文献类型：期刊文献

中文题名：正常范围内甲状腺激素水平与妊娠期糖尿病发生风险的Meta分析

英文题名：A Meta-analysis of normal thyroid hormone levels and risk of diabetic urine disease during pregnancy

作者：肖国庆[1];康学东[2];杨维杰[2];易希善[1]

第一作者：肖国庆

机构：[1]甘肃中医药大学,甘肃兰州730000;[2]甘肃中医药大学附属医院,甘肃兰州730000

第一机构：甘肃中医药大学

年份：2023

卷号：15

期号：4

起止页码：139

中文期刊名：中医临床研究

外文期刊名：Clinical Journal Of Chinese Medicine

基金：国家自然科学基金(8216150429)。

语种：中文

中文关键词：妊娠期糖尿病;甲状腺激素;Meta分析

外文关键词：Gestational diabetes mellitus;Thyroid hormone;Meta-analysis

摘要：目的:评估甲状腺激素水平在正常范畴内的转变与妊娠期糖尿病(Gestational Diabetes Mellitus,GDM)产生的关联性。方法:应用计算机检索中国知网、维普、Pub Med和万方数据库中2021年4月20日之前发表的有关甲状腺激素水平与GDM发生风险关系研究的文献,获取相应资料,选用Rev Man 5.4软件实施Meta分析。结果:10篇契合标准的文献被采纳,共4108例患者。与正常孕妇相比,GDM患者的血清游离三碘甲状腺原氨酸(Free Triiodothyronine,FT3)水平降低(MD=-0.50,95%CI:-0.89~-0.11,P=0.01),血清游离甲状腺素(Free Thyroxine,FT4)水平明显降低(MD=-1.64,95%CI:-2.46~-0.82,P<0.0001),促甲状腺激素(Thyroid Stimulating Hormone,TSH)水平升高(MD=0.36,95%CI:0.14~0.57,P=0.001),GDM患者糖化血红蛋白(Glycated Hemoglobin A1c,HbAl c)明显高于正常孕妇(MD=1.04,95%CI:0.71~1.37,P<0.00001),差异有统计学意义。结论:在正常甲状腺激素水平范围内,FT3、FT4水平下降以及TSH水平的升高均与GDM患者血糖指标的变化密切相关,是GDM发生的危险因素。这为临床GDM的发生、发展提供了检测依据。
Objective:To systematically evaluate the relationship between normal thyroid hormone level and the risk of gestational diabetes mellitus(GDM).Methods:Studies on the relationship between thyroid hormone level and the risk of GDM published before April 20,2021 in CNKI,VIP,PubMed and Wanfang Data were searched by computer,and relevant data were extracted.A meta-analysis was performed using RevMan 5.4 software.Results:A total of 10 articles met the criteria were included,including 4108 patients.Compared with normal pregnant women,serum free triiodothyronine(FT3)level in GDM patients was decreased(MD=0.50,95%CI:-0.89 to-0.11,P=0.01),the serum free thyroxine(FT4)level was significantly decreased(MD=-1.64,95%CI:-2.46 to-0.82,P<0.0001),and the serum to free thyroxine(FT4)level was significantly decreased(MD=-1.64,95%CI:-2.46 to-0.82,P<0.0001).The thyroid stimulating hormone level was increased(MD=0.36,95%CI:0.14 to 0.57,P=0.001).Hemoglobin A1 c(HbAl c)in GDM patients was significantly higher than that in normal pregnant women(MD=1.04,95%CI:0.71 to 1.37,P<0.00001),and the difference was statistically significant.Conclusion:Within the normal range of thyroid hormone index,the decrease of FT3 and FT4 level and the increase of TSH level in pregnant women during pregnancy are closely related to the blood glucose index of GDM patients,and are risk factors for the occurrence of GDM.This conclusion provides a basis for the detection of clinical occurrence and development of GDM.