ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P753

Thyroid function and glucose tolerance in pregnancy: THYROMOBIL pilot study in Poland

Zbigniew Szybinski1, Grzegorz Sokolowski1, Aleksandra Gilis-Januszewska1, Alicja Hubalewska-Dydejczyk1, Agnieszka Stefanska1, Monika Buziak-Bereza1, Irena Kaim2 & Antoni Basta2

1Chair and Department of Endocrinology, Medical College, Jagiellonian University, Krakow, Poland; 2Chair and Department of Gynecology and Obstetrics, Medical College, Jagiellonian University, Krakow, Poland.

Aim of the study was

1. To assess the thyroid function in pregnancy in the course of effective iodine prophylaxis model introduced in 1997, based on obligatory salt iodization.

2. To exam glucose tolerance and insulinemia in pregnancy.

Methods: TSH, fT4, aTPO, urine iodine concentration, usg thyroid volume and homogeneity, glucose and insulin during OGTT, blood pressure, BMI, and thyroid function and glucose metabolism family history questionnaire, use of iodine supplements questionnaire were examined in healthy pregnant women (npilot=103, recruited from the patients of Department of Gynecology and Obstetrics, pregnancy trimester I-37%, II-47%, III-16%) in THYROMIBIL action.

Results: Goiter prevalence was 3.1%. Solitary thyroid nodules and abnormal homogeneity were detected in 17.5 and 20.5% of pregnant women respectively. TSH over 2.5 μj/ml, decreased fT4 and increased aTPO were detected in 18.7, 14.1 and 9.6% of probants respectively. Sixty percent of pregnant women supplemented diet with 150–200 μg of iodine, only 26% had no supplementation. Family history of thyroid dysfunction was observed in 28.9%. Increased fasting glucose was found in 5%, and impaired glucose tolerance was observed in 3.3% of pregnant women. Mean fasting and after glucose load insulin was 12.1 μj/ml (S.D.=12) and 37 μj/ml (S.D.=22) respectively. Increased systolic and diastolic blood pressure was found in 5.2 and 12.4% of probants.

Conclusions: In spite of obligatory model of iodine prophylaxis still high incidence of nodules in thyroid was observed. More than 70% of women had additional iodine supplementation.

Abnormal glucose metabolism and hypertension in pregnancy requiring medical consultation was observed in more than 5% of women.

Our study confirms usefulness of THYROMOBIL model in assessment of thyroid function and glucose metabolism in pregnancy.

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