ECE2023 Poster Presentations Thyroid (163 abstracts)
Iodine supply and thyroid status of women with gestational diabetes mellitus and their impact on birth outcomes
Hana Vitkova 1,2 , Jan Kratky 1,2 , Tomas Brutvan 1,3 , Jan Jiskra 1,2 , Katerina Anderlova 1,3 , Veronika Radimerska 1,4 , Radovan Bilek 5 , Drahomira Springer 1,4 , Felix Votava 6,7 & Eliska Potlukova 8
1First Faculty of Medicine Charles University, Prague, Czech Republic; 2General University Hospital in Prague, Third Department of Medicine, Czech Republic; 3General University Hospital in Prague, Department of Obstetrics and Gynaecology, Czech Republic; 4General University Hospital in Prague, Institute of Clinical Biochemistry and Laboratory Medicine, Czech Republic; 5Institute of Endocrinology, Czech Republic; 63rd Faculty of Medicine Charles University, Czech Republic; 7University Hospital Královské Vinohrady, Department of Children and Adolescents, Czech Republic; 8Universitätsspital Basel, Basel, Switzerland
Introduction: Urinary iodine concentration (UIC) and neonatal thyroid stimulating hormone (neoTSH) concentrations can reflect changes in iodine status and serve as a sensitive marker of iodine intake in pregnancy. As gestational diabetes mellitus (GDM) requires some diet modification, the study aimed to map the situation of iodine intake in women with GDM compared to healthy pregnant women and explore a relationship to thyroid function.
Methods: In the two groups consisting of 195 pregnant women with GDM and 88 healthy pregnant women, we assessed UIC using spectrophotometry after alkalisation and demineralisation and serum concentrations of TSH, free thyroxine (FT4) and autoantibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) were detected by chemiluminescent immunoassay. Neonatal TSH was determined in the newborns of women with GDM by immunofluorescence from a dry drop of blood on a screening card.
Results: The median of UIC was significantly lower in women with GDM than in the control group (89.50 mg/l vs 150.05 mg/l; P<0,001). The optimal iodine supply was found only in nine women with GDM (4.62%) and 33 healthy pregnant women (37.5%) (P<0.001). Most pregnant women with GDM (88.72%) and half of the controls (50.00%) had iodine deficiency (P<0.001). Neither TSH serum concentrations nor the prevalence of TSH >4 IU/l were different in both groups. However, the women with GDM had a significantly higher prevalence of isolated hypothyroxinemia compared to controls (12.31 % vs 3.41 %, P=0.032). Also, the prevalence of neonatal TSH >5 IU/l was 5.22% in newborns of women with GDM and signalled iodine deficiency. The positive association between FT4 and HbA1c in women with GDM was found in the regression model. Hypothyroxinemia <11.5 pmol/l was also associated with a higher risk of preterm birth in the same group.
Conclusion: UIC was lower in women with GDM than in control and corresponded with the iodine deficiency. Most pregnant women with GDM (88.72%) and half of the controls (50.00%) had iodine deficiency. In addition, the women with GDM had a significantly higher prevalence of isolated hypothyroxinemia compared to controls (12.31 % vs 3.41 %, P=0.032). Also, the prevalence of neonatal TSH > 5 IU/l was 5.22% in newborns of women with GDM and signalled iodine deficiency.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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