Graves病并糖代谢紊乱患者甲亢控制后胰岛素敏感指数变化  

Changes of insulin sensitivity index of hyperthyroidism controlling in the patients with Graves' disease and glucose metabolism

作　　者：陈冬梅[1] 陈洁华[1] 李晓春[1] 吴建能[1] 胡春梅[1] 熊斌[1] 

机构地区：[1]广东省韶关市粤北人民医院内分泌科,广东韶关512026

出　　处：《中国医药导报》2012年第15期39-40,共2页China Medical Herald

基　　金：广东省医学科学技术研究基金(项目编号:WSTJJ2008915440203197303041541)

摘　　要：目的观察甲状腺机能亢进(Graves病)并糖代谢紊乱患者甲亢控制后血糖、血清胰岛素、胰岛素敏感指数变化,了解甲亢状态时,超生理浓度的甲状腺激素对胰岛β细胞分泌功能、胰岛素敏感性的影响。方法对比32例Graves病并糖代谢紊乱患者甲亢控制后前后血糖、胰岛素水平及胰岛素敏感指数的变化。结果 112例Graves患者合并糖代谢紊乱32例,合并糖代谢紊乱的发生率为28.57%;治疗前后空腹血糖(FPG)及甲状腺激素水平(FT3、FT4)比较差异均有统计学意义(均P<0.05);PPG治疗后较治疗前有下降,但差异无统计学意义(P>0.05);治疗前后胰岛素水平(FINS、PINS)及胰岛素敏感指数(HOMA-IR、HOMA-IS)比较差异均有统计学意义(P<0.05)。结论Graves病并糖代谢紊乱患者存在胰岛β细胞分泌功能降低及外围胰岛素抵抗,甲亢控制后,有利于胰岛素敏感指数的改善。Objective To observe the changes of blood glucose, serum insulin, insulin sensitivity index of hyperthyroidism controlling in the patients with Graves＂ disease and glucose metabolism, understudied the super-physiological concentra- tions of thyroid hormones on the impact of islet 13-cell function and insulin sensitivity. Methods The changes of blood glu- cose, serum insulin, insulin sensitivity index were compared before and after hyperthyroidism controlling. Results 18 cases had been glucose metabolism in 112 cases with Graves＂ disease, the incidence of glucose metabolism was 16.07%; there were significant differences in FPG and thyroid hormone levels （FT3, FT4） before and after the treatment （P 〈 0.05）; PPG had been dropped after treatment, however, the difference had no significant differences （P 〉 0.05）; there were significant differences in insulin levels （FINS, PINS） and insulin sensitivity index （HOMA-IR, HOMA-IS） before and after the treat- ment （P 〈 0.05）. Conclusion The patients with Graves＂ disease and glucose metabolism have the drop of [3-cell function and resistance of peripheral insulin, and the hyperthyroidism controlling is conducive to the improvement of insulin sensi- tivity index.

关 键 词：甲状腺机能亢进症 糖尿病 胰岛素敏感指数 

分 类 号：R581[医药卫生—内分泌]