格雷夫斯病患者糖代谢特点及其影响因素分析

The glucose metabolism in Graves′ disease

目的 了解格雷夫斯病(Graves′disease ,GD)患者胰岛素、C肽变化与糖耐量的关系。方法 未经治疗的格雷夫斯病患者6 5例,行口服葡萄糖耐量 胰岛素释放试验后,用化学发光法测血清胰岛素、C肽值并与正常对照比较。结果 格雷夫斯病组除空腹外其余各点血糖值明显增高(P <0 .0 0 1) ,基础免疫活性胰岛素正常,葡萄糖刺激后明显增高(P <0 . 0 0 2 7) ,总血清胰岛素/总血糖(∑IRI/∑BG)在弥漫性甲状腺肿伴格雷夫斯病组明显增加,游离三碘甲状腺原氨酸(FT3 )与多个时点血清胰岛素、C肽呈显著负相关。结论 格雷夫斯病在治疗前存在高血糖与高胰岛素血症并存的胰岛素抵抗状态。

Objective To investigate the relationship betwe en insulin and glucose tolerance in Graves′ disease (GD).Methods The study was performed in 65 untreated GD patients and in 30 euthyroid subjec ts.After the normal oral glucose tolerance test,the glucose,immunoreactive insul in (IRI),C-peptide (C-P) were measured.Results The serum gluc ose,IRI and C-P of the patients were significantly higher than those of the eut hyroid controls except for the date at 0 minute.The ∑IRI/∑BG increased signifi cantly in GD group.FT 3 correlated negatively with IRI (30,60,120 minutes),C-P (60 minutes),FT 4 did not correlate with the data at these points.Con clusion Graves′ disease can affect the metabolism of glucose and cause a series of abnormality,such as hyperglycaemia and hyperinsulinism,which sugges t that insulin-resistance is underlying in this condition.