First trimester thyroid function in pregnant women residing in Saint Petersburg (Russia): reference values and risk of gestational diabetes

Background. Subclinical hypothyroidism during pregnancy and gestational diabetes mellitus (GDM) is known to be associated with maternal and child morbidity. The concept of subclinical dysfunction of the thyroid gland in pregnant women depends on the population-specific and trimester-specific referen...

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Autores principales:	Polina V. Popova, Ekaterina S. Shilova, Alexandra S. Tkachuk, Alexandra V. Dronova, Anna D. Anopova, Alla E. Nikolaeva, Elena N. Grineva
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2018
Materias:	gestational diabetes mellitus thyrotropin thyroxine reference values Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/fe2c642c6eb942aaa0afb52680d47a47
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spelling	oai:doaj.org-article:fe2c642c6eb942aaa0afb52680d47a472021-11-14T09:00:21ZFirst trimester thyroid function in pregnant women residing in Saint Petersburg (Russia): reference values and risk of gestational diabetes2072-03512072-037810.14341/DM9283https://doaj.org/article/fe2c642c6eb942aaa0afb52680d47a472018-03-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/9283https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378Background. Subclinical hypothyroidism during pregnancy and gestational diabetes mellitus (GDM) is known to be associated with maternal and child morbidity. The concept of subclinical dysfunction of the thyroid gland in pregnant women depends on the population-specific and trimester-specific reference values so fixed universal cutoff concentrations for thyroid-stimulating hormone (TSH) that were recommended earlier now are put under the question. Population-specific and trimester-specific reference values have not been defined for pregnant women residing in Saint Petersburg. The data concerning the association of maternal thyroid status with GDM development are controversial. Aims. The aim of the study was to determine the reference values of TSH and free thyroxin (fT4) in the first trimester of pregnancy in women living in St. Petersburg, and to assess the relationship between thyroid status and the risk of subsequent development of GDM. Materials and methods. The levels of TSH, fT4 and thyroid peroxidase antibodies (TPO-Ab) were analyzed in 503 pregnant women before the 14th week of gestation. The women underwent oral glucose tolerance test (OGTT) at 24–28 weeks to find out those with GDM. The association between thyroid function, thyroid autoimmunity and the risk of GDM we estimated. Results. The reference values for TSH were 0.07 – 4.40 mU /L, and for fT4 11.7 – 20.3 pmol/L. The prevalence of subclinical hypothyroidism in the 503 pregnant women was 16.9% according to the diagnostic criteria of TSH> 2.5 mIU / L and 3.8% using our calculated reference interval. Hypothyroxinemia was registered in 5,3% using reference values recommended by diagnostic tests manufacturer and in 2,8% according to our calculated reference interval for fT4. GDM was diagnosed in 23% of women. Logistic regression analysis showed associations of hypothyroxinemia and TPO-Ab-positivity with the increased risk of GDM that remained significant after adjustments on age and body mass index (BMI) [adjusted OR (95% CI) = 7.39 (1.27–42.93) for hypothyroxinemia, p=0.026; and adjusted OR (95% CI) = 2.02 (1.01–4.04) for TPO-Ab-positivity, p=0.047). Conclusions. Reference intervals for first trimester TSH and fT4 have been established for pregnant women living in St. Petersburg. Hypothyroxinemia and TPO-Ab-positivity were associated with the increased risk of GDM.Polina V. PopovaEkaterina S. ShilovaAlexandra S. TkachukAlexandra V. DronovaAnna D. AnopovaAlla E. NikolaevaElena N. GrinevaEndocrinology Research Centrearticlegestational diabetes mellitusthyrotropinthyroxinereference valuesNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 21, Iss 1, Pp 34-41 (2018)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	gestational diabetes mellitus thyrotropin thyroxine reference values Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	gestational diabetes mellitus thyrotropin thyroxine reference values Nutritional diseases. Deficiency diseases RC620-627 Polina V. Popova Ekaterina S. Shilova Alexandra S. Tkachuk Alexandra V. Dronova Anna D. Anopova Alla E. Nikolaeva Elena N. Grineva First trimester thyroid function in pregnant women residing in Saint Petersburg (Russia): reference values and risk of gestational diabetes
description	Background. Subclinical hypothyroidism during pregnancy and gestational diabetes mellitus (GDM) is known to be associated with maternal and child morbidity. The concept of subclinical dysfunction of the thyroid gland in pregnant women depends on the population-specific and trimester-specific reference values so fixed universal cutoff concentrations for thyroid-stimulating hormone (TSH) that were recommended earlier now are put under the question. Population-specific and trimester-specific reference values have not been defined for pregnant women residing in Saint Petersburg. The data concerning the association of maternal thyroid status with GDM development are controversial. Aims. The aim of the study was to determine the reference values of TSH and free thyroxin (fT4) in the first trimester of pregnancy in women living in St. Petersburg, and to assess the relationship between thyroid status and the risk of subsequent development of GDM. Materials and methods. The levels of TSH, fT4 and thyroid peroxidase antibodies (TPO-Ab) were analyzed in 503 pregnant women before the 14th week of gestation. The women underwent oral glucose tolerance test (OGTT) at 24–28 weeks to find out those with GDM. The association between thyroid function, thyroid autoimmunity and the risk of GDM we estimated. Results. The reference values for TSH were 0.07 – 4.40 mU /L, and for fT4 11.7 – 20.3 pmol/L. The prevalence of subclinical hypothyroidism in the 503 pregnant women was 16.9% according to the diagnostic criteria of TSH> 2.5 mIU / L and 3.8% using our calculated reference interval. Hypothyroxinemia was registered in 5,3% using reference values recommended by diagnostic tests manufacturer and in 2,8% according to our calculated reference interval for fT4. GDM was diagnosed in 23% of women. Logistic regression analysis showed associations of hypothyroxinemia and TPO-Ab-positivity with the increased risk of GDM that remained significant after adjustments on age and body mass index (BMI) [adjusted OR (95% CI) = 7.39 (1.27–42.93) for hypothyroxinemia, p=0.026; and adjusted OR (95% CI) = 2.02 (1.01–4.04) for TPO-Ab-positivity, p=0.047). Conclusions. Reference intervals for first trimester TSH and fT4 have been established for pregnant women living in St. Petersburg. Hypothyroxinemia and TPO-Ab-positivity were associated with the increased risk of GDM.
format	article
author	Polina V. Popova Ekaterina S. Shilova Alexandra S. Tkachuk Alexandra V. Dronova Anna D. Anopova Alla E. Nikolaeva Elena N. Grineva
author_facet	Polina V. Popova Ekaterina S. Shilova Alexandra S. Tkachuk Alexandra V. Dronova Anna D. Anopova Alla E. Nikolaeva Elena N. Grineva
author_sort	Polina V. Popova
title	First trimester thyroid function in pregnant women residing in Saint Petersburg (Russia): reference values and risk of gestational diabetes
title_short	First trimester thyroid function in pregnant women residing in Saint Petersburg (Russia): reference values and risk of gestational diabetes
title_full	First trimester thyroid function in pregnant women residing in Saint Petersburg (Russia): reference values and risk of gestational diabetes
title_fullStr	First trimester thyroid function in pregnant women residing in Saint Petersburg (Russia): reference values and risk of gestational diabetes
title_full_unstemmed	First trimester thyroid function in pregnant women residing in Saint Petersburg (Russia): reference values and risk of gestational diabetes
title_sort	first trimester thyroid function in pregnant women residing in saint petersburg (russia): reference values and risk of gestational diabetes
publisher	Endocrinology Research Centre
publishDate	2018
url	https://doaj.org/article/fe2c642c6eb942aaa0afb52680d47a47
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First trimester thyroid function in pregnant women residing in Saint Petersburg (Russia): reference values and risk of gestational diabetes

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