Value of vitamin D level in early pregnancy combined with thyroid function indexes and immune inflammatory factors in evaluating the occurrence of subclinical hypothyroidism in pre-gestational diabetes mellitus patients
Chen Qiuling, Li Wenxia
Department of Obstetrics, Changsha Hospital for Maternal and Child Health Care, Hu nan, Changsha 410007, China
Abstract: 【Abstract】 Objective To explore the value of vitamin D level in early pregnancy combined with thyroid function index and immune inflammatory factors in evaluating the occurrence of subclinical hypothyroidism in patients with pregestational diabetes mellitus (PGDM). Method A tatal of 148 pregnant women with PGDM diagnosed in Changsha Maternal and Child Health Hospital from September 2018 to January 2020 were divided into vitamin D deficiency group (n=86), vitamin D lack group (n=38) and vitamin D adequacy group (n=24). The level difference of thyroid function indexes on free thyroxine (FT4), freetriiodothyronine (FT3), thyroid stimutating hormone (TSH), thyroid peroxidase antibody(TPOAb), transforming growth factor-β(TGF-β1) and tumor necrosis factor α(TNF-α)were compared among the three groups. According to the occurrence of subclinical hypothyroidism, patients were divided into subclinical hypothyroidism group(n=78) and simple PGDM group (n=70). The clinical data of the two groups were compared, the factorsaffecting the occurrence of subclinical hypothyroidism were analyzed by multivariate Logistic regression,the line chart model was constructed, and its predictive efficiency was evaluated. T test, one-way analysisof variance, χ2 test, receiver operating characteristic (ROC), area under curve (AUC) and correction curve wereused for statistical analysis. Result FT4 of vitamin D deficiency group, vitamin D lack group and vitamin Dadequacy group increased with the increase of vitamin D level [(11.2±1.3), (14.2±1.4) vs (16.2±1.8) pmol/L,F=6.642], while TSH [(6.2±1.2), (4.3±1.1) vs (3.4±0.7) IU/ml, F=4.743], TPOAb [(45.5±5.2), (31.3±3.4)vs (12.4±2.6) IU/ml, F=17.004], TGF- β1[(118.2±25.2), (90.4±21.4) vs (75.8±15.6) ng/L, F=4.143] andTNF-α [(60.2±10.3), (54.8±9.2) vs (41.3±7.9) ng/L, F=2.952] decreased with the increase of vitaminD level, and the differences were statistically significant (all P<0.05). The levels of 25(OH)D in subclinicalhypothyroidism group were significantly lower than those in simple PGDM group, while the levels of TSH[(5.9±1.4) vs (3.6±1.1) mIU/L, t=5.931], TPOAb [(43.9±17.7) vs (28.3±6.4) IU/ml, t=13.344], TGF-β1[(115.3±27.5) vs (91.4±19.4) ng/L, t=5.929] and TNF-α [(65.3±13.6) vs (45.1±12.4) ng/L, t=9.469]in subclinical hypothyroidism group were significantly higher than those in simple PGDM group, which weresignificant differences in statistics (all P<0.05). Multivariate analysis showed that 25(OH)D, TSH, TPOAb,TGF- β1 and TNF-α were independent risk factors for subclinical hypothyroidism (OR=6.423, 2.621,12.132, 3.451, 5.116, respectively, all P<0.05). When the above indexes were included in the line chart model,it was found that the line chart prediction model AUC (0.878) of vitamin D combined with TSH, TPOAb,TGF- β1 and TNF-α was higher than predicted AUC of each variable alone, the model had high accuracy. Conclusion The line chart model established based on 25(OH)D, thyroid function index,TGF-β1,TNF-αhashigh predictive value for subclinical hypothyroidism in patients with PGDM in early pregnancy, which is helpful to formulate effective intervention strategies according to specific quantitative values.
陈秋玲 李文霞. 妊娠早期维生素D水平联合甲状腺功能及免疫炎性因子评估孕前糖尿病患者亚临床甲状腺功能减退发生的价值[J]. 发育医学电子杂志, 2022, 10(3): 182-188.
Chen Qiuling, Li Wenxia. Value of vitamin D level in early pregnancy combined with thyroid function indexes and immune inflammatory factors in evaluating the occurrence of subclinical hypothyroidism in pre-gestational diabetes mellitus patients. Journal of Developmental Medicine(Electronic Version), 2022, 10(3): 182-188.
2022, Vol. 10 
