The Predictive Value of TG/HDL-C Combined with FT3/FT4 for Gestational Diabetes Mellitus in Pregnant Women with Hypothyroidism
REN Qian
SUN Yan
WANG Jiaying
SHI Shaowen
Abstract：Objective To analyze the predictive value of the triglyceride to high-density lipoprotein cholesterol ratio(TG/HDL-C)combined with the free triiodothyronine to free thyroxine ratio(FT3/FT4)for gestational diabetes mellitus(GDM)in pregnant women with hypothyroidism.Methods A total of 116 pregnant women with hypothyroidism who were admitted to the First Hospital of Qinhuangdao from January 2022 to January 2024 were selected and divided into a GDM group(28 cases)and a non-GDM group(88 cases)based on the occurrence of GDM.The ROC curve was used to analyze the value of TG/HDL-C combined with FT3/FT4 in predicting GDM in pregnant women with hypothyroidism,and multivariate Logistic stepwise regression analysis was applied to identify influencing factors for GDM in these patients.Results The levels of TG,FT3,TG/HDL-C,and FT3/FT4 in the GDM group were higher than those in the non-GDM group,while HDL-C and FT4 levels were lower(P<0.05).The area under the curve(AUC)of the combined prediction of GDM using TG/HDL-C and FT3/FT4 was 0.903,which was significantly better than that of TG/HDL-C(0.772)or FT3/FT4(0.825)alone(P<0.01).The GDM group also had higher age,pre-pregnancy body mass index,thyroid-stimulating hormone,glycated hemoglobin,testosterone,and homocysteine levels compared to the non-GDM group(P<0.05).Multivariate Logistic stepwise regression analysis showed that elevated glycated hemoglobin(OR=1.958,95%CI:1.297-2.955),elevated testosterone(OR=2.282,95%CI:1.360-3.828),elevated homocysteine(OR=2.048,95%CI:1.336-3.140),TG/HDL-C≥1.59(OR=3.025,95%CI:1.591-5.754),and FT3/FT4≥0.24(OR=3.040,95%CI:1.770-5.222)were independent risk factors for GDM in pregnant women with hypothyroidism(P<0.01).Conclusion Elevated TG/HDL-C and FT3/FT4 are closely associated with the occurrence of GDM in pregnant women with hypothyroidism.The combined use of these two ratios offers significantly better predictive value for GDM than either indicator alone and may serve as a biomarker for predicting the development of GDM.
Keywords：triglyceride to high-density lipoprotein cholesterol ratiofree triiodothyronine to free thyroxine ratiohypothyroidismgestational diabetes mellitus
Publication Date：2025-10-20
Online Publishing Date：2025-10-28(First online date of this platform, not the publication date of the document)
Pages：5( 43-47 )