摘要
目的 探讨格雷夫斯病 (GD)患者糖代谢改变及不同糖代谢水平时血清胰岛素原 (PI)的水平变化及与垂体 -甲状腺轴、血糖的关系 ,分析GD患者胰岛 β细胞功能变化。方法 所有入选者行 75g口服葡萄糖耐量试验 ,采用放射免疫法测定其空腹及糖负荷后 2小时血清PI水平 ,并与血糖及垂体 -甲状腺功能作相关分析。血清PI水平作为评价GD患者胰岛 β细胞功能受损的早期指标。结果 85例患者中 ,6 0 %合并糖代谢异常。空腹及糖负荷后 2小时血清PI水平 ,GD各组均高于对照组。GD患者中 ,随血糖升高 ,各组PI值逐渐升高。空腹及糖负荷后 2小时PI均与游离甲状腺素呈正相关 ,与促甲状腺激素呈负相关 ,且各自与空腹与糖负荷后 2小时血糖呈正相关。GD患者随血糖水平升高 ,胰岛 β细胞功能受损逐渐加重。结论 GD患者常合并不同程度的糖代谢紊乱。GD患者的PI水平高于正常 ,且随糖代谢紊乱程度加重 ,PI水平逐渐升高。GD患者存在胰岛 β细胞功能失调。高甲状腺功能状态是造成胰岛 β细胞功能受损的主要原因。
Objective To study the changes of glucose metabolism in Graves disease(GD) patients and proinsulin(PI) with different blood glucose level.The correlation between PI and pituitary-thyroid axis and blood glucose is evaluated. To evaluate the changes of islet β-cell function. Methods 75 g oral glucose tolerance test was performed on all the cases. PI was measured in fasting and 2 h post oral glucose serum by respective radioimmunoassay kits and correlation was performed between PI and blood glucose,pituitary-thyroid function. PI was considered as the early marker of islet β-cell dysfunction. Results In all the patients, 60% had abnormal glucose metabolism. Either in fasting or in 2 h serum, the PI levels were higher in GD patients than those in controls. In GD patients, the PI levels increased with blood glucose level rising. There was a positive correlation between PI and free triiodothytonine(FT3), highly negative correlation with thryoid-stimulating hormone(TSH). PI levels also had positive correlation with blood glucose, islet β-cell function became worse with blood glucose level rising. Conclusions There were often some degrees of abnormal glucose metabolism in GD patients. The PI levels in GD patients were higher than those in controls and the PI levels became higher with the glucose levels. There was islet β-cell dysfunction in GD patients. High thyroid function was the important cause of islet β-cell dysfunction.
出处
《临床荟萃》
CAS
北大核心
2004年第17期986-988,共3页
Clinical Focus
关键词
格雷夫斯病
胰岛素原
垂体
甲状腺
Graves'disease
pituitary gland
thyroid gland
proinsulin
