IEEE H. Sen Selım and M. Sengul, “Is subclinical hypothyroidism a risk factor for gestational diabetes mellitus?”, Marmara Med J, vol. 36, no. 2, pp. 230–234, 2023, doi: 10.5472/marumj.1302525.
ISNAD Sen Selım, Halime - Sengul, Mustafa. “Is Subclinical Hypothyroidism a Risk Factor for Gestational Diabetes Mellitus?”. Marmara Medical Journal 36/2 (May 2023), 230-234. https://doi.org/10.5472/marumj.1302525.
JAMA Sen Selım H, Sengul M. Is subclinical hypothyroidism a risk factor for gestational diabetes mellitus?. Marmara Med J. 2023;36:230–234.
MLA Sen Selım, Halime and Mustafa Sengul. “Is Subclinical Hypothyroidism a Risk Factor for Gestational Diabetes Mellitus?”. Marmara Medical Journal, vol. 36, no. 2, 2023, pp. 230-4, doi:10.5472/marumj.1302525.
Vancouver Sen Selım H, Sengul M. Is subclinical hypothyroidism a risk factor for gestational diabetes mellitus?. Marmara Med J. 2023;36(2):230-4.