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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Clinical Diabetes
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1427925
This article is part of the Research Topic Exploring the New Biomarkers and Clinical Indicators for Diabetes: Insights from Real-World Studies View all 22 articles

Title：Thyroid FT4-to-TSH Ratio in the first trimester is associated with Gestational Diabetes Mellitus in Women Carrying Male Fetus: A Prospective Bi-center Cohort Study

Provisionally accepted
Shuoning Song Shuoning Song 1Yuemei Zhang Yuemei Zhang 2Xiaolin Qiao Xiaolin Qiao 3Yanbei Duo Yanbei Duo 1Jiyu Xu Jiyu Xu 4Jing Zhang Jing Zhang 2Yan Chen Yan Chen 3Xiaorui Nie Xiaorui Nie 3Qiujin Sun Qiujin Sun 3Ailing Wang Ailing Wang 5Zechun Lu Zechun Lu 5Wei Sun Wei Sun 4Yong Fu Yong Fu 1Yingyue Dong Yingyue Dong 1Tao Yuan Tao Yuan 1*Weigang Zhao Weigang Zhao 1*
  • 1 Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Acadamy of Medical Sciences, Beijing, Beijing, China
  • 2 Haidian Maternal and Child Health Hospital of Beijing, Beijing, China
  • 3 Beijing Chaoyang Maternal and Child Care Health Centre, Beijing, Beijing, China
  • 4 Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  • 5 National Center for Women and Children's Health, China CDC, Beijing, China, Beijing, China

The final, formatted version of the article will be published soon.

    Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy, which increases the risk of other pregnant complications and adverse perinatal outcomes. Thyroid dysfunction is closely with the risk of diabetes mellitus. However, the relationship between euthyroid function in early pregnancy and GDM is still controversial.This study was to find the relationship between thyroid function within normal range during early pregnancy as well as glucose and lipids metabolisms as well as the risk of subsequent GDM.A total of 1486 pregnant women were included in this prospective double-center cohort study. Free thyroxine (FT4), thyroid stimulating hormone (TSH) and antithyroid peroxidase antibodies (TPOAb) were tested during 6-12 weeks of gestation and oral glucose tolerance test (OGTT) was conducted during 24-28 weeks to screen GDM. Relative risks (RR) with 95% confidence intervals (CI) for subsequent risk of GDM by thyroid function quartiles were assessed adjusting for major risk factors.The incidence of GDM was 23.0% (342/1486). TSH, FT4 and the percentage of positive TPOAb were no significant difference between women with and without GDM, but FT4/TSH ratio was significantly higher in GDM group compared with NGT group [6.97(0.84,10.61) vs. 4.88(0.66,12.44), P=0.025)]. The linear trends of TC, TG, HDL-C, LDL-C, fasting glucose in the first trimester, insulin, C-peptide, HOMA-IR, fasting glucose during OGTT and incidence of GDM according to FT4/TSH ratio were all statistically significant. Further analysis based on fetal sex presented only the third quartile of FT4/TSH ratio in women carrying male fetus was associated with higher incidence of GDM statistically significant [RR (95% CI), 1.917 (1.143,3.216)], rather than in women carrying female fetus.Thyroid function even in normal range is closely related to glucose and lipids metabolisms during the first trimester. Unappropriated FT4/TSH ratio in the first trimester is an independent risk factor of GDM in women carrying male fetus.

    Keywords: gestational diabetes mellitus, Thyroid function, glucose and lipids metabolisms, Pregnancy, Fetal sex

    Received: 05 May 2024; Accepted: 04 Nov 2024.

    Copyright: © 2024 Song, Zhang, Qiao, Duo, Xu, Zhang, Chen, Nie, Sun, Wang, Lu, Sun, Fu, Dong, Yuan and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Tao Yuan, Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Acadamy of Medical Sciences, Beijing, 100730, Beijing, China
    Weigang Zhao, Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Acadamy of Medical Sciences, Beijing, 100730, Beijing, China

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