1型糖尿病患儿生长障碍与甲状腺功能及皮质醇变化的关系研究

Relationship between growth retardation and changes of thyroid function and cortisol in patients with type 1 diabetes mellitus

目的 探讨 1型糖尿病 (T1DM)患儿生长障碍与甲状腺功能及皮质醇变化的关系。方法 1用化学发光免疫法检测 30例 T1DM患儿 (T1DM组 )及 4 1例正常儿童 (对照组 )的 T3、T4 、TSH、FT3、FT4 及皮质醇 ;用放射免疫法检测两组抗甲状腺球蛋白抗体 (TG- Ab)及抗甲状腺微粒体抗体 (TM- Ab) ,并进行比较。2比较两组间各指标的差异。3分析 T1DM患儿 TSH与生长速度 (GV)、皮质醇与空腹血糖的相关性。结果 1T1DM组 T3、 T4 、 FT3均较对照组显著降低 ,TSH、皮质醇、 TG- Ab及 TM- Ab均较对照组显著升高。2 T1DM组 TSH、 TG- Ab及 TM- Ab异常率最高 ,但与其他指标异常率无显著性差异。3T1DM组 TSH与 GV呈负相关(r=- 0 .4 14 ,P>0 .0 5 )。4 T1DM组皮质醇与空腹血糖呈正相关 (r=0 .73,P<0 .0 5 )。结论 1T1DM患儿可并发桥本病。2 T1DM患儿生长障碍的部分原因与甲状腺功能低下及皮质醇升高有关。

Objective To investigate the relationship between growth retardation and changes of thyroid function and cortisol in patients with type 1 diabetes mellitus(T1DM) Methods ① Serum levels of T 3,T 4,TSH,FT 3,FT 4 and cortisol were measured by chemiluminescence assay in 30 patients with T1DM(T1DM group )and 41 healthy children(control group) Antithyroid globulin antibody(TG Ab)and antithyroid microsomal antibody(TM Ab)were measured by radio immunity assay in two groups ②The differences of above indexes between two groups were compared ③Linear correlation analysis were made between TSH and growth velocity (GV),cortisol and fasting plasma glucose(FPG) in T1DM group Results ① T 3,T 4,FT 3 decreased significantly and TSH,cortisol, TG Ab,TM Ab increased significantly in T1DM group when compared with control group ② Abnormal rate of TSH, TG Ab,TM Ab were higher than other indexes but did not show significant difference in T1DM group ③There was a negative linear correlation between TSH and GV in patients with T1DM but had no significance(r=-0 414, P>0 05) ④There was a positive linear correlation between cortisol and FPG (r=0 73,P<0 05) Conclusion ① T1DM may develop in association with Hashimoto disease ②Growth retardation in patients with T1DM may be due,in part,to hypothyrosis and increased cortisol