CAJ | 학술논문

目的探讨2型糖尿病合并原发性亚临床甲状腺功能减退症(亚临床甲减)患者服用二甲双胍后促甲状腺激素(TSH)水平的改变.方法 55例2型糖尿病合并亚临床甲减患者按是否服用二甲双胍治疗分为二甲双胍治疗组(28例,第1组)及未用二甲双胍治疗组(27例,第2组),分别在基线、15周、30周观察血TSH水平的改变.31例甲状腺功能正常的使用二甲双胍治疗的2型糖尿病患者作为对照(第3组).结果第1组TSH水平在治疗30周后由基线的(6.98±1.92) mIU/L下降至(2.44±0.61) mIU/L(=2.91,P＜0.05),研究结束后14例患者停用二甲双胍,在52周时其TSH恢复至接近基线水平[(6.99±1.76) mIU/L](P＞0.05).第2组治疗30周后TSH水平较基线改变无统计学意义[(6.21±1.71) mIU/L与(6.01±1.63)mIU/L,P ＞0.05].两组治疗前后的体质量指数、甲状腺激素水平均无明显变化.在第3组中,治疗30周后TSH水平改变无统计学意义[(1.82 ±0.51) mIU/L与(1.77±0.46) mIU/L,P＞0.05].结论二甲双胍可改善2型糖尿病合并原发性亚临床甲减患者的TSH水平.
목적 탐토2형당뇨병합병원발성아림상갑상선공능감퇴증(아림상갑감)환자복용이갑쌍고후촉갑상선격소(TSH)수평적개변.방법 55례2형당뇨병합병아림상갑감환자안시부복용이갑쌍고치료분위이갑쌍고치료조(28례,제1조)급미용이갑쌍고치료조(27례,제2조),분별재기선、15주、30주관찰혈TSH수평적개변.31례갑상선공능정상적사용이갑쌍고치료적2형당뇨병환자작위대조(제3조).결과 제1조TSH수평재치료30주후유기선적(6.98±1.92) mIU/L하강지(2.44±0.61) mIU/L(=2.91,P＜0.05),연구결속후14례환자정용이갑쌍고,재52주시기TSH회복지접근기선수평[(6.99±1.76) mIU/L](P＞0.05).제2조치료30주후TSH수평교기선개변무통계학의의[(6.21±1.71) mIU/L여(6.01±1.63)mIU/L,P ＞0.05].량조치료전후적체질량지수、갑상선격소수평균무명현변화.재제3조중,치료30주후TSH수평개변무통계학의의[(1.82 ±0.51) mIU/L여(1.77±0.46) mIU/L,P＞0.05].결론 이갑쌍고가개선2형당뇨병합병원발성아림상갑감환자적TSH수평.
Objective To examine the effect of metformin on serum thyrotropin (TSH) level in diabetic patients with subclinical hypothyroidism (SCH).Methods The long-term effects of metformin on thyroid axis hormones were assessed in 55 diabetic patients with primary SCH who were untreated with L-T4(study group),as well as in 31 diabetic patients with normal thyroid function (control group).According to using metformin or not,patients of study group were divided into the metformin group (group 1,n =28),and the non-metformin group(group 2,n =27).Serum TSH levels were compared between baseline and follow-up in patients receiving metformin treatment.Results After 30 weeks of metformin administration,a significant TSH decrease(t =2.91,P ＜ 0.05) was observed in group 1 [from(6.98 ± 1.92) to(2.44 ± 0.61) mIU/L].After stopping metformin therapy,the level of TSH at 52 weeks fol low-up was back to the baseline level [(6.99 ± 1.76) mIU/L,P ＞ 0.05].There was no significant difference in TSH level between baseline and after 30 weeks follow-up in group 2[(6.01 ± 1.63) mIU/L vs(6.21 ± 1.71) mIU/L,P ＞0.05].At the end of 30 weeks follow-up,no significant differences were found in body mass index and thyroid func tion in both metformin group and non-metformin group.In control group,metformin administration for 30 weeks had no effect on TSH level(P ＞ 0.05).Conclusion Metformin administration influences TSH without change of FT4 level in type 2 diabetic patients with primary SCH.