甲状腺功能亢进患者OGTT结果与胰岛β细胞功能状态的初步观察

Preliminary observation of the relationship between OGTT results in hyperthyroidism and pancreatic β cell function

目的探讨胰岛β细胞功能障碍在甲亢合并糖代谢紊乱发病过程中的作用。方法对6例正常人(NC组)、36例不同糖代谢紊乱的甲亢患者进行研究,测定空腹、60、120分钟血糖、胰岛素,并计算比较各组胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、胰岛素敏感指数(ISI)。结果甲亢合并糖代谢紊乱组HOMA-IR明显高于NC组(P<0.05),而ISI明显低于NC组(P<0.05),甲亢糖尿病组HOMA-β明显低于NC组(P<0.05)。结论甲亢合并糖代谢紊乱患者的胰岛素敏感性降低,严重患者胰岛β细胞功能降低;甲亢治疗后短期随访上述指标有所好转。

Objective To investigate the effect of pancreatic β cell dysfunction on abnormal glucose tolerance during Graves hyperthyroidism. Methods We investigated 6 healthy people and 36 Graves disease patients with abnormal glucose tolerance, and determined blood sugar and insulin at 0, 60 and 120 minutes after breakfast respectively. Then the HOMA-IR, HOMA-β and ISI were compared between the two groups. Results The HOMA-IR in the Graves disease patients with abnormal glucose tolerance is evidently higher than in the healthy subjects （P〈0. 05）, but ISI is evidently lower than the health group （P〈0. 05）. The HOMA-β in Graves disease with diabetes is obviously lower than in the health group （P 〈0. 05）. Conclusions The hyperthyroidism patients with abnormal glucose tolerance show lower insulin sensitivity and higher insulin resistance,as well as the decreased pancreatic β-cell function.