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Thyroid dysfunction and gestational diabetes mellitus. Is there a relationship ?

[Reviews]
Natalia Volkova; Ilya Yuryevich Davidenko; Yulia Sergeevna Degtyareva;

Gestational diabetes mellitus (GDM) is one of the most common pathologies accompanying pregnancy and is associated with a number of short and long term complications for the mother and fetus. Dysfunctions of the thyroid gland are common in women of reproductive age, and therefore have a rather high frequency of occurrence among pregnant women, in some cases accompanying GDM. The hypothesis of the influence of hypo- and hyperthyroidism on the occurrence of disorders of carbohydrate metabolism during pregnancy formed the basis of numerous studies, the results of which are discussed in this review. However, in order to isolate the pathology of the thyroid gland and the presence of thyroid autoantibodies as additional risk factors for GDM and to begin to carry out widespread screening in pregnant women, research results are needed to confirm the feasibility of such measures.

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References:
1. Roberts C., Ford J., Algert C., Antonsen S., Chalmers J. [et al.]. Population-based trends in pregnancy hypertension and pre-eclampsia: an international comparative study. BMJ Open. 2011;1(1):e000101-e000101. https://doi.org/10.1136/bmjopen-2011-000101
2. Рrevention C, diabetes G. International Diabetes Federation – Gestational diabetes. Idf.org. Available at: https://www.idf.org/our-activities/care-prevention/gdm. Published 2021. Accessed January 10, 2021.
3. Melchior H., Kurch-Bek D., Mund M. The Prevalence of Gestational Diabetes: A Population-Based Analysis of a Nationwide Screening Program. Deutsches Aerzteblatt. Online. 2017. https://doi.org/10.3238/arztebl.2017.0412
4. Farrar D., Simmonds M., Griffin S., Duarte A., Lawlor D. [et al.]. The identification and treatment of women with hyperglycaemia in pregnancy: an analysis of individual participant data, systematic reviews, meta-analyses and an economic evaluation. Health Technol. Assess. (Rockv). 2016;20(86):1-348. https://doi.org/10.3310/hta20860
5. Garrison A. Screening, diagnosis, and management of gestational diabetes mellitus. Am. Fam. Physician. 2015;91(7):460-467.
6. Pons R. S., Rockett F. C., de Almeida Rubin B., Oppermann M. L. R., Bosa V. L. Risk factors for gestational diabetes mellitus in a sample of pregnant women diagnosed with the disease. Diabetol. Metab. Syndr. 2015;7(Suppl 1):A80. https://doi.org/10.1186/1758-5996-7-S1-A80
7. Dhanwal D., Bajaj S., Rajput R., Subramaniam K., Chowdhury S. [et al.]. Prevalence of hypothyroidism in pregnancy: An epidemiological study from 11 cities in 9 states of India. Indian J. Endocrinol. Metab. 2016;20(3):387. https://doi.org/10.4103/2230-8210.179992
8. Ezzeddine D., Ezzeddine D., Hamadi C., Abbas H., Nassar A. [et al.]. Prevalence and Correlation of Hypothyroidism With Pregnancy Outcomes Among Lebanese Women. J. Endocr. Soc. 2017;1(5):415-422. https://doi.org/10.1210/js.2017-00014
9. Sapana C. Shah, Chaitanya R. Shah. Prevalence of hypothyroidism during pregnancy. Int. J. Basic Appl. Med. Sci. 2014;4(3):130-134.
10. Yalamanchi S., Cooper D. S. Thyroid disorders in pregnancy. Curr. Opin. Obstet. Gynecol. 2015;27(6):406-415. https://doi.org/10.1097/GCO.0000000000000226
11. Lazarus J. H. Thyroid function in pregnancy. Br.Med. Bull. 2011;97:137-148. https://doi.org/10.1093/bmb/ldq039
12. Olivieri A., Valensise H., Magnani F., Medda E., De Angelis S. [et al.]. High frequency of antithyroid autoantibodies in pregnant women at increased risk of gestational diabetes mellitus. Eur. J. Endocrinol. 2000:741-747. https://doi.org/10.1530/eje.0.1430741
13. Tudela C., Casey B., McIntire D., Cunningham F. Relationship of Subclinical Thyroid Disease to the Incidence of Gestational Diabetes. Obst. Gynecol. 2012;119(5):983-988. https://doi.org/10.1097/aog.0b013e318250aeeb
14. Vafaeimanesh J., Asgarani F., Bagherzadeh M., Ebrahimi G., Parham M. Thyroid function in pregnant women with gestational diabetes: Is screening necessary? Thyroid Res. Pract. 2015;12(1):3. https://doi.org/10.4103/0973-0354.147271
15. Furukawa S., Miyakawa K., Shibata J., Iwashita M. Women with Subclinical Hypothyroidism Are at Low Risk of Poor Pregnancy Outcome in Japan. Tohoku J. Exp. Med. 2017;242(3):167-172. https://doi.org/10.1620/tjem.242.167
16. Divakar H., Singh R., Narayanan P., G. V. D., Kulkarni B., Hegde A. Dual endocrinopathy – the nexus between hyperglycaemia (gestational diabetes) and hypothyroidism among pregnant women in India. J. Evidence Based Med. Health. 2017;4(61):3658-3661. https://doi.org/10.18410/jebmh/2017/729
17. Zhang Y., Dai X., Yang S., Zhang C., Han M. [et al.]. Maternal low thyroxin levels are associated with adverse pregnancy outcomes in a Chinese population. PLoS One. 2017;12(5):e0178100. https://doi.org/10.1371/journal.pone.0178100
18. 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(2):171-175. https://doi.org/10.1016/j.tjog.2016.02.004
19. Velkoska Nakova V., Krstevska B., Dimitrovski Ch., Simeonova S., Hadzi-Lega M. [et al.]. Prevalence of thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes and diabetes type 1. Prilozi. 2010;31(2):51-59.
20. Yang S., Shi F., Leung P., Huang H., Fan J. Low Thyroid Hormone in Early Pregnancy Is Associated With an Increased Risk of Gestational Diabetes Mellitus. J. Clin. Endocrin. Metab. 2016;101(11):4237-4243. https://doi.org/10.1210/jc.2016-1506
21. Iranparvar M., Ghorbani H., Azami A., Darvishkhah H. Thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus: a cross-sectional study. Intern. J. Adv. Med. 2015:350-353. https://doi.org/10.18203/2349-3933.ijam20151007
22. Popova P. V., Shilova E. S., Tkachuk A. S., Dronova A. V., Anopova A. D. [et al.]. First trimester thyroid function in pregnant women residing in Saint Petersburg: reference values and risk of gestational diabetes. Sakharny diabet. – Diabetes mellitus. 2018;21(1):34-41. (In Russ.). https://doi.org/10.14341/DM9283
23. Barišić T., Mandić V., Vasilj A., Tiric D. Higher levels of thyrotropin in pregnancy and adverse pregnancy outcomes. J. Maternal-Fetal Neonat. Med. 2018;32(17):2883-2888. https://doi.org/10.1080/14767058.2018.1451509
24. Toulis K., Stagnaro-Green A., Negro R. Maternal Subclinical Hypothyroidsm and Gestational Diabetes Mellitus: A Meta-Analysis. End. Pract. 2014;20(7):703-714. https://doi.org/10.4158/ep13440.ra
25. Nelson D., Casey B., Cunningham F. 815: Subsequent pregnancy outcomes in women previously diagnosed with subclinical hypothyroidism. Am. J. Obstet. Gynecol. 2012;206(1):S357-S358. https://doi.org/10.1016/j.ajog.2011.10.833
26. Pascual Corrales E., Andrada P., Aubá M., Ruiz Zambrana Á., Guillén Grima F. [et al.]. Is autoimmune thyroid dysfunction a risk factor for gestational diabetes? Endocrin. Nutr. (English Edition). 2014;61(7):377-381. https://doi.org/10.1016/j.endoen.2014.06.010
27. Fatima S., Rehman R., Butt Z., Asif Tauni M., Fatima Munim T. [et al.]. Screening of subclinical hypothyroidism during gestational diabetes in Pakistani population. J. Maternal-Fetal Neonat. Med. 2015;29(13):2166-2170. https://doi.org/10.3109/14767058.2015.1077513
28. Sharmeen M., Shamsunnahar P., Laita T., Chowdhury S. Overt and subclinical hypothyroidism among Bangladeshi pregnant women and its effect on fetomaternal outcome. Bangladesh Med. Res. Counc. Bull. 2015;40(2):52-57. https://doi.org/10.3329/bmrcb.v40i2.25183
29. Ying H., Tang Y., Bao Y., Su X., Cai X. [et al.]. Maternal TSH level and TPOAb status in early pregnancy and their relationship to the risk of gestational diabetes mellitus. Endocrine. 2016;54(3):742-750. https://doi.org/10.1007/s12020-016-1022-6
30. Jia M., Wu Y., Lin B., Shi Y., Zhang Q. [et al.]. Metaanalysis of the association between maternal subclinical hypothyroidism and gestational diabetes mellitus. Intern. J. Gynecol. Obstet. 2019;144(3):239-247. https://doi.org/10.1002/ijgo.12751
31. Ju R., Lin L., Long Y., Zhang J., Huang J. Clinical efficacy of therapeutic intervention for subclinical hypothyroidism during pregnancy. Genet. Mol. Res. 2016;15(4):10.4238/gmr15049019. https://doi.org/10.4238/gmr15049019
32. Yang J., Guo H., Ding S., Tao B., Zhang X. Zhonghua Fu Chan Ke Za Zhi. 2015;50(9):652-657
33. Li J., Shen J., Qin L. Effects of Levothyroxine on Pregnancy Outcomes in Women With Thyroid Dysfunction: A Meta-analysis of Randomized Controlled Trials. Altern. Ther. Health. Med. 2017;23(2):49-58
34. Turunen S., Vääräsmäki M., Männistö T., Hartikainen A., Lahesmaa-Korpinen A. [et al.]. Pregnancy and Perinatal Outcome Among Hypothyroid Mothers: A Population-Based Cohort Study. Thyroid. 2019;29(1):135-141. https://doi.org/10.1089/thy.2018.0311
35. Sahu M. T., Das V., Mittal S., Agarwal A., Sahu M. Overt and subclinical thyroid dysfunction among Indian pregnant women and its effect on maternal and fetal outcome. Arch. Gynecol. Obstet. 2010;281(2):215-220. https://doi.org/10.1007/s00404-009-1105-1
36. Gudovic A., Spremovic-Radjenovic S., Lazovic G., Marinkovic J., Glisic A. [et al.]. Maternal autoimmune thyroid disease and pregnancy complication. Vojnosanit Pregl. 2010;67(8):617-621. https://doi.org/10.2298/vsp1008617g
37. Männistö T., Vää räsmäki M., Pouta A., Hartikainen A., Ruokonen A. [et al.]. Thyroid Dysfunction and Autoantibodies during Pregnancy as Predictive Factors of Pregnancy Complications and Maternal Morbidity in Later Life. J. Clin. Endocrin. Metab. 2010;95(3):1084-1094. https://doi.org/10.1210/jc.2009-1904
38. Stohl H. E., Ouzounian J., Rick A. M., Hueppchen N. A., Bienstock J. L. Thyroid disease and gestational diabetes mellitus (GDM): is there a connection? J. Matern. Fetal. Neonatal. Med. 2013;26(11):1139-1142. https://doi.org/10.3109/14767058.2013.773309
39. Aggarawal N., Suri V., Singla R., Chopra S., Sikka P. [et al.]. Pregnancy Outcome in Hyperthyroidism: A Case Control Study. Gynecol. Obstet. Invest. 2014;77(2):94-99. https://doi.org/10.1159/000357615
40. Oguz A., Tuzun D., Ozdemir D., Baci Y., Ersoy R. [et al.]. Prevalance of gestational diabetes mellitus in patients with gestational transient thyrotoxicosis. Gynecol. Endocr. 2013;29(4):336-339. https://doi.org/10.3109/09513590.2012.752451
41. Rawal S., Tsai M., Hinkle S., Zhu Y., Bao W. [et al.]. A Longitudinal Study of Thyroid Markers Across Pregnancy and the Risk of Gestational Diabetes. J. Clin. Endocr. Met. 2018;103(7):2447-2456. https://doi.org/10.1210/jc.2017-02442
42. Catalano P. M. Trying to understand gestational diabetes. Diabet. Med. 2014;31(3):273-281. https://doi.org/10.1111/dme.12381
43. Kramer C., Swaminathan B., Hanley A., Connelly P., Sermer M. [et al.]. Each Degree of Glucose Intolerance in Pregnancy Predicts Distinct Trajectories of β-Cell Function, Insulin Sensitivity, and Glycemia in the First 3 Years Postpartum. Diabetes Care. 2014;37(12):3262-3269. https://doi.org/10.2337/dc14-1529
44. Stanická S., Vondra K., Pelikánová T., Vlcek P., Hill M. [et al.]. Insulin sensitivity and counter-regulatory hormones in hypothyroidism and during thyroid hormone replacement therapy. Clin. Chem. Lab. Med. 2005;43(7):715-720. https://doi.org/10.1515/CCLM.2005.121
45. Maratou E., Hadjidakis D., Kollias A., Tsegka K., Peppa M. [et al.]. Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. Eur. J. Endocrinol. 2009;160(5):785-790. https://doi.org/10.1530/eje-08-0797
46. Haddow J., Craig W., Neveux L., Palomaki G., Lambert- Messerlian G. [et al.]. Free Thyroxine During Early Pregnancy and Risk for Gestational Diabetes. PLoS One. 2016;11(2):e0149065. https://doi.org/10.1371/journal.pone.0149065
47. Mitrou P., Raptis S. A., Dimitriadis G. Insulin action in hyperthyroidism: a focus on muscle and adipose tissue. Endocr. Rev. 2010;31(5):663-679. https://doi.org/10.1210/er.2009-0046
48. Lambadiari V., Mitrou P., Maratou E., Raptis A., Tountas N. [et al.]. Thyroid hormones are positively associated with insulin resistance early in the development of type 2 diabetes. Endocrine. 2010;39(1):28-32. https://doi.org/10.1007/s12020-010-9408-3

Keywords: thyroid pathology, hypothyroidism, hyperthyroidism, thyroid autoantibodies, gestational diabetes mellitus


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