Prevalence of dual endocrinopathy: hypothyroidism and gestational diabetes mellitus in patients of preeclampsia
Keywords:Dual endocrinopathy, Gestational diabetes mellitus, Hypothyroidism, Preeclampsia
Background: Hypertension associated with proteinuria greater than 0.3g/L in a 24-hour urine collection or 1+ by qualitative urine examination, after 20 weeks of gestation is preeclampsia. The present study was conducted to evaluate prevalence of dual endocrinopathy (hypothyroidism and gestational diabetes mellitus) in patients of preeclampsia.
Methods: The observational study was conducted within a period of one year from November 2015 to October 2016 in the Department of Obstetrics and Gynaecology SMGS Hospital, GMC, Jammu. A total of 400 patients of preeclampsia were included in the study and underwent serum TSH and oral glucose tolerance test.
Results: In this study 32.5% of the preeclampsia patients (130 out of 400) had hypothyroidism, 15.25% patients (61 out of 400 preeclampsia) had gestational diabetes mellitus, 9.75 % patients of preeclampsia had dual endocrinopathy (both hypothyroidism and gestational diabetes mellitus).
Conclusions: The current study concluded that dual endocrinopathy (both hypothyroidism and gestational diabetes mellitus) has substantially higher prevalence (9.75%) in the patients of preeclampsia.
Martin Jr JN, Owens My, Keiser SD, Parrish MR, Tam Tam KB, Brewer JM, et al. Standardised Mississippi protocol treatment of 190 patients with HELLP syndrome: slowing disease progression and preventing new major maternal morbidity. Hypertens Pregnancy 2012; 31(1): 79.
Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systemic review. Lancet 2006; 367:1066.
Berg CJ, Harper MA, Atkinson SM, Bell EA, Brown HL, Hage ML, et al. Preventability of pregnancy-related deaths. Obstet Gynecol 2005; 106:1228.
Roberts JM, Lain KY. Recent insights into the pathogenesis of pre-eclampsia. Placenta 2002; 23: 359–72.
Ferrara A. Increasing prevalence of gestational diabetes. Diabetes 2007; 30: S141.
Getahun D, Nath C, Ananth CV, Chavez MR, Smulian JC. Gestational diabetes in the United States: temporal trends 1989 through 2004. Am J Obstet Gynecol 2008; 198: 525.
Paradisi G, Biaggi A, Ferrazzani S, Decarolis S, Caruso A. Abnormal Carbohydrate Metabolism During Pregnancy. Diabetes Care 2002; 25: 560-64.
Barahona MJ, Sucunza N, Garcia Patterson A, Hernandez M, Adelantado JM, Ginovart G, et al. Period of gestational diabetes mellitus diagnosis and maternal and fetal morbidity. Acta Obstet Gynecol Scand 2005; 84(7) : 622-27.
Le Beau SO, Mandel SJ. Thyroid disorders during pregnancy Endocrinol Metab Clin North Am 2006; 35(1): 117-36
Poppe K, Glinoer D. Thyroid autoimmunity and hypothyroidism before and during pregnancy. Hum Reprod Update 2003; 9(2): 149- 61.
Barber KJ, Franklyn IA, Mc Cabe CJ, Khanim FC, Bulmer JN, Whittey GSJ, Rowan J. The In-vitro Effects of Thyroid Hormone on Trophoblast. J Clin Endocrinal Metab 2005; 90(3): 1655-61.
Levine RJ, Vatten LJ, Horowitz GL, Qian C, Romundstad PR, Yu KF, et al. Pre-eclampsia, soluble fms-like tyrosine Kinase 1 and the risk of reduced thyroid function. BMJ 2009; 339.
Sahu MT, Das V, Mittal S, Aggarwal A, Sahu M. Overt and subclinical thyroid dysfunction among Indian pregnant women and its effect on maternal and fetal outcome. Arch Gynecol obstet 2010; 281(2): 215-20.
Betti M, Ceccatelli G, Belcari F, Moscuzza F, Cuttano A, Vuerich M et al. Neonatal outcome in newborns from mothers with endocrinopathies. Gynecol Endocrinol 2011; 27(4): 248-50.
Kaya E, Sahin Y, Ozkececi Z, Pasaoglu H. Relation between birth weight and thyroid function in preeclampsia – eclampsia. Gynaecol Obstet Invest 1994; 37: 30-33.
Kumar A, Ghosh BK, Murthy NS. Maternal thyroid hormonal status in preeclampsia. Indian J Med Sci. 2005; 59(2) : 57-63.
Larijani B, Marsoosi V, Aghakhani S, Moradi A, Hashemipour S. Thyroid hormone alteration in pre-eclamptic women. Gynecol Endocrinol. 2004 ; 18(2) : 97-100.
Wendland EM, Duncan BB, Belizan JM, Vigo A, Schmidt MI Gestational diabetes and pre-eclampsia: common antecedents? Arq Bras Endocrinol Metabol. 2008; 52(6): 975-84.