Free thyroxine in early pregnancy is an independent negative predictor of 3rd trimester HbA1c. Odense child cohort

Marianne Skovsager Andersen*, Tina Kold Jensen, Anja Fenger Dreyer, Jeppe Buur Madsen, Henrik Thybo Christesen, Ivan Brandslund, Niels Bilenberg, Dorte Glintborg

*Kontaktforfatter for dette arbejde

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Abstrakt

Background: Lower thyroid function outside pregnancy is associated with an increased risk of type 2 diabetes mellitus. The relationship between thyroid function in early pregnancy and glucose status in 3rd trimester has not been investigated. Aims: To study the association between 1st trimester thyroid function and 3rd trimester glucose status. Design: In the prospective study Odense Child Cohort (OCC), 1,041 women had 1st trimester blood samples analysed for thyroid-stimulating hormone (TSH), free T4 (FT4), thyroid peroxidase antibody and HbA1c. Third trimester (week 28) fasting blood samples included plasma glucose, insulin and HbA1c. Oral glucose tolerance test (OGTT, 75 g glucose) was performed in 509 women. First trimester FT4 was dichotomized >vs. ≤ the 25th percentile (25p = 12.9 pmol/L). Homeostatic model assessment-insulin resistance (HOMA)-IR and HOMA-β were calculated. Results: Women with FT4 ≤25p had significantly higher HbA1c in 1st and 3rd trimesters and higher 3rd trimester fasting glucose, insulin, HOMA-IR and HOMA-β compared to women with FT4 >25p. In multiple regression analyses, FT4 was an independent negative predictor of 3rd trimester HbA1c. FT4 levels in 3rd and 4th quartiles (high-normal FT4 levels) showed closest inverse associations with HbA1c (p-trend <.001). TSH was not associated with 3rd trimester HbA1c. Conclusion: Women with lower levels of FT4 in early pregnancy had higher HbA1c in 3rd trimester and FT4 was an independent negative predictor of 3rd trimester HbA1c.

OriginalsprogEngelsk
TidsskriftClinical endocrinology
Vol/bind95
Udgave nummer3
Sider (fra-til)508-519
ISSN0300-0664
DOI
StatusUdgivet - sep. 2021

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© 2021 John Wiley & Sons Ltd

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