新诊断酮症倾向糖尿病患者临床特点及甲状腺功能的分析

Clinical characteristics and screening of thyroid dysfunction in newly diagnosedketosis-prone diabetes

目的探讨新诊断酮症倾向糖尿病患者临床特点、血清甲状腺激素水平变化及临床意义。方法患者根据血糖、酮体及甲状腺功能分为糖尿病酮症倾向(KPD)组、非KPD(NKPD)组及正常对照(NC)组,收集各组身高、体重、高血压病史等,行馒头餐试验及C-P释放试验,并检测甲状腺功能、胰岛素抗体及血脂。结果甲亢与甲减33例,女性多于男性(P<0.05)。与NC组比较,KPD组和NKPD组FPG、馒头餐试验0min、120min血糖,HbA1c,TC及低T3综合征均升高(P<0.05)。NC组、NKPD组、KPD组0min、120min C-P逐渐下降(P<0.05)。与NC组比较,糖尿病患者甲减及低T3综合征升高(P<0.05)。结论新诊断酮症倾向糖尿病患者低T3综合征多见,其次为甲状腺功能减退症。

Objective To investigate the variety and clinical significances of serum thyroid hormones and thyroid autoantibody in newly diagnosed ketosis-prone diabetes.Methods 275 patients were categorized into ketosis-prone diabetes （KPD）group,non-ketosis-prone diabetes group,normal control group according to blood sugar,presence of ketosis and thyroid function.Clinical characteristics,including height,weight and history of hypertensive disease of three groups were collected,and steamed bread meal test and C-P release test were preformed.Besides,thyroid function,blood lipid,uric acid,the 100 g carbohydrate challenge of c-peptide（C-P）,ICA,IAA,GAD-Ab,et al,were compared.Results There were 33 cases of hypothyroidism or hyperthyroidism in 175 cases with newly diagnosed diabetes（male 15,female 18,P＜0.05）.Fasting blood glucose,blood glucose （BG）at 0 min and 120 min after steamed bread meal test,the levels of glycosylated hemoglobin （HbA1c）,TC and low T3 syndrome were obviously higher in NC group than in non KPD group and KPD group （all P＜0.05）.During C peptide releasing test,C-P levels at 0 min and 120 min were obviously lower in KPD group than in non KPD group and KPD group （P＜0.05）.Hypothyroidism and low T3 syndrome were obviously higher in diabetics than in normal individuals （P＜ 0.05）.Conclusion Newly diagnosed ketosis-prone diabetes often combined with a variety of thyroid dysfunctions,among which,low T3 syndrome most,followed by hypothyroidism.