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BACKGROUND: Over the past decade, gestational diabetes mellitus has become of increasing medical and social importance. It happens due to its increased prevalence and due to its negative impact on pregnancy and long-term metabolic disorders in the mother and fetus. AIM: The aim of this study was to assess the relationship between subclinical gestational hypothyroidism and gestational diabetes mellitus, the two most common endocrine pathologies in pregnancy. MATERIALS AND METHODS: We studied 200 medical records of pregnant women. The main group included 133 patients with subclinical gestational hypothyroidism, and the control group consisted of 67 women without endocrine pathology. The diagnosis of gestational diabetes mellitus was made based on the Ministry of Health of the Russian Federation clinical guidelines criteria. The diagnosis of subclinical hypothyroidism was made based on the thyroid-stimulating hormone level above 2.5 IU/ml in combination with an increased titer of antithyroid antibodies or above 4.0 IU/ml in the absence of any thyroid disorder. Statistical analysis was carried out using the StatTech v.2.1.0 program (Stattech Ltd, Russia). RESULTS: The prevalence of hypothyroidism was higher among women with family history of diabetes mellitus. The chances of developing gestational diabetes mellitus increased by 9.706 times in the presence of hypothyroidism, by 1.077 times with an increase in age by one full year at the time of seeing the doctor, and by 1.023 times with an increase in weight before pregnancy by one kilogram. The thyroid-stimulating hormone level of more than 2.7 IU/ml predicted the development of gestational diabetes mellitus with a sensitivity of 71.4% and a specificity of 63.1%. CONCLUSIONS: Subclinical gestational hypothyroidism and gestational diabetes mellitus are interrelated endocrine disorders with common pathophysiological predictors. Among women with a normal body mass index, subclinical gestational hypothyroidism is a more significant risk factor for gestational diabetes mellitus than an increase in age or body weight. A certain threshold level of thyroid-stimulating hormone (more than 2.7 IU/ml) in the first trimester increases the chances of developing gestational diabetes mellitus and should be considered as a signal for timely prevention and detection of gestational diabetes mellitus.

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Aim. To perform a systematic review of common risk factors and prognostic markers of gestational diabetes mellitus (GDM) and hypothyroidism (HT), as well as maternal and perinatal complications in these diseases. For achieving this task, we screened and analysed the relevant data from the publications in a PubMed database over the past 6 years.Key Points. A common risk factor for both diseases is obesity, which is characterized by pregestational insulin resistance, as well as the combination of by low-grade chronic inflammation and metabolic dysfunction termed as meta-inflammation. Antibodies to the thyroid-stimulating hormone receptor (TSHR) are associated with the reduced the risk of GDM. Studies on pathogenesis of pre-eclampsia in patients with GDM and HT have shown unequivocal results, although most of them suggest both HT and GDM as risk factors for the development of this pregnancy complication. Elevated levels of thyroid-stimulating hormone are associated with reduced antioxidant capacity and long-term endothelial activation. The heterogeneity of the anemia in GDM requires a rigorous differential diagnosis.Conclusion. GDM and HT are the most common endocrine diseases during pregnancy which significantly increase the risk of maternal and perinatal complications. Common risk factors, interrelationship, and ambiguous data on GDM and HT development mechanisms indicate the need for screening and detailed monitoring of patients with thyroid dysfunction for early detection and correction of hyperglycemia.