妊娠期亚临床甲状腺功能减退症对妊娠期糖尿病糖脂代谢的影响

目的：探讨妊娠期亚临床甲状腺功能减退症（ SCH ）对孕妇妊娠期糖尿病糖脂代谢的影响。方法比较115例妊娠期糖尿病合并SCH的孕妇（观察组）和110例单纯妊娠期糖尿病孕妇（对照组）的血脂、尿酸、糖耐量实验、C肽释放实验的水平。结果观察组三酰甘油（ TG）、总胆固醇（ TC）、低密度脂蛋白（ LDL-C）、尿酸的水平高于对照组（ P <0 n．05）。观察组FBG、1 h PBG、2 h PBG低于对照组（ P <0．05）；C肽释放实验显示：观察组0 min（ CP0）、60 min（CP1h）、120 min（CP2h）C肽水平明显高于对照组（ P <0．05）；相关分析表明FPG、1 h PBG、2 h PBG与TSH呈负相关（ r值分别为-0．448、-0．492、-0．526， P值分别为0．012、0．009、0．003），C肽释放试验0 min、60 min、120 min C肽水平与TSH 呈正相关（ r值分别为0．467、0．432、0．426， P值分别为0．013、0．042、0．046）。结论合并妊娠期SCH可能使妊娠期糖尿病患者血脂水平升高，血糖水平降低，C肽水平升高，且随着TSH的升高，血糖的降低及胰岛功能的改善更加明显。

Effects of subclinical hypothyroidism in gestational period on blood glucose and blood lipid metabolism in pregnant women with gestational diabetes mellitus

Objective To investigate the effects of subclinical hypothyroidism ( SCH) in gestational period on blood glucose and blood lipid metabolism in pregnant women with gestational diabetes mellitus ( GDM) .Methods One hundred and fifteen pregnant women with GDM complicated by SCH were enrolled as observation group ,and the other 110 pregnant women with simple GDM were served as control group .The levels of blood lipid and uric acid were detected ,and OGTT and C-peptide release test were performed and compared between two groups .Results The levels of TC , TG , LDL-C, uric acid in observation group were significantly higher than those in control group ( P <0.05),however,the levels of FPG,1hPBG, 2hPBG were significantly lower than those in control group ( P <0.05).The C-peptide release test showed that the levels of C-peptide in 0min(CP0),60min(CP1h),120min(CP2h) in observation group were significantly higher than those in control group ( P <0.05).The correlation analysis indicated that the levels of FPG ,1hPBG,2hPBG were negatively correlated to those of TSH ( r =0.489, 0.498, 0.504, respectively, P <0.01).The C-peptide release test showed that the levels of C-peptide in cp0,cp1,cp2 were positively correlated to those of TSH ( r =0.467, 0.432, 0.426,respectively, P <0.05). Conclusion The gestational diabetes mellitus complicated by SCH can enhance the levels of blood lipid of patients ,reduce the levels of blood glucose and increase the levels of C-peptide,moreover, along with the increase of TSH , the decrease of blood glucose and improvement of pancreatic islet function are more obvious .