IDDM儿童和青少年甲状旁腺和甲状腺功能测定及其临床价值

THE ESTIMATIONS OF PARATHYROID AND THYROID FUNCTION IN CHILDREN AND ADOLESCENTS WITH IDDM AND THEIR CLINICAL VALUES

测定32例胰岛素依赖性糖尿病(IDDM)儿童和青少年血Ca、P、AKP、iPTH、CT、T_3和T_4浓度,与正常对照组相比,血Ca、AKP、iPTH和CT水平均明显升高,血T_3水平则明显降低。IDDM儿童和青少年患者钙磷代谢和骨代谢发生了明显异常变化,可以认为是糖尿病性骨质疏松发病的开始。作者认为,糖尿病性骨质疏松的发病可能有一个从继发性甲旁亢到甲旁低的连续变化过程。而IDDM儿童和青少年患者亚临床甲状腺功能减低对缓解钙磷代谢紊乱可能具有重要作用。

Serum calcium (Ca), phosphorus (P), alkaline phosphatase (AKP), immunoreactive parathyroid hormone (iPTH), calcitonin (CT), triiodothyronine (T3), and thyroxine (T4) concentrations were measured in 32 children and adolescents with insulin-dependent diabetes mellitus (IDDM) and 32 age-matched normal subjects. The Ca (P<0.01), AKP (P< 0.01), iPTH (P<0.001), and CT (P<0.001) levels were much higher in IDDM than in normal subjects. Only serum T, was significantly lower (P< 0.001). The results showed that the calcium-phosphorus metabolism and bone metabolism were abnormal in children and adolescents with IDDM, and it may be regarded as the beginning of diabetic osteoporosis. The diabetic osteoporosis was underlain by a continuous evolution from secondary hyper- to hypo-parathy-roidism. In addition, the decrease of serum T3 in IDDM subjects may probably reduced the disturbance of calcium-phosphorus metabolism.