To the content
3 . 2021

Gestational diabetes mellitus and hypothyroidism: disease comorbidity

Abstract

The obesity pandemic that gripped the population in the 21st century led to a significant increase in metabolic-associated diseases that are triggers of pathological processes during pregnancy, primarily gestational diabetes mellitus (GDM). According to the Atlas of the International Diabetes Federation, the prevalence of hyperglycemia in pregnant women in 2019 was 15.8%, of which 83.6% of cases were caused by GDM. Despite the large number of studies devoted to the study of GDM, the search for its predictors remains highly relevant for the prevention and timely diagnosis of this disease. In this regard, the identification of comorbidity and the relationship of hypothyroidism (HT) with hyperglycemia during pregnancy will make it possible to clarify the significance of HT in the occurrence of GDM.

The aim of this study is to establish the frequency of subclinical hypothyroidism (SHT) in patients with GDM and to identify the commonality of their risk factors for the timely diagnosis of SHT and GDM and prevention of pregnancy complications.

Material and methods. Retrospective analysis of the birth histories of 453 patients with GDM (group 1), 223 with SHT (group 2) and 90 - control group, as well as the reporting indicators of the Perinatal Center of the Bauman State Clinical Hospital # 29 for 2020 was carried out.

Results. The conducted study showed the commonality of SHT and GDM risk factors. The revealed comorbidity frequency of SHT and GDM allows us to assume their relationship and consider SHT as a risk factor for GDM. Detection of subclinical hypothyroidism in the pre-pregnancy period or in the early stages of pregnancy improves the screening strategy for GDM.

Keywords:gestational diabetes mellitus, subclinical hypothyroidism, risk factors, obesity, comorbidity

Funding. The authors received no financial support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Startseva N.M., Sviridova M.I., Uchamprina V.A., Anikeev A.S., Leffad L.M. Gestational diabetes mellitus and hypothyroidism: disease comorbidity. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2021; 9 (3): 11-6. DOI: https://doi.org/10.33029/2303-9698-2021-9-3-11-16 (in Russian)

References

1. Gestational diabetes mellitus. Diagnosis, treatment, obstetric tactics, postpartum observation. Clinical guidelines. Russian Association of Endocrinologists, Russian Society of Obstetricians and Gynecologists. Year of approval 2020. (in Russian)

2. IDF Diabetes Atlas. 9th ed. Brussels, Belgium: International Diabetes Federation, 2019.

3. Kapustin R.V., Alekseenkova E.N., Arzhanova O.N., et al. Preterm birth in women with diabetes mellitus. Zhurnal akusherstva i zhenskikh bo-lezney [Journal of Obstetrics and Women's Diseases]. 2020; 69 (1): 17-26. DOI: https://doi.org/10.17816/JOWD69117-26 (in Russian)

4. Yankina S.V., Shatrova N.V., et al. Features of the course and outcomes of pregnancy in women with gestational diabetes mellitus. Rossi-yskiy mediko-biologicheskiy vestnik imeni akademika I.P. Pavlova [Russian Medical and Biological Bulletin named after academician I.P. Pavlov]. 2018; (1): 96-105. (in Russian)

5. Papysheva O.V., Startseva N.M., Savenkova I.V., et al. The health of infants born to mothers with gestational diabetes mellitus. Doctor.Ru. 2019; (7): 12-8. (in Russian)

6. Zeki R., Oats J.J.N., Wang A.Y., Li Z., et al. Cesarean section and diabetes during pregnancy: an NSW population study using the Robson classification. J Obstet Gynaecol Res. 2018; 44 (5): 890-8.

7. Rosstat. Statistics. Official statistics. Population. Healthcare. Indicators of the health of the mother and child, the activities of the child protection and maternity services. The state of health of pregnant women, women in labor, maternity hospitals and newborns. 2019. (in Russian)

8. Akhmetova E.S. Pathophysiological and genetic changes in the body of a pregnant with gestational diabetes. Zhurnal akusherstva i zhenskikh bolezney [Journal of Obstetrics and Women's Diseases]. 2017; 66 (5): 2736. DOI: https://doi.org/10.17816/JOWD66527-36 (in Russian)

9. Prokhorenko T.S., Saprina T.V., Budeeva S.V. Promising markers for the risk and prognosis of gestational diabetes mellitus. Terapevtichesky arhiv [Therapeutic Archive]. 2016; 88 (4): 112-6. (in Russian)

10. Zakharko A.Yu., Н. Mit'kovskaya N.P., Doronina O.K., et al. Assessment of carbohydrate, lipid metabolism, hormonal activity of adipose tissue in pregnant women with gestosis and metabolic syndrome. Kardiologiya v Belarusi [Cardiology in Belarus]. 2018; 10 (1): 45-55. (in Russian)

11. Papysheva O.V., Kotaysh G.A., Savenkova I.V., Arakelyan G.A., Lu-kanovskaya O.B., Damirova S.F. The influence of pregestational obesity to perinatal outcomes in women with gestation diabetes mellitus. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2019; 7 (S): 25-30. (in Russian)

12. Olina A.A., Sadykova G.K. Functional state of the thyroid gland during pregnancy: a modern view of the problem. Meditsinskaya nauka i obrazovaniye Urala [Medical Science and Education of the Urals]. 2018; 19 (2): 178-81. (in Russian)

13. Haddow J.E., Craig W.Y., Neveux L.M., Palomaki G.E., Lambert-Mes-serlian G., Malone F.D., et al.; First and Second Trimester Risk of Aneuploidy (FaSTER) Research Consortium. Free thyroxine during early pregnancy and risk for gestational diabetes. PLoS One. 2016; 11 (2): e0149065. DOI: https://doi.org/10.1371/journal.pone.0149065 PMID: 26910563; PMCID: PMC4766100.

14. Knight B.A., Shields B.M., Hattersley A.T., Vaidya B. Maternal hy-pothyroxinaemia in pregnancy is associated with obesity and adverse maternal metabolic parameters. Eur J Endocrinol. 2016; 174 (1): 51-7. DOI: https://doi.org/10.1530/EJE-15-0866 PMID: 26586839

15. Biryukova E.V., Kileynikov D.V., Solov'yeva I.V. Hypothyroidism: current state of the problem. Meditsinskiy sovet [Medical Council]. 2020; (7): 96-107. DOI: https://doi.org/10.21518/2079-701X-2020-7-96-107 (in Russian)

16. Panfilova E.A., Isaeva M.P., Troshina E.A. Hypothyroidism: a lecture for primary care physicians. Meditsinskiy sovet [Medical Council]. 2020; (11): 124-30. DOI: https://doi.org/10.21518/2079-701X-2020-11-124-130 (in Russian)

17. Dedov I.I. Endocrinology: a national guide. In: Dedov I.I., Mel'ni-chenko G.A. (eds). 2nd ed., revised and expanded. Moscow: GEOTAR-Media, 2021: 1112 p. ISBN 978-5-9704-6054-2 (in Russian)

18. Zhukova L.A., Andreeva N.S., Saenko N. Obesity: what do we know today? Evraziyskiy soyuz uchonikh [Euroasian Scientists Union]. 2019; 5-3 (62). (in Russian)

19. Jia M., Wu Y., Lin B., Shi Y., Zhang Q., Lin Y., et al. Meta-analysis of the association between maternal subclinical hypothyroidism and gestational diabetes mellitus. Int J Gynaecol Obstet. 2018; 144 (3).

20. Gong L.L., Liu H., Liu L.H. Relationship between hypothyroidism and the incidence of gestational diabetes: a meta-analysis. Taiwan J Obstet Gynecol. 2016; 55: 171-5.

21. Urvanova E.Yu. The frequency of thyroid pathology in pregnant women with gestational diabetes mellitus. In: A.I. Vostretsov (ed). Materialy mezhdunarodnoy (zaochnoy) nauchno-prakticheskoy konferentsii [Materials of the International (Correspondence) Scientific and Practical Conference]. 2020: 148-51. (in Russian)

22. Khabarov S.V. Screening determination of thyroid stimulating hormone in diagnosis of subclinical hypothyroidism in pregnant women: versions and contraversions. Meditsinskiy alfavit [Medical Alphabet]. 2020; (34): 59-65. DOI: https://doi.org/10.33667/2078-5631-2020-34-59-65 (in Russian)

23. Fadeyev V.V. Review of American Thyroid Association guidelines for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Klinicheskaya i eksperimental'naya tireodologiya [Clinical and Experimental Thyroidology]. 2018; 14 (3): 128-39. DOI: https://doi.org/10.14341/ket9794 (in Russian)

24. Gul B.A., Aysel U.D., Onur E., Aysun U., Seyit U., Ayhan H.C. Comparison of thyroid function tests and blood count in pregnant women with versus without gestational diabetes mellitus: thyroid function and blood count in GDM. J Obstet Gynaecol Res. 2017; 43 (5): 848-54.

25. Bobryk M.I. Mutual influence of thyroid and carbohydrate metabolism. Paradigms and paradoxes. Mezhdunarodniy endokrinologicheskiy zhurnal [International Journal of Endocrinology]. 2015; 3 (67): 127-32. (in Russian)

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITORS
CHIEF EDITOR
Sukhikh Gennadii Tikhonovich
Academician of the Russian Academy of Medical Sciences, V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Moscow
CHIEF EDITOR
Kurtser Mark Arkadievich
Academician of the Russian Academy of Sciences, MD, Professor, Head of the Obstetrics and Gynecology Subdepartment of the Pediatric Department, N.I. Pirogov Russian National Scientific Research Medical University, Ministry of Health of the Russian Federation
CHIEF EDITOR
Radzinsky Viktor Evseevich
Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of the Subdepartment of Obstetrics and Gynecology with a Course of Perinatology of the Medical Department in the Russian People?s Friendship University

Journals of «GEOTAR-Media»