Association of maternal triglyceride responses to thyroid function in early pregnancy with gestational diabetes mellitus.
Association of maternal triglyceride responses to thyroid function in early pregnancy with gestational diabetes mellitus.
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DOI：
10.3389/fendo.2022.1032705
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发表时间：
2022
影响因子：
5.2
通讯作者：
Huang, Hefeng
中科院分区：
文献类型：
--
作者：
Zhang, Chen;Bai, Lilian;Sun, Kuan;Ding, Guolian;Liu, Xinmei;Wu, Yanting;Huang, Hefeng
妊娠期糖尿病（GDM）的患病率在全球范围内增加，妊娠早期高水平的甘油三酯（TG）和低水平的游离甲状腺素（FT 4）与GDM的风险增加有关;然而，相互作用和中介作用仍然未知。本研究的目的是探讨FT 4和TG联合作用对妊娠早期妇女GDM患病率的影响以及相应的因果关系。这项研究包括40，156名孕妇，他们的早期妊娠甲状腺激素，空腹血糖以及甘油三酯。根据美国糖尿病协会指南，使用2小时75克口服葡萄糖耐量试验（OGTT）诊断GDM，并根据结果对孕妇进行分组和比较。FT 4与GDM呈L型相关。GDM患病率随TG水平升高而升高。在考虑多个协变量后，发现与高FT 4且TG水平处于最低四分位数（Q1）的母亲相比，低FT 4且TG浓度最高的孕妇发生GDM的风险最高（比值比，2.44，95%CI，2.14至2.80; P<0.001）。母体FT 4和TG水平对GDM的危险性有显著的交互作用（交互作用P = 0.036）。母亲TG水平的中介作用比例估计为21.3%（95%CI，15.6%~ 36.0%; P < 0.001）。在敏感性分析中，TG水平的介导作用在各亚组中稳定。这项研究表明，母亲的FT 4水平和GDM和低TG水平的好处之间的L形关联，其中母亲的TG水平作为一个重要的中介在这种关联。我们的研究结果表明，治疗甲状腺功能减退症的孕妇也应该在怀孕早期降低甘油三酯水平，以防止GDM的发展。
The prevalence of Gestational Diabetes Mellitus (GDM) is increasing globally, and high levels of triglyceride (TG) and low levels of free thyroxine (FT4) in early pregnancy are associated with an increased risk of GDM; however, the interaction and mediation effects remain unknown. The aim of the present study is to examine the impact of FT4 and TG combined effects on the prevalence of GDM and the corresponding casual paths among women in early pregnancy. This study comprised 40,156 pregnant women for whom early pregnancy thyroid hormones, fasting blood glucose as well as triglyceride were available. GDM was diagnosed using a 2-hour 75-g oral glucose tolerance test (OGTT) according to the American Diabetes Association guidelines, and the pregnant women were grouped and compared according to the results. An L-shaped association between FT4 and GDM was observed. The prevalence of GDM increased with increasing TG levels. After accounting for multiple covariables, the highest risk for GDM was found among pregnant women of lower FT4 with the highest TG concentrations (odds ratio, 2.44, 95% CI, 2.14 to 2.80; P<0.001) compared with mothers of higher FT4 with the TG levels in the lowest quartile (Q1). There was a significant interaction effect of maternal FT4 and TG levels on the risk for GDM (P for interaction = 0.036). The estimated proportion of the mediating effect of maternal TG levels was 21.3% (95% CI, 15.6% to 36.0%; P < 0.001). In the sensitivity analysis, the mediating effect of TG levels was stable across subgroups. This study demonstrated an L-shaped association between maternal FT4 levels and GDM and the benefit of low TG levels, in which maternal TG levels act as an important mediator in this association. Our findings suggested that pregnant women who treat hypothyroidism should also reduce triglycerides levels in early pregnancy to prevent GDM development.
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影响因子：
3.7
作者：
Bertrand C;Blanchet E;Pessemesse L;Annicotte JS;Feillet-Coudray C;Chabi B;Levin J;Fajas L;Cabello G;Wrutniak-Cabello C;Casas F
通讯作者：
Casas F
影响因子：
15.1
作者：
Hu J;Gillies CL;Lin S;Stewart ZA;Melford SE;Abrams KR;Baker PN;Khunti K;Tan BK
通讯作者：
Tan BK
影响因子：
0.2
作者：
Kapadia KB;Bhatt PA;Shah JS
通讯作者：
Shah JS
妊娠中期甘油三酯升高作为妊娠糖尿病产后高血糖的生物标志物
影响因子：
4.3
作者：
Lai, Mengyu;Fang, Fang;Peng, Yongde
通讯作者：
Peng, Yongde
影响因子：
5.8
作者：
Cappola, AR;Ladenson, PW
通讯作者：
Ladenson, PW