CAJ | 학술논문

目的：探讨亚临床甲状腺功能减退症（SCH）对2型糖尿病患者糖代谢及胰岛功能的影响。方法从我院于2011年10月至2013年10月内分泌科收治的2型糖尿病患者350例中选取合并亚临床甲状腺功能减退症患者作为观察组（50例），甲状腺功能正常者作为对照组（70例），比较两组患者间糖代谢水平和胰岛功能指标的变化。结果观察组患者空腹血糖（FBG）、餐后2 h血糖（PBG）、糖化血红蛋白（HbA1C）明显低于对照组（t=5.32、2.86、2.19，均P＜0.05）；促甲状腺激素（TSH）、胰岛素分泌功能指数（HOMA-β）以及胰岛素抵抗指数（HOMA-IR）明显高于对照组（t=15.41、3.00、4.90，均P＜0.05）；胰岛素C肽释放试验显示观察组0 min（Cp 0）及30 min（Cp 1）C肽水平明显高于对照组（t=3.33、3.66，P＜0.05）；相关分析发现FBG、PBG及HbA1C与TSH呈负相关（r=-0.33、-0.29、-0.28，P＜0.05），C肽释放试验各点C肽水平、HOMA-β及HOMA-IR与TSH呈正相关（r=0.23、0.25、0.24、0.24、0.23、0.26，P＜0.05）。结论在年龄、性别、病程及体重指数无明显差异的情况下，合并SCH使2型糖尿病患者血糖水平降低，而C肽水平、HOMA-β及HOMA-IR升高，且随着SCH病情的进展而更明显。
목적：탐토아림상갑상선공능감퇴증（SCH）대2형당뇨병환자당대사급이도공능적영향。방법종아원우2011년10월지2013년10월내분비과수치적2형당뇨병환자350례중선취합병아림상갑상선공능감퇴증환자작위관찰조（50례），갑상선공능정상자작위대조조（70례），비교량조환자간당대사수평화이도공능지표적변화。결과관찰조환자공복혈당（FBG）、찬후2 h혈당（PBG）、당화혈홍단백（HbA1C）명현저우대조조（t=5.32、2.86、2.19，균P＜0.05）；촉갑상선격소（TSH）、이도소분비공능지수（HOMA-β）이급이도소저항지수（HOMA-IR）명현고우대조조（t=15.41、3.00、4.90，균P＜0.05）；이도소C태석방시험현시관찰조0 min（Cp 0）급30 min（Cp 1）C태수평명현고우대조조（t=3.33、3.66，P＜0.05）；상관분석발현FBG、PBG급HbA1C여TSH정부상관（r=-0.33、-0.29、-0.28，P＜0.05），C태석방시험각점C태수평、HOMA-β급HOMA-IR여TSH정정상관（r=0.23、0.25、0.24、0.24、0.23、0.26，P＜0.05）。결론재년령、성별、병정급체중지수무명현차이적정황하，합병SCH사2형당뇨병환자혈당수평강저，이C태수평、HOMA-β급HOMA-IR승고，차수착SCH병정적진전이경명현。
Objective To investigate glucose metabolism in type 2 diabetics with subclinical hypothyroidi-sm(SCH).Methods The study population consisted of 350 cases of type 2 diabetics registered in our hospital,and the clinical biochemistry indexes,the functions of thyroid and pancreas islets were examined in the SCH patients (50)and non-SCH type 2 diabetic patients(70).Results The observation group patients with impaired fasting glucose (FBG), 2 h postprandial blood glucose (PBG), glycosylated hemoglobin (HbA1C) was significantly lower than that of the control group (t=5.32,2.86,2.19,al P<0.05); thyroid stimulating hormone (TSH) and insulin secretion index (HOMA-) and insulin resistance index (HOMA-IR) was significantly higher than that of the control group (t=15.41,3.00, 4.90,al P<0.05);show the observation group of 0 min insulin C peptide release test (Cp 0) and 30 min (Cp 1) C peptide levels were significantly higher than that of the control group (t=3.33,3.66,P<0.05);correlation analysis found negatively correlated with FBG,PBG and HbA1C with TSH(r=-0.33,-0.29,-0.28,P<0.05),C peptide release test al of the C peptide level,HOMA-beta and HOMA-IR was positively correlated with TSH (r=0.23,0.25,0.24, 0.24,0.23,0.26,P<0.05). Conclusion When the age,sex,course of disease and body mass index was not significantly different.SCH can affect glucose metabolism,and became notable with the aggravation of SCH.