2型糖尿病患者血清甲状腺激素,尿酸和胰岛素抵抗相关性的临床分析

Clinical Analysis of Relationship Between TH, UA and IR in Type2 Diabetes Mellitus Patients

目的 探讨2型糖尿病(type 2 diabetes mellitus, T2DM)患者血清甲状腺激素(thyroid hormone, TH),尿酸(uric acid, UA)和胰岛素抵抗(insulin resistance, IR)相关性.方法 采用电化学发光免疫分析和化学酶法测定125 例T2DM患者、31 例尿毒症患者和80 名正常对照组的血清TH,UA,空腹血糖(fasting blood glucose, FBG)和空腹胰岛素(fasting insulin, FIns)水平,计算稳态模型胰岛素抵抗指数(homestasis model assessment-insulin resistance, HOMA-IR),并进行对比性研究.结果 T2DM患者血清T3、FT3和FT4水平明显低于正常对照组(P<0.05或0.01),并随T2DM患者严重程度增高而降低;血清TSH水平明显高于正常对照组(P<0.05或0.01),并随T2DM严重程度增高而增高;血清T4水平和T2DM无相关性.T2DM患者UA水平明显高于正常对照组(P<0.05或0.01),并随T2DM严重程度增高而增高.T2DM和尿毒症患者HOMA-IR水平明显高于正常对照组(P<0.01).结论 血清TH,UA和HOMA-IR是T2DM患者早期诊断和严重程度衡量的有价值指标.

Objective To investigatethe relationship between thyroid hormone (TH), uric acid (UA), and insulin resistance (IR) in type 2 diabetes mellitus (T2DM) patients. Methods The serum TH, UA, fasting blood glucose (FBG), fasting insulin (FIns) and homestasis model assessment-insulin resistance (HOMA-IR) levels were determined in 125 patients with T2DM, 31 patients with uremic and 80 normal controls by elctro-chemiluminsence immunoassay and biochemistry enzyme methods with comparison study. Results The serum T3, FT3 and FT4 levels in patients with T2DM were obviously lower than those in normal controls (P<0.05 or 0.01), and decreased with T2DM severity. The serum TSH levels was obviously higher than those in normal controls (P<0.05 or 0.01), and increased with T2DM severity. There was no correlation between serum T4 level and T2DM (P>0.05). The serum UA levels in patients with T2DM was obviously higher than those in normal controls (P<0.05 or 0.01), and increased with T2DM severity. The HOMA-IR levels in patients with T2DM and patients with uremic were obviously higher than those in normal controls (P<0.01). Conclusion Serum TH, UA and HOMA-IR were valuable indexes of early diagnosis and severity predicting for patients with T2DM.