中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
14期
1084-1088
,共5页
糖尿病,2型%甲状腺激素类%胰岛β细胞功能
糖尿病,2型%甲狀腺激素類%胰島β細胞功能
당뇨병,2형%갑상선격소류%이도β세포공능
Diabetes mellitus,type 2%Thyroid hormones%Beta cell function
目的 研究甲状腺激素水平对甲状腺功能正常的2型糖尿病患者胰岛β细胞功能的影响.方法 以2010年4-9月在复旦大学附属中山医院内分泌科住院的266例甲状腺功能正常的2型糖尿病患者为研究对象,测定人体参数、相关生化指标、甲状腺相关激素及精氨酸刺激的胰岛β细胞一相分泌功能(AIR).结果 按AIR水平三分位分组的血三碘甲状腺原氨酸(T3)水平分别为(1.49±0.03)、(1.59±0.03)、(1.70±0.04)μmol/L,游离三碘甲状腺原氨酸(FT3)水平分别为(4.01 ±0.08)、(4.37 ±0.09)、(4.44±0.07) pmoL/L,3组间T3、FT3差异均有统计学意义(均P＜0.01)；而3组间甲状腺素(T4)、游离甲状腺素(FT4)、促甲状腺激素(TSH)的差异均无统计学意义(均P ＞0.05).血lnAIR水平与T3(r=0.303,P＜0.01)及FT3(r=0.302,P＜0.01)水平呈正相关.血lnAIR水平与T4及FT4水平无相关性(均P＞0.05).按血T3水平三分位分组的AIR分别为(2.38±0.12)、(2.64±0.12)、(3.03±0.10) mU/L,差异有统计学意义(P＜0.01)；按血FT3水平三分位分组的AIR分别为(2.34±0.11)、(2.69±0.13)、(2.99±0.10) mU/L,差异有统计学意义(P＜0.01).按T4、FT4、TSH三分位分组的组间AIR差异均无统计学意义(均P＞0.05).多元线性回归分析显示在校正了多个相关危险因素后,血T3、FT3水平分别与AIR独立相关(β =0.686,95％ CI0.289 ～0.884,P=0.001；β=0.296,95％CI0.125 ～0.467,P=0.001).结论 甲状腺功能正常的2型糖尿病患者血T3、FT3与AIR显著正相关.然而,正常范围的T3和FT3是否为2型糖尿病患者胰岛β细胞功能的保护因素需要进一步的研究.
目的 研究甲狀腺激素水平對甲狀腺功能正常的2型糖尿病患者胰島β細胞功能的影響.方法 以2010年4-9月在複旦大學附屬中山醫院內分泌科住院的266例甲狀腺功能正常的2型糖尿病患者為研究對象,測定人體參數、相關生化指標、甲狀腺相關激素及精氨痠刺激的胰島β細胞一相分泌功能(AIR).結果 按AIR水平三分位分組的血三碘甲狀腺原氨痠(T3)水平分彆為(1.49±0.03)、(1.59±0.03)、(1.70±0.04)μmol/L,遊離三碘甲狀腺原氨痠(FT3)水平分彆為(4.01 ±0.08)、(4.37 ±0.09)、(4.44±0.07) pmoL/L,3組間T3、FT3差異均有統計學意義(均P＜0.01)；而3組間甲狀腺素(T4)、遊離甲狀腺素(FT4)、促甲狀腺激素(TSH)的差異均無統計學意義(均P ＞0.05).血lnAIR水平與T3(r=0.303,P＜0.01)及FT3(r=0.302,P＜0.01)水平呈正相關.血lnAIR水平與T4及FT4水平無相關性(均P＞0.05).按血T3水平三分位分組的AIR分彆為(2.38±0.12)、(2.64±0.12)、(3.03±0.10) mU/L,差異有統計學意義(P＜0.01)；按血FT3水平三分位分組的AIR分彆為(2.34±0.11)、(2.69±0.13)、(2.99±0.10) mU/L,差異有統計學意義(P＜0.01).按T4、FT4、TSH三分位分組的組間AIR差異均無統計學意義(均P＞0.05).多元線性迴歸分析顯示在校正瞭多箇相關危險因素後,血T3、FT3水平分彆與AIR獨立相關(β =0.686,95％ CI0.289 ～0.884,P=0.001；β=0.296,95％CI0.125 ～0.467,P=0.001).結論 甲狀腺功能正常的2型糖尿病患者血T3、FT3與AIR顯著正相關.然而,正常範圍的T3和FT3是否為2型糖尿病患者胰島β細胞功能的保護因素需要進一步的研究.
목적 연구갑상선격소수평대갑상선공능정상적2형당뇨병환자이도β세포공능적영향.방법 이2010년4-9월재복단대학부속중산의원내분비과주원적266례갑상선공능정상적2형당뇨병환자위연구대상,측정인체삼수、상관생화지표、갑상선상관격소급정안산자격적이도β세포일상분비공능(AIR).결과 안AIR수평삼분위분조적혈삼전갑상선원안산(T3)수평분별위(1.49±0.03)、(1.59±0.03)、(1.70±0.04)μmol/L,유리삼전갑상선원안산(FT3)수평분별위(4.01 ±0.08)、(4.37 ±0.09)、(4.44±0.07) pmoL/L,3조간T3、FT3차이균유통계학의의(균P＜0.01)；이3조간갑상선소(T4)、유리갑상선소(FT4)、촉갑상선격소(TSH)적차이균무통계학의의(균P ＞0.05).혈lnAIR수평여T3(r=0.303,P＜0.01)급FT3(r=0.302,P＜0.01)수평정정상관.혈lnAIR수평여T4급FT4수평무상관성(균P＞0.05).안혈T3수평삼분위분조적AIR분별위(2.38±0.12)、(2.64±0.12)、(3.03±0.10) mU/L,차이유통계학의의(P＜0.01)；안혈FT3수평삼분위분조적AIR분별위(2.34±0.11)、(2.69±0.13)、(2.99±0.10) mU/L,차이유통계학의의(P＜0.01).안T4、FT4、TSH삼분위분조적조간AIR차이균무통계학의의(균P＞0.05).다원선성회귀분석현시재교정료다개상관위험인소후,혈T3、FT3수평분별여AIR독립상관(β =0.686,95％ CI0.289 ～0.884,P=0.001；β=0.296,95％CI0.125 ～0.467,P=0.001).결론 갑상선공능정상적2형당뇨병환자혈T3、FT3여AIR현저정상관.연이,정상범위적T3화FT3시부위2형당뇨병환자이도β세포공능적보호인소수요진일보적연구.
Objective To explore the effects of thyroid hormone on islet β cell function among type 2 diabetics with normal thyroid function.Methods A total of 266 type 2 diabetics with normal thyroid function were recruited.Their clinical,biochemical parameters and thyroid related hormones were measured.And acute insulin response (AIR) was examined by arginine stimulating test.Results The serum levels of triiodothyronine (T3) ((1.49 ±0.03),(1.59 ±±0.03),(1.70 ±0.04) μmol/L) and free triiodothyronine (FT3) ((4.01 ±±0.08),(4.37 ±±0.09),(4.44 ±±0.07) pmol/L) were significantly different among tertile groups of AIR (both P ＜ 0.01) while those of thyroxine (T4),free thyroxine (FT4) and thyroid stimulating hormone (TSH) showed no significant differences among tertile groups of AIR (all P ＞ 0.05).A significant positive correlation existed between lnAIR and T3,FT3 (r =0.303,0.302,both P ＜ 0.01).T4 and FT4 were not correlated with lnAIR (both P ＞ 0.05).AIR was significantly different among tertile groups of T3 ((2.38 ±0.12),(2.64 ±0.12) and (3.03 ±0.10) mU/L)and FT3 ((2.34 ±0.11),(2.69 ± 0.13),(2.99 ±0.10) mU/L,P ＜0.01).AIR were not significantly different among tertile groups of T4,FT4 and TSH(all P ＞ 0.05).Multivariate linear regression demonstrated that T3 and FT3 level were independently associated with AIR(β =0.686,95％ CI 0.289-0.884,P =0.001,β =0.296,95％ CI 0.125-0.467,P =0.01).Conclusions Significant positive associations exist between serum T3,FT3 and AIR in type 2 diabetics with normal thyroid function.Serum T3 and FT3 may be the independent risk factors of predicting islet beta cell function in type 2 diabetics with normal thyroid function.However,it remains to be determined whether or not normal physiological concentrations of T3 and FT3 are protective factors for islet β cell functions among type 2 diabetics.
