Graves病患者胰岛素、真胰岛素变化与糖耐量的关系

Relationship Among Insulin, True Insulin and Glucose Tolerance in Graves Disease

选取未经治疗的弥漫性毒性甲状腺肿 (Graves病 ,简称GD) 4 0例、健康者 11例 ,行口服葡萄糖耐量 胰岛素释放试验后 ,用化学发光法测血清胰岛素、C肽 (C P)值 ,用ELISA法测血清真胰岛素 (TI)值 ,并分析Graves病患者胰岛素、真胰岛素变化与糖耐量的关系。结果 :GD组空腹血糖 (BG)明显增高 (P <0 .0 0 1) ,葡萄糖刺激后基础免疫活性胰岛素 (IRI)明显增高 (P <0 .0 2 7) ,真胰岛素有升高但不明显 ,∑IRI/∑BG在GD组明显增加 ,游离三碘甲腺原氨酸(FT3 )与多个时点血清胰岛素、C肽、真胰岛素呈显著负相关。说明GD患者在治疗前存在高血糖与高胰岛素血症并存的胰岛素抵抗状态 ;GD患者真胰岛素相对不足 。

The study was performed in 40 untreated GD patients and in 11 euthyro id subjects. After the normal oral glucose tolerance test, the glucose、 IRI、 C -P and TI were measured in order to investigate the relationship among insulin , true insulin and glucose tolerance in Graves' disease. It was found that the serum glucose, IRI and C-P of the patients' were significantly higher than thos e of the euthyroid controls except for the data at 0 min. The true insulin le vel of the patients' were higher than that of the controls', but only at 60 and 120 min with significant difference. The sigma IRI/sigma BG increased signif icantly in GD group. FT 3 was correlated negatively with IRI(30, 60, 120 min ), C-P(60 min), TI(60 min), and FT 4 was not correlated with the data at the se points. These results indicate that Graves' disease could affect the metabol ism of glucose and cause a series of abnormality, such as hyperglycaemia and hy perinsulinism, which suggests that insulin-resistance is underlying in this c ondition.