甲状腺机能亢进症和血糖代谢关系的研究

Study on Relationship between Hyperthyroidism and Glycometabolism

目的研究甲状腺机能亢进症（简称甲亢）和血糖代谢的关系。方法选取52例甲亢患者和38例糖尿病患者分别使用电化学发光免疫分析仪检测血清甲状腺激素（TH，包括FT3、T3、FT4、T4和sTSH）、胰岛素（INS）和C-肽（CP）水平以及全自动生化分析仪检测空腹血糖水平，并同时测定了口服葡萄糖耐量试验后3h的血糖水平并与60名正常对照组进行了比较性分析。结果甲亢组血清FT3、T3、FT4和T4水平较正常对照组明显增高（P〈0．01），糖尿病组亦然（P〈0．01），而sTSH水平明显降低（P〈0．01）。口服葡萄糖耐量试验表明：甲亢组空腹血糖明显高于正常对照组（P〈0．01），而低于糖尿病组；口服糖后3h，正常对照组恢复至正常水平，甲亢组和糖尿病组糖耐量降低；甲亢组和糖尿病组空腹INS和CP水平较正常对照组明显增高，INS释放功能欠佳，甲亢组和糖尿病组CP释放试验呈现分离现象。结论甲亢具有糖代谢紊乱、糖耐量明显降低、且合并糖尿病，是一种临床代谢综合症。

Objective To study the relationship between hyperthyroidism and glycometabolism.Methods The serum thyroid hormone（TH,including FT3,T3,FT4,T4 and sTSH）,insulin（1NS）,c-peptide（C-P） levels were measured in 52 patients with hyperthyroidism,38 patients with diabetes mellitus and 60 healthy controls by electrochemiluminescence immunoassay（ECLIA）.The fasting blood glucose（FBG） and 3h blood glucose were measured by biochemistry.INS and C-P levels after oral glucose tolerance test were determined.Results The serum TH（including FT3,T3,FT4 and T4） levels in 52 patients with hyperthyroidism and in 38 patients with diabetes mellitus were significantly higher than those in 60 controls（P 〈 0.01）,but the sTSH level was significantly lower（P 〈 0.01）.The oral glucose tolerance test showed：the FBG level in 52 patients with hyperthyroidism was significantly higher than those in 60 controls（P 〈 0.01）,but lower than those in 38 patients with diabetes mellitus.After 3h,the FBG level in 60 controls were recovery to normal level,but the glucose tolerance of patients with hyperthyroidism and diabetes mellitus were decreased.The fasting INS and C-P levels in patients with hyperthyroidism and diabetes mellitus were significantly higher than those in controls,but the INS release function was not good and showed separated phenomenon.Conclusion The hyperthyroidism could be clinical metabolism syndrome with glycometabolism,glucose tolerance down and accompanied diabetes mellitus.