格雷夫斯病患者抗甲状腺药物治疗后骨代谢指标、血糖、胰岛素抵抗变化  

Changes in bone metabolism index,blood sugar and insulin resistance after anti-thyroid drug treatment in patients with Graves′disease

作　　者：陈垂这 吴花桂 王新军 王转锁 CHEN Chui-zhe;WU Hua-gui;WANG Xin-jun;WANG Zhuan-suo(NHC Key Laboratory of Tropical Disease Control,School of Tropical Medicine,Hainan Medical University,Haikou 571199,Hainan,China;不详)

机构地区：[1]海南医科大学热带医学院与国家卫生健康委员会热带病防治重点实验室,海南海口571199 [2]海南医科大学第一附属医院检验科,海南海口570102 [3]海南医科大学第一附属医院内分泌科,海南海口570102

出　　处：《广东医学》2024年第9期1124-1130,共7页Guangdong Medical Journal

基　　金：海南省自然科学基金项目(20168306)。

摘　　要：目的观察初诊格雷夫斯病患者抗甲状腺药物治疗后骨代谢指标、血糖、胰岛素抵抗指数的变化。方法32例初诊格雷夫斯病患者进行为期1年的纵向观察,在抗甲状腺药物治疗前及治疗后4、8和12个月分别采集空腹血样本,采用生物化学方法测定血糖、胰岛素及骨代谢指标等。以55例正常人群为对照组。结果与对照组相比,初诊格雷夫斯病患者抗甲状腺药物治疗前空腹血糖(FBG)、胰岛素和胰岛素抵抗指数(HOMA-IR)增高;血甲状旁腺激素(PTH)水平降低,血钙、总前胶原Ⅰ型氨基末端肽(PINP)、骨钙素(OC)、碱性磷酸酶(ALP)、25羟维生素D(25(OH)D)和β异构C末端肽(β-CTX)水平升高。抗甲状腺药物治疗8个月后FBG恢复正常;治疗4个月后血胰岛素、HOMA-IR恢复正常。抗甲状腺药物治疗4个月后血钙恢复正常。抗甲状腺药物治疗后血ALP、PINP、OC和β-CTX水平显著下降,血PTH显著升高。结论未治疗的格雷夫斯病患者空腹血糖升高、胰岛素抵抗,抗甲状腺药物治疗可恢复正常。格雷夫斯病患者抗甲状腺药物治疗12个月后血清ALP、PINP、骨钙素和β-CTX水平降低,但仍未恢复。Objective To observe changes in bone metabolism markers,blood glucose,and insulin resistance index in patients with newly diagnosed Graves′disease after antithyroid drug treatment.Methods A longitudinal study was conducted with 32 newly diagnosed Graves′disease patients over one year.Fasting blood samples were collected before and after 4,8,and 12 months of antithyroid drug treatment.Biochemical methods were used to measure blood glucose,insulin,and bone metabolism markers.A control group of 55 healthy individuals was included for comparison.Results Compared with the healthy control group,before treatment,Graves′disease patients had elevated fasting blood glucose(FBG),insulin,and insulin resistance index(HOMA-IR);decreased blood parathyroid hormone(PTH)levels;and increased blood calcium,PINP,osteocalcin(OC),alkaline phosphatase(ALP),25(OH)D,andβ-CTX levels.After 8 months of treatment,fasting blood glucose returned to normal.After 4 months of treatment,blood insulin and HOMA-IR also returned to normal.Blood calcium levels normalized after 4 months of treatment.However,after treatment,ALP,PINP,OC,andβ-CTX levels significantly decreased,while PTH levels significantly increased.Conclusion Untreated Graves′disease patients exhibit elevated fasting blood glucose and insulin resistance,which can normalize with antithyroid drug treatment.After 12 months of treatment,serum levels of ALP,PINP,osteocalcin,andβ-CTX in Graves′disease patients decreased but had not fully normalized.

关 键 词：格雷夫斯病 骨代谢 血糖 胰岛素抵抗 

分 类 号：R581.2[医药卫生—内分泌] R589.5[医药卫生—内科学]