Journal of Capital Medical University ›› 2025, Vol. 46 ›› Issue (4): 626-631.doi: 10.3969/j.issn.1006-7795.2025.04.007

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Correlation between thyroid autoimmunity and gestational diabetes mellitus in Chinese euthyroid women

Zhao Yue1，Ruan Xiangyan1*，Zou Liying2，Ma Jun1，Wang Yuejiao1，Tian Xuanxuan1，Jin Jing1   

  1. 1.Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China；2.Department of Perinatal Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
  • Received:2024-12-25 Online:2025-08-21 Published:2025-08-29
  • Supported by:
    This study was supported by Beijing Obstetrics and Gynecology Hospital , Capital Medical University. Beijing Maternal and Child Health Care Hospital “Excellent Youth” Plan Special Funds（YQRC201807），Association for Maternal and Child Health Studies ( 2018AMCHS011).

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Abstract: Objective  To explore the correlation between thyroid autoimmunity (TAI) and gestational diabetes mellitus (GDM) in Chinese euthyroid women. Methods  A total of 508 euthyroid women were enrolled in the cross-sectional study, who performed their entire clinical/biological workup and oral glucose tolerance test (OGTT) from the department of Gynecology and Endocrinology of the Beijing Obstetrics and Gynecology Hospital, Capital Medical University from June 2023 to June 2024. At median 8 (6-10) weeks of gestation, thyroid-stimulating hormone (TSH), free thyroxine (fT4), and thyroid peroxidase antibodies (TPOAb) were measured, baseline characteristics were recorded, and an OGTT was performed between 24 and 28 weeks of pregnancy. According to the OGTT results, they were divided into GDM group (n=169) and non GDM group (n=339). Thyroid parameters, the demographic and obstetric parameters, and the prevalence of TAI were compared with two groups. The factors associated with GDM were analyzed with multivariate Logistic regression analysis. Results  The age, body mass index (BMI), and proportion of obese women before pregnancy in the GDM group were all significantly higher than those in the non-GDM group, with statistically significant differences (P<0.001). The proportion of pregnant women over 30 years old in the GDM group was significantly higher than that in the non-GDM group (59.17% vs 6.79%, χ2=168.667, P<0.001). The proportion of obese mothers (BMI ≥ 28 kg/m2) before pregnancy in the GDM group was 24.26%, which was significantly higher than that in the non-GDM group (8.26%) (χ2=24.599, P<0.001). The incidence of TAI in the GDM group was 54.44%, while it was 15.93% in the non-GDM group. The difference between the two groups was statistically significant (χ2=81.659, P<0.001). The results of Logistic regression analysis showed that maternal age over 30 years and pre-pregnancy obesity increased the risk of GDM occurrence in TAI women by 6.08 times (OR=6.08, 95% CI 3.61-10.25, P<.001). Conclusion  Among early pregnancy women with normal thyroid function, as age increases during follow-up (especially over 30 years old), pre-pregnancy BMI increases (especially in obese individuals), and those with pre-pregnancy TAI, the risk of developing GDM during pregnancy significantly increases. It is necessary to explore preventive strategies for GDM in euthyroid TAI women, with a view to improving adverse pregnancy outcomes.

Key words: thyroid autoimmunity, thyroid peroxidase antibodies, gestational diabetes mellitus, thyrotropin, free thyroxine, first trimester

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