胰岛素抗体阳性的2型糖尿病患者血清甲状腺激素、促甲状腺激素水平分析  

Analysis on serum thyroid hormone and thyroid stimulating hormone levels in type 2 diabetic patients with insulin antibody positive

作　　者：彭扬洋 刘艳秋[1] 邱樊[1] PENG Yangyang;LIU Yanqiu;QIU Fan(Clinical Nuclear Medicine Center,Affiliated Nanjing Hospital of Nanjing Medical University/Nanjing Municipal First Hospital,Nanjing,Jiangsu 210017,China)

机构地区：[1]南京医科大学附属南京医院/江苏省南京市第一医院临床核医学中心

出　　处：《检验医学与临床》2019年第22期3236-3239,共4页Laboratory Medicine and Clinic

基　　金：南京医科大学科技发展基金项目（2015NJMUZD048）

摘　　要：目的分析胰岛素抗体阳性的2型糖尿病患者血清甲状腺激素、促甲状腺激素(TSH)水平的变化情况。方法选取2016年11月至2017年11月该院收治的接受重组人胰岛素治疗的2型糖尿病患者156例为病例组,按照胰岛素抗体检测结果分为胰岛素抗体阳性组(85例)与胰岛素抗体阴性组(71例),另选取同期健康体检者64例为对照组,检测3组空腹胰岛素(FINS)、空腹血糖(FBG)、空腹C肽(FCP)、糖化血红蛋白(HbA1c)以及三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、TSH水平。结果胰岛素抗体阳性组与胰岛素抗体阴性组FINS、FBG、FCP、HbA1c水平均显著高于对照组(P<0.05),而胰岛素抗体阳性组与胰岛素抗体阴性组以上指标比较,差异均无统计学意义(P>0.05)。3组T4、TSH水平比较,差异无统计学意义(P>0.05),胰岛素抗体阳性组与胰岛素抗体阴性组T3、FT3、FT4水平均显著低于对照组(P<0.05),胰岛素抗体阳性组T3、FT3、FT4水平均显著低于胰岛素抗体阴性组(P<0.05)。结论部分2型糖尿病患者应用胰岛素治疗后会产生胰岛素抗体,并且胰岛素抗体阳性的2型糖尿病患者T3、FT3、FT4水平明显降低。Objective To analyze the changes of serum thyroid hormone(TH)and thyroid stimulating hormone(TSH)in the patients with type 2 diabetes mellitus(T2DM)and insulin antibody positive.Methods One hundred and fifty-six patients with T2DM treated with recombinant human insulin in this hospital from November 2016 to November 2017 were selected as the case group and divided into the insulin antibody positive group(85 cases)and insulin antibody negative group(71 cases)according to the insulin antibody detection results.Other contemporaneous 64 people undergoing healthy physical examination were selected as the control group.The levels of fasting insulin(FINS),fasting blood glucose(FBG),fasting C peptide(FCP),glycosylated hemoglobin(HbA1c),triiodothyronine(T3),tetraiodothyronine(T4),free triiodothyronine(FT3),free tetraiodothyronine(FT4)and TSH were detected in the three groups.Results The levels of FINS,FBG,FCP and HbA1c in the insulin antibody positive group and insulin antibody negative group were significantly higher than those in the control group(P<0.05),while which had no statistically significant difference between the insulin antibody positive group and insulin antibody negative group(P>0.05);there was no statistically significant difference in the levels of T4 and TSH among the three groups,while the levels of T3,FT3 and FT4 in the insulin antibody positive group and insulin antibody negative group were significantly lower than those in the control group(P<0.05),and the levels of T3,FT3 and FT4 in the insulin antibody positive group were significantly lower than those in the insulin antibody negative group(P<0.05).Conclusion Partial patients with T2DM can produce the insulin antibody when using the insulin treatment,moreover the levels of T3,FT3 and FT4 in patients with T2DM and insulin antibody positive are decreased significantly.

关 键 词：胰岛素抗体 胰岛素抵抗 2型糖尿病 甲状腺激素 促甲状腺激素 

分 类 号：R587.1[医药卫生—内分泌]