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

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 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.