| BackgroundGestational Diabetes mellitus(GDM)is a Gestational disorder pregnancy.The occurrence of gestational diabetes seriously threatens the short-term and long-term health of pregnant women and fetuses.If the blood glucose control is not promptly,the GDM pregnant women are prone to a variety of complications,such as hydramnios,premature birth,macrosomia,premature rupture of membranes and postpartum hemorrhage,and so on,occur Ⅱ diabetes risk will increase significantly.Therefore,early detection of GDM and active intervention and corresponding treatment measures are of great significance for reducing its harm to pregnant women and perinatal babies.Multiple studies have shown that pregnant women with gestational diabetes have significant differences in biomarkers such as thyroid stimulating hormone(TSH)compared with women with normal glucose metabolism,and to some extent are associated with patients’ liver function.However,the association between TSH combined with liver function and GESTational diabetes remains to be determined.Therefore,this study will analyze and compare TSH and liver function indicators of normal non-pregnant women,normal pregnant women and patients with gestational diabetes,to explore the relationship between thyroid stimulating hormone and liver function indicators in the incidence of gestational diabetes.ObjectiveBy analyzing and comparing the thyroid stimulating hormone and liver function indexes of normal non-pregnant women,normal pregnant women and patients with gestational diabetes,the relationship between thyroid stimulating hormone and liver function indexes in the pathogenesis of gestational diabetes was discussed,so as to provide some help for the diagnosis,prevention and treatment of gestational diabetes in clinic.MethodsThis study randomly selected 30 gestational diabetes patients as gestational diabetes group and 30 normal pregnancy as the normal pregnancy group,underwent routine pregnancy test in the obstetrics department of Xuchang municipal hospital From January2019 to March 2020.Meanwhile,30 healthy women of childbearing age were selected as healthy group.All the patients in three groups were between 25-30 years old and have no other diseases such as autoimmune diseases,infectious diseases,use of large doses of drugs,serious heart,lung,kidney diseases,mental diseases,and chronic consumptive diseases,etc.To detect the object of ALT、AST、TBIL、TSH results and glucose tolerance test results of 75 g at 24-28 weeks gestation.At the same time,the results of ALT、AST、TBIL、TSH in the first trimester of the study subjects were collected.Application SpSS19.0statistical software to analyze data,measurement data used in this study mean + /-standard deviation(X + S)said,gestational diabetes mellitus group,normal pregnancy group and normal non pregnant the comparison between the three groups with variance analysis,correlation analysis using pearson correlation analysis,p < 0.05 is difference was statistically significant.At the same time,subject work curve analysis(ROC curve analysis)was performed for TSH and liver function during pregnancy,and changes in the area under the curve of individual biochemical indexes and the area under the curve of each biochemical index were compared to further evaluate the predictive value of TSH and liver function in gestational diabetes mellitus.Results1.The average value and standard deviation of fasting blood glucose were(5.19±0.33)mmol/L,(9.87±2.11)mmol/L after 1 h taking glucose and(8.07±1.86)mmol/L after 2 h taking glucose in GDM group,respectively.The average value and standard deviation of fasting blood glucose were(4.69±0.24)mmol/L,(7.48±1.20)mmol/L after 1 h taking glucose and(6.34±1.01)mmol/L after 2 h taking glucose in normal pregnancy group,respectively.Compared with the normal pregnancy group,the fasting blood glucose at 0 h,1 h and 2 h after taking glucose had statistical significance in GDM group(p<0.05).2.The average value and standard deviation of thyroid stimulating hormone(TSH)were(2.50±0.88)u IU/ml in the gestational diabetes group,were(1.98±0.78)u IU/ml in the normal pregnancy group and were(1.62±0.36)u IU/ml in the healthy group.The levels of TSH in GDM group and normal pregnancy group were significantly increased than that in normal non pregnancy group.There were significant differences in TSH among the three groups(p<0.05).3.The average value and standard deviation of alanine aminotransferase(ALT)were(19.71±4.91)U/L in the gestational diabetes group,were(16.24±7.62)U/L in the normal pregnancy group and were(13.09±3.31)U/L in the healthy group.There were significant differences in ALT among the three groups(p<0.05).4.The average value and standard deviation of aspartate aminotransferase(AST)were(18.14±4.66)U/L in the gestational diabetes group,were(15.75±2.9)U/L in the normal pregnancy group.and were(15.97±1.85)U/L in the healthy group.There were significant differences in AST among the three groups(p<0.05).5.The average value and standard deviation of serum total bilirubin(TBIL)were(9.48±2.13)u mol/L in the gestational diabetes group,were(10.92±2.46)umol/L in the normal pregnancy group and were(12.30±2.93)umol/L in the healthy group.The differences in total bilirubin(TBIL)among the three groups were statistically significant(p<0.05).6.In the gestational diabetes group,the average value and standard deviation of thyroid stimulating hormone in early pregnancy were(2.43±0.68)u IU/mL;the average value and standard deviation of alanine aminotransferase were(15.86± 4.18)U/L;the average value and standard deviation of aspartate aminotransferase were(17.83± 4.12)U/L;the mean and standard deviation of serum total bilirubin is(9.72± 1.67)umol/L.Compared with the normal pregnancy group,the data of the gestational diabetes group in the first trimester showed statistically significant differences in the levels of thyroid-stimulating hormone,aspartate aminotransferase,and serum total bilirubin(P<0.05).7.According to the pearson correlation analysis results in gestational diabetes group,TSH,ALT,AST,TBIL and OGTT test(p>0.05)in each group had no correlation,suggesting that the levels of TSH,ALT,AST and TBIL had no significant relation with blood glucose changes in the gestational diabetes.8.Using receiver operating curve(ROC curve)to analyze that the area under the curve(AUC)of TSH,AST,ALT during pregnancy is between 0.5 and 0.7,and the area under the TBIL curve(AUC)is less than 0.5;combined with the area under the curve of AST,ALT,TBIL 0.746(AUC=0.746);combined TSH and liver function area under the curve is 0.778(AUC=0.778).9.At the same time,ROC curve was used to analyze the area under the curve of TSH,AST,ALT in the first trimester.The area under the curve of combined AST,ALT,TBIL was0.702(AUC=0.702);the area under the curve of combined TSH and liver function was0.801(AUC=0.801).It shows that the combination of TSH and liver function has a certain relationship with the occurrence of gestational diabetes,and the combination of TSH and liver function has the value of predicting gestational diabetes.Conclusions1.The serum TSH level in patients with gestational diabetes was significantly higher than that in the normal pregnancy group and the normal non-pregnancy group.Therefore,regular detection of TSH level during pregnancy has an important guiding role in the diagnosis,prevention and treatment of gestational diabetes.2.The liver function of patients with gestational diabetes is more serious than that of the normal pregnancy group and the normal non-pregnancy group.Therefore,regular detection of liver function indicators during pregnancy plays an important role in assessing the liver function of pregnant women and preventing complications caused by abnormal liver function.3.The combination of TSH and liver function testing is helpful to predict gestational diabetes,and provides a certain reference for clinical early screening and diagnosis of gestational diabetes.However,the single indexes of TSH,ALT,AST and TBIL in gestational diabetes group were not significantly correlated with the changes of blood glucose in gestational diabetes group.The correlation between GDM and other factors should be discussed in the future. |
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