Is There Any Relationship Between Thyroid Function Abnormalities, Thyroid Antibodies and Development of Gestational Diabetes Mellitus (GDM) in Pregnant Women?

Objective: To determine the levels of thyroid-stimulating hormone (TSH), thyroxin (T4), triiodothyronine (T3), anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG) and renal iodine excretion (RIE) in the first trimester of the pregnancy and to estimate the risk of developing GDM in these patients.

Method: The levels of TSH, T3, T4, anti-TPO, anti-TG, and RIE were retrospectively evaluated. A total of 312 pregnant women were included in the study (GDM (-) group n=240, GDM (+) group n=62). Diagnosis of GDM was made according to the recommendation of American Diabetes Organization (ADA). The association between thyroid dysfunction and GDM was evaluated.

Results: Our study included a total of 302 women. Sixty-two of these women were diagnosed as GDM (62/302=20.5%). When compared with the GDM (-) group the mean TSH level (2.02 vs 4.13 p=0.019), anti-TPO positivity (8.3% vs 30.64% p=0.044), anti-TG positivity (8.3% vs 19.4% p=0.019) and RIE (156 vs 178 p=0.017) were significantly higher in the GDM (+) group. TSH levels were statistically significantly higher in patients with positive anti-TPO levels (P=0.045).

Conclusion: Elevated TSH levels , TPO and TG antibody positivity rates were more frequent among the patients with GDM. These results may be a guide to perform routine thyroid function tests for patients with increased risk of GDM, on the other hand, they will alert the physicians for GDM progression and ensure taking preventive attempts for the patients who have thyroid disorder, especially those with positive thyroid antibodies in the first trimester of the pregnancy.