Graves病糖代谢紊乱与胰岛素抵抗

Glucose metabolism disorder and insulin resistance of Graves disease

目的探讨Graves病对糖代谢的影响及Graves病患者糖代谢状况、胰岛素变化的临床意义。方法对85例Graves病患者作口服葡萄糖耐量试验(OGTT)、胰岛素释放试验及甲状腺激素水平测定,糖耐量结果表现为糖耐量正常者定为GD1组,糖尿病或糖耐量减低者定为GD2组,并与正常人组进行比较。结果 Graves病患者合并糖代谢异常者占44.71%(38/85),其中糖调节受损者占23.53%,达到糖尿病诊断标准者占21.18%,糖尿病患者餐后胰岛素明显升高。经抗甲治疗6～12个月,甲状腺激素恢复正常后,糖耐量减低组17例(占85.00%)患者血糖恢复正常,糖尿病患者组5例(占27.78%)患者血糖恢复正常。结论 Graves病患者应常规作OGTT检查,并定期随访,采取合理的方法及时控制高血糖,防止不可逆性糖代谢紊乱及各种并发症的发生。

【Objective】 The purpose of this study was to investigate glycometabolic disorder in patients with Graves disease（GD）,and to investigate the clinical significance on the change of glycometablism and insulin in GD patients.【Methods】 The oral glucose tolerance tests（OGTT）,insulin release tests and the concentration of serum thyroxin were conducted in 85 Graves disease patients,patients with normal glucose tolerance were assigned into GD1 group,with impaired glucose tolerance or diabetes mellitus（DM） as GD2 group,and these indexes were compared with those of the normal group.【Results】 The abnormality rate of glycometabolism was 44.71% in Graves disease patients,23.53% of patients showed impaired glucose tolerance（IGT）,21.18% of the patients presented glucose tolerance compatible with diabetes（GTCD） who were found to be with obviously high postprandial insulin.After 6 months to 1 year＇s antithyroid treatment,in IGT group,85.0% of patients showed normal blood glucose,and in GTCD group only 27.78% of patients presented normal blood glucose.【Conclusion】 It is suggested that a routine detection of OGTT,and regularly following up these indexes are necessary for Graves disease patients.Take reasonable and timely control of high blood sugar and prevent irreversible disorder of glucose metabolism and various complications.