The relationship between the two endocrine pathologies: subclinical gestational hypothyroidism and gestational diabetes mellitus

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BACKGROUND: Over the past decade, gestational diabetes mellitus has become of increasing medical and social importance. It happens due to its increased prevalence and due to its negative impact on pregnancy and long-term metabolic disorders in the mother and fetus.

AIM: The aim of this study was to assess the relationship between subclinical gestational hypothyroidism and gestational diabetes mellitus, the two most common endocrine pathologies in pregnancy.

MATERIALS AND METHODS: We studied 200 medical records of pregnant women. The main group included 133 patients with subclinical gestational hypothyroidism, and the control group consisted of 67 women without endocrine pathology. The diagnosis of gestational diabetes mellitus was made based on the Ministry of Health of the Russian Federation clinical guidelines criteria. The diagnosis of subclinical hypothyroidism was made based on the thyroid-stimulating hormone level above 2.5 μIU/ml in combination with an increased titer of antithyroid antibodies or above 4.0 μIU/ml in the absence of any thyroid disorder. Statistical analysis was carried out using the StatTech v.2.1.0 program (Stattech Ltd, Russia).

RESULTS: The prevalence of hypothyroidism was higher among women with family history of diabetes mellitus. The chances of developing gestational diabetes mellitus increased by 9.706 times in the presence of hypothyroidism, by 1.077 times with an increase in age by one full year at the time of seeing the doctor, and by 1.023 times with an increase in weight before pregnancy by one kilogram. The thyroid-stimulating hormone level of more than 2.7 μIU/ml predicted the development of gestational diabetes mellitus with a sensitivity of 71.4% and a specificity of 63.1%.

CONCLUSIONS: Subclinical gestational hypothyroidism and gestational diabetes mellitus are interrelated endocrine disorders with common pathophysiological predictors. Among women with a normal body mass index, subclinical gestational hypothyroidism is a more significant risk factor for gestational diabetes mellitus than an increase in age or body weight. A certain threshold level of thyroid-stimulating hormone (more than 2.7 μIU/ml) in the first trimester increases the chances of developing gestational diabetes mellitus and should be considered as a signal for timely prevention and detection of gestational diabetes mellitus.

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About the authors

Vera A. Uchamprina

N.E. Bauman City Clinical Hospital No. 29

ORCID iD: 0000-0001-5341-4731

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Ekaterina I. Bobrova

Medical Unit No. 95, Central Medical Unit No. 119 of Russian Federal Biomedical Agency

ORCID iD: 0000-0002-0558-2578

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Nadezhda M. Startseva

Peoples’ Friendship University of Russia

Author for correspondence.
ORCID iD: 0000-0001-5795-2393
SPIN-code: 3415-3773

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Andrey S. Anikeev

Peoples’ Friendship University of Russia

ORCID iD: 0000-0002-4585-4646
SPIN-code: 3020-0434
Russian Federation, Moscow

Mariya I. Sviridova

N.E. Bauman City Clinical Hospital No. 29

ORCID iD: 0000-0001-8942-3111

MD, Cand. Sci. (Med.)

Russian Federation, Moscow


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Supplementary files

Supplementary Files
1. Fig. 1. Analysis of thyroid-stimulating hormone dynamics in the group of patients with subclinical gestational hypothyroidism during therapy

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2. Fig. 2. Odds ratio (OR) estimates with the 95% confidence interval (CI) for the studied predictors of gestational diabetes mellitus

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3. Fig. 3. ROC-curve characterizing the dependence of gestational diabetes mellitus likelihood on the logistic function P

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4. Fig. 4. Analysis of the sensitivity and specificity of the model depending on the logistic function P threshold values

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия Эл № 77 - 6389
от 15.07.2002 г.

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