甲状腺过氧化物酶抗体与游离甲状腺激素对妊娠期糖尿病发病影响的相关性研究

doi:10.3969/j.issn.1006-7795.2026.01.011

首都医科大学学报 ›› 2026, Vol. 47 ›› Issue (1): 87-92.doi: 10.3969/j.issn.1006-7795.2026.01.011

甲状腺过氧化物酶抗体与游离甲状腺激素对妊娠期糖尿病发病影响的相关性研究

王春雨^1,2,邹丽颖^1*,赵越³

1.首都医科大学附属北京妇产医院/北京妇幼保健院围产医学部，北京 100026;2.北京市通州区张家湾镇张家湾社区卫生服务中心，北京 101113；3.首都医科大学附属北京妇产医院/北京妇幼保健院医务处，北京 100026

收稿日期:2025-09-30 修回日期:2025-11-18 出版日期:2026-02-21 发布日期:2026-02-02
通讯作者: 邹丽颖 E-mail:zouliying@ccmu.edu.cn
基金资助:
北京市自然基金项目（7192067）,首都医科大学附属北京妇产医院/北京妇幼保健院“优青人才”计划专项经费资助项目（YQRC201807）。

Correlation analysis of thyroid peroxidase antibody and free thyroxine on the incidence of gestational diabetes mellitus

Wang Chunyu^1，2, Zou Liying^1*, Zhao Yue³

1.Department of Perinatal Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University/Beijing Maternal and Child Health Care Hospital, Beijing 100026, China; 2.Zhangjiawan Community Healthcare Center, Tongzhou District, Beijing, Beijing 101113, China；3.Medical Administration Department, Beijing Obstetrics and Gynecology Hospital, Capital Medical University/Beijing Maternal and Child Health Care Hospital, Beijing 100026, China

Received:2025-09-30 Revised:2025-11-18 Online:2026-02-21 Published:2026-02-02
Supported by:
This study was supported by Beijing Municipal Natural Science Foundation（7192067）,Beijing Obstetrics and Gynecology Hospital,Capital Medical University/Beijing Maternal and Child Health Care Hospital “Excellent Youth” Plan Special Funds（YQRC201807）.

摘要/Abstract

摘要： 目的分析孕早期甲状腺过氧化物酶抗体（thyroid peroxidase antibody,TPOAb）、游离甲状腺激素（free thyroxine,FT4）与妊娠期糖尿病（gestational diabetes mellitus,GDM）发生风险的关系。方法选取2020年1月至2020年10月在首都医科大学附属北京妇产医院围产医学部建档并进行规律产检,资料完整的440例孕妇，根据是否诊断为GDM分为GDM组（n=335）和非GDM组（n=105），用单因素和多因素回归分析探讨孕早期TPOAb和FT4浓度与GDM的发生关系。结果 GDM组患者年龄、体质量指数（body mass index，BMI）、TPOAb浓度均高于非GDM组，FT4浓度低于非GDM组，差异有统计学意义（P<0.05），2组患者促甲状腺激素（thyroid-stimulating hormone，TSH）浓度差异无统计学意义（P>0.05）。由单因素分析可知，GDM的发生与年龄、BMI及TPOAb、FT4浓度存在相关性，进一步进行多因素Logistic回归分析显示，GDM发病的影响因素分别为年龄（OR=1.111，95%CI：1.005～1.228）、BMI（OR=1.141，95%CI：1.028～1.266）、TPOAb浓度（OR=1.046，95%CI：1.015～1.078）、FT4浓度（OR=0.749，95%CI：0.644～0.871）；TPOAb、FT4浓度预测GDM患病率联合曲线下面积高于单一指标。结论孕期TPOAb升高和FT4降低是GDM的独立危险因素，且两者联合检测对GDM发生风险具有更高的预测价值，建议对孕早期女性开展甲状腺功能及抗体筛查，为早期干预GDM提供参考依据。

关键词: 甲状腺过氧化物酶抗体, 游离甲状腺激素, 妊娠期糖尿病, 促甲状腺激素, 自身免疫, 甲状腺功能减退症

Abstract: Objective To analyze the relationship between thyroid peroxidase antibody (TPOAb), free thyroxine (FT4) in the first trimester of pregnancy and the risk of gestational diabetes mellitus (GDM). Methods A total of 440 pregnant women who received regular prenatal check-ups and had complete data in the Department of Perinatal Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2020 to October 2020 were selected. They were divided into the GDM group (n=335) and the non-GDM group (n=105) according to whether GDM was diagnosed. Univariate and multivariate regression analyses were used to explore the relationship between TPOAb, FT4 in the first trimester and the occurrence of GDM. Results The age, body mass index (BMI) and TPOAb levels of patients in the GDM group were higher than those in the non-GDM group, while the FT4 level was lower than that in the non-GDM group, with statistically significant differences (P<0.05). There was no statistically significant difference in thyroid-stimulating hormone (TSH) level between the two groups (P>0.05). Univariate analysis showed that the occurrence of GDM was correlated with age, BMI, TPOAb and FT4 levels. Multivariate Logistic regression analysis showed that the influencing factors for the incidence of GDM were age (OR=1.111, 95%CI: 1.005-1.228), BMI (OR=1.141, 95%CI: 1.028-1.266), TPOAb level (OR=1.046, 95%CI: 1.015-1.078) and FT4 level (OR=0.749, 95%CI: 0.644-0.871). The combined area under the curve (AUC) of TPOAb and FT4 levels for predicting the prevalence of GDM was higher than that of a single indicator. Conclusion Increased TPOAb and decreased FT4 during pregnancy are independent risk factors for GDM, and the combined detection of these two indicators has higher predictive value for the risk of GDM. It is recommended to conduct thyroid function and antibody screening for women in the first trimester of pregnancy, to provide a reference for early intervention of GDM.

Key words: thyroid peroxidase antibody, free thyroxine, gestational diabetes mellitus, thyroid-stimulating hormone, autoimmunity, hypothyroidism

中图分类号:

R714

王春雨, 邹丽颖, 赵越. 甲状腺过氧化物酶抗体与游离甲状腺激素对妊娠期糖尿病发病影响的相关性研究[J]. 首都医科大学学报, 2026, 47(1): 87-92.

Wang Chunyu, Zou Liying, Zhao Yue. Correlation analysis of thyroid peroxidase antibody and free thyroxine on the incidence of gestational diabetes mellitus[J]. Journal of Capital Medical University, 2026, 47(1): 87-92.

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甲状腺过氧化物酶抗体与游离甲状腺激素对妊娠期糖尿病发病影响的相关性研究

Correlation analysis of thyroid peroxidase antibody and free thyroxine on the incidence of gestational diabetes mellitus

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