Increased Central and Peripheral Thyroid Resistance Indices During the First Half of Gestation Were Associated With Lowered Risk of Gestational Diabetes-Analyses Based on Huizhou Birth Cohort in South China

Zhao-Min Liu; Guoyi Li; Yi Wu; Di Zhang; Sujuan Zhang; Yuan-Tao Hao; Weiqing Chen; Qi Huang; Shuyi Li; Yaojie Xie; Mingtong Ye; Chun He; Ping Chen; Wenjing Pan

doi:10.3389/fendo.2022.806256

Increased Central and Peripheral Thyroid Resistance Indices During the First Half of Gestation Were Associated With Lowered Risk of Gestational Diabetes-Analyses Based on Huizhou Birth Cohort in South China

Front Endocrinol (Lausanne). 2022 Mar 8:13:806256. doi: 10.3389/fendo.2022.806256. eCollection 2022.

Authors

Zhao-Min Liu^{1

2}, Guoyi Li^{1

2}, Yi Wu^{1

2}, Di Zhang^{1

2}, Sujuan Zhang^{1

2}, Yuan-Tao Hao², Weiqing Chen², Qi Huang^{1

2}, Shuyi Li^{1

2}, Yaojie Xie³, Mingtong Ye⁴, Chun He⁴, Ping Chen⁴, Wenjing Pan⁴

Affiliations

¹ Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
² School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China.
³ School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China.
⁴ Huizhou First Mother and Child Health-Care Hospital, Huizhou, China.

Abstract

Objectives: The study aimed to explore the relationship of thyroid function and resistance indices with subsequent risk of gestational diabetes (GDM).

Design: This was a longitudinal study embedded in the Huizhou Birth Cohort.

Methods: A total of 2,927 women of singleton pregnancy were recruited from January to October of 2019. Thyroid central resistance indices were evaluated by Thyroid Feedback Quartile-Based index (TFQI), Thyrotrophy T4 Resistance Index (TT4RI), and TSH Index (TSHI) based on plasma-free thyroxine (FT4) and thyroid-stimulating hormone (TSH) levels during the first half of pregnancy. Thyroid peripheral sensitivity was assessed by free triiodothyronine (FT3) to FT4 ratio (FT3/FT4), a proxy of deiodinase activity. GDM was diagnosed between 24 and 28 weeks of gestation by a standardized 75 g oral glucose tolerance test. Multivariable linear and logistic regression was applied to examine the associations of thyroid markers with GDM risk.

Results: FT3 and FT3/FT4 were positively associated with both fasting and post-load glucose levels, while TSH, TSHI, TT4RI, and TFQI were negatively associated with 1 and 2 h post-load glucose levels. Compared with the lowest quartile, GDM risk in the highest quartile increased by 44% [odds ratio (OR) = 1.44; 95%CI, 1.08-1.92; p_trend = 0.027] for FT3 and 81% (OR = 1.81; 95%CI, 1.33-2.46; p_trend < 0.001) for FT3/FT4, while it lowered by 37% (OR = 0.63; 95%CI, 0.47-0.86; p_trend = 0.002] for TSHI, 28% for TT4RI (OR = 0.72; 95%CI, 0.54-0.97; p_trend = 0.06), and 37% for TFQI (OR = 0.63; 95%CI, 0.46-0.85; p_trend < 0.001).

Conclusions: This longitudinal study indicated that higher FT3 and FT3/FT4 and lower central thyroid resistance indices were associated with increased risk of GDM.

Keywords: gestational diabetes mellitus; prevention; thyroid; thyroid function tests; thyroid hormone resistance index.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Birth Cohort
China / epidemiology
Diabetes, Gestational* / epidemiology
Female
Glucose
Humans
Longitudinal Studies
Pregnancy
Thyroid Gland*
Thyrotropin
Thyroxine

Substances

Thyrotropin
Glucose
Thyroxine