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Diabetes and Hypothyroidism Alone and Simultaneously in Bulgarian Pregnant Women - Frequency and Features of Various Risk Factors

Received: 24 August 2021    Accepted: 16 September 2021    Published: 27 September 2021
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Abstract

Gestational hypothyroidism affects the maturation and function of the beta cell, which can influence glucose metabolism. The aim of the study is to investigate the relationship between Hypothyroidism and Hyperglycemia in Bulgarian pregnant women and to look for the influence of various factors on the manifestation of each of these diseases separately, as well as their role in cases of simultaneous combination of the two diseases. Маterial: We studied 547 pregnant women, mean 30±5 years. The cross-sectional population-based multicenter study was conducted in 84 Bulgarian towns and villages. Pregnant women were divided into 4 groups according to the presence or absence of Diabetes (Diab) resp. Hypothyroidism (Thyr): Group 0 – 62.7% (n-343) – without Thyr or Diab; Group 1 – 22.9% (n-125) – Thyr; Group 2 – 11% (n-60) – Diab; Group 3 – 3.5% (n-19) – with Thyr and Diab. Methods: Fasting morning venous blood (TSH, FT4 - determined by ECLIA method) and fresh morning urine sample (to determine urine iodine concentration - UIC) was taken. A two-hour, 75 g oral glucose tolerance test (OGTT) was performed. The peripheral levels of 25(OH)D were tested using a standard assay in a central laboratory on the day of the sampling. The statistical analysis was conducted using standard SPSS 13.0 for Windows. Results: Group 2 were the oldest and Group 1 - the youngest, P<0.001. Group 2 as well as Group 3 had significantly higher BMI compared to Group 0 and Group 1, P<0.0001 / P<0.016. In Group 1 thyroid pathology had manifested itself earlier in the course of pregnancy, while in Group 2 dysglycemia occurred later, P<0.029 as well as for group 3, P<0.004. There was a significant negative correlation between 25(OH)D with level of fasting plasma glycemia - P<0.004, and at 120 minute of OGTT, P<0.003. In the group of pregnant women with Hyperglycaemia (n-79), deficiency of UIC (<150 µg / L) was reported in 45.6%, and twice more frequently artificial excess in the UIC level (>500 µg / L), compared with the Group with Normoglycemia (n-368). Conclusion: All international guidelines specifically emphasize the main risk factors when pregnant women should be screened for early detection of major endocrine diseases. However, the role of some additional factors, such as deficiency of 25(OH)D and iodine, should not be underestimated.

Published in International Journal of Diabetes and Endocrinology (Volume 6, Issue 3)
DOI 10.11648/j.ijde.20210603.14
Page(s) 114-124
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Pregnancy, Hypothyroidism, Diabetes, Age, BMI, Deficiency of 25(OH)D, Deficiency of UIC

References
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    Anna-Maria Borissovа, Boyana Trifonova, Lilia Dakovska, Eugenia Michaylova, Mircho Vukov. (2021). Diabetes and Hypothyroidism Alone and Simultaneously in Bulgarian Pregnant Women - Frequency and Features of Various Risk Factors. International Journal of Diabetes and Endocrinology, 6(3), 114-124. https://doi.org/10.11648/j.ijde.20210603.14

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    ACS Style

    Anna-Maria Borissovа; Boyana Trifonova; Lilia Dakovska; Eugenia Michaylova; Mircho Vukov. Diabetes and Hypothyroidism Alone and Simultaneously in Bulgarian Pregnant Women - Frequency and Features of Various Risk Factors. Int. J. Diabetes Endocrinol. 2021, 6(3), 114-124. doi: 10.11648/j.ijde.20210603.14

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    AMA Style

    Anna-Maria Borissovа, Boyana Trifonova, Lilia Dakovska, Eugenia Michaylova, Mircho Vukov. Diabetes and Hypothyroidism Alone and Simultaneously in Bulgarian Pregnant Women - Frequency and Features of Various Risk Factors. Int J Diabetes Endocrinol. 2021;6(3):114-124. doi: 10.11648/j.ijde.20210603.14

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  • @article{10.11648/j.ijde.20210603.14,
      author = {Anna-Maria Borissovа and Boyana Trifonova and Lilia Dakovska and Eugenia Michaylova and Mircho Vukov},
      title = {Diabetes and Hypothyroidism Alone and Simultaneously in Bulgarian Pregnant Women - Frequency and Features of Various Risk Factors},
      journal = {International Journal of Diabetes and Endocrinology},
      volume = {6},
      number = {3},
      pages = {114-124},
      doi = {10.11648/j.ijde.20210603.14},
      url = {https://doi.org/10.11648/j.ijde.20210603.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20210603.14},
      abstract = {Gestational hypothyroidism affects the maturation and function of the beta cell, which can influence glucose metabolism. The aim of the study is to investigate the relationship between Hypothyroidism and Hyperglycemia in Bulgarian pregnant women and to look for the influence of various factors on the manifestation of each of these diseases separately, as well as their role in cases of simultaneous combination of the two diseases. Маterial: We studied 547 pregnant women, mean 30±5 years. The cross-sectional population-based multicenter study was conducted in 84 Bulgarian towns and villages. Pregnant women were divided into 4 groups according to the presence or absence of Diabetes (Diab) resp. Hypothyroidism (Thyr): Group 0 – 62.7% (n-343) – without Thyr or Diab; Group 1 – 22.9% (n-125) – Thyr; Group 2 – 11% (n-60) – Diab; Group 3 – 3.5% (n-19) – with Thyr and Diab. Methods: Fasting morning venous blood (TSH, FT4 - determined by ECLIA method) and fresh morning urine sample (to determine urine iodine concentration - UIC) was taken. A two-hour, 75 g oral glucose tolerance test (OGTT) was performed. The peripheral levels of 25(OH)D were tested using a standard assay in a central laboratory on the day of the sampling. The statistical analysis was conducted using standard SPSS 13.0 for Windows. Results: Group 2 were the oldest and Group 1 - the youngest, P500 µg / L), compared with the Group with Normoglycemia (n-368). Conclusion: All international guidelines specifically emphasize the main risk factors when pregnant women should be screened for early detection of major endocrine diseases. However, the role of some additional factors, such as deficiency of 25(OH)D and iodine, should not be underestimated.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Diabetes and Hypothyroidism Alone and Simultaneously in Bulgarian Pregnant Women - Frequency and Features of Various Risk Factors
    AU  - Anna-Maria Borissovа
    AU  - Boyana Trifonova
    AU  - Lilia Dakovska
    AU  - Eugenia Michaylova
    AU  - Mircho Vukov
    Y1  - 2021/09/27
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijde.20210603.14
    DO  - 10.11648/j.ijde.20210603.14
    T2  - International Journal of Diabetes and Endocrinology
    JF  - International Journal of Diabetes and Endocrinology
    JO  - International Journal of Diabetes and Endocrinology
    SP  - 114
    EP  - 124
    PB  - Science Publishing Group
    SN  - 2640-1371
    UR  - https://doi.org/10.11648/j.ijde.20210603.14
    AB  - Gestational hypothyroidism affects the maturation and function of the beta cell, which can influence glucose metabolism. The aim of the study is to investigate the relationship between Hypothyroidism and Hyperglycemia in Bulgarian pregnant women and to look for the influence of various factors on the manifestation of each of these diseases separately, as well as their role in cases of simultaneous combination of the two diseases. Маterial: We studied 547 pregnant women, mean 30±5 years. The cross-sectional population-based multicenter study was conducted in 84 Bulgarian towns and villages. Pregnant women were divided into 4 groups according to the presence or absence of Diabetes (Diab) resp. Hypothyroidism (Thyr): Group 0 – 62.7% (n-343) – without Thyr or Diab; Group 1 – 22.9% (n-125) – Thyr; Group 2 – 11% (n-60) – Diab; Group 3 – 3.5% (n-19) – with Thyr and Diab. Methods: Fasting morning venous blood (TSH, FT4 - determined by ECLIA method) and fresh morning urine sample (to determine urine iodine concentration - UIC) was taken. A two-hour, 75 g oral glucose tolerance test (OGTT) was performed. The peripheral levels of 25(OH)D were tested using a standard assay in a central laboratory on the day of the sampling. The statistical analysis was conducted using standard SPSS 13.0 for Windows. Results: Group 2 were the oldest and Group 1 - the youngest, P500 µg / L), compared with the Group with Normoglycemia (n-368). Conclusion: All international guidelines specifically emphasize the main risk factors when pregnant women should be screened for early detection of major endocrine diseases. However, the role of some additional factors, such as deficiency of 25(OH)D and iodine, should not be underestimated.
    VL  - 6
    IS  - 3
    ER  - 

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Author Information
  • Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria

  • Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria

  • Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria

  • Medical Diagnostic Laboratоry Bodimed, Sofia, Bulgaria

  • Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria

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