CAJ | 학술논문

目的：探讨甲状腺功能异常时患者的糖代谢状态。方法：对100例甲状腺功能亢进（甲亢组）、50例甲状腺功能减退（甲减组）和50例健康者（对照组）进行葡萄糖耐量试验（OGTT）及胰岛素激发试验（OGIRT），并计算胰岛素抵抗指数（HOMA－IR）、胰岛细胞分泌功能（HOMA－β）、胰岛素敏感指数（HOMA－IS）。抗甲状腺治疗6个月后，甲亢合并糖代谢异常患者及甲减患者复查 OGTT 试验及 OGIRT 试验。结果：甲亢组空腹血糖（FPG）、OGTT2h 血糖（2hPG）、餐后胰岛素水平（2hINS）及 HOMA－IR 均较对照组明显增高（P ＜0．01），甲亢组HOMA－IS 较对照组明显降低（P ＜0．01）。甲亢组OGTT 试验提示80例存在糖代谢异常；甲减组FPG、2hPG 均较对照组偏低，FTNS、2hINS、 HOMA－IS 与对照组相比无明显差异（P ＞0．05），甲减组 HOMA－IR 较对照组明显升高（P ＜0．05），HOMA－β较对照组降低（P ＜0．05）。抗甲状腺治疗后，80例甲亢组并糖代谢异常患者、50例甲减复查 OGTT 试验及 OGIRT 试验，甲亢组 FPG、2hPG、2hINS、HOMA－IR 明显降低（P ＜0．01），而 HOMA－β和HOMA－IS 则较治疗前增高（P ＜0．01）。甲减组 HOMA－IR 和 HOMA－β明显改善，FPG、2hPG、2hINS 与对照组相比无明显差异（P ＞0．05）。结论：甲亢时常合并胰岛素抵抗及糖代谢异常，甲减对糖代谢的影响临床意义不大。
목적：탐토갑상선공능이상시환자적당대사상태。방법：대100례갑상선공능항진（갑항조）、50례갑상선공능감퇴（갑감조）화50례건강자（대조조）진행포도당내량시험（OGTT）급이도소격발시험（OGIRT），병계산이도소저항지수（HOMA－IR）、이도세포분비공능（HOMA－β）、이도소민감지수（HOMA－IS）。항갑상선치료6개월후，갑항합병당대사이상환자급갑감환자복사 OGTT 시험급 OGIRT 시험。결과：갑항조공복혈당（FPG）、OGTT2h 혈당（2hPG）、찬후이도소수평（2hINS）급 HOMA－IR 균교대조조명현증고（P ＜0．01），갑항조HOMA－IS 교대조조명현강저（P ＜0．01）。갑항조OGTT 시험제시80례존재당대사이상；갑감조FPG、2hPG 균교대조조편저，FTNS、2hINS、 HOMA－IS 여대조조상비무명현차이（P ＞0．05），갑감조 HOMA－IR 교대조조명현승고（P ＜0．05），HOMA－β교대조조강저（P ＜0．05）。항갑상선치료후，80례갑항조병당대사이상환자、50례갑감복사 OGTT 시험급 OGIRT 시험，갑항조 FPG、2hPG、2hINS、HOMA－IR 명현강저（P ＜0．01），이 HOMA－β화HOMA－IS 칙교치료전증고（P ＜0．01）。갑감조 HOMA－IR 화 HOMA－β명현개선，FPG、2hPG、2hINS 여대조조상비무명현차이（P ＞0．05）。결론：갑항시상합병이도소저항급당대사이상，갑감대당대사적영향림상의의불대。
Objective:To explore the status of glucose metabolism when patients with thyroid dysfunction. Method:100 patients with hyperthyroidism (group A), 50 patients with hypothyroidism (group A) and 50 healthy persons(group C) were measured by the oral glucose tolerance test(OGTT) and the oral glucose insulin releasing test (OGIRT),also calculated the homeostasis model assessment insulin resistance (HOMA -IR),homeostasis model assessment β (HOMA-β),homeostasis model assessment insulin sensitivity (HOMA-IS).After cured six month,the glucometabolic profile of patients with hyperthyroidism and hypothyroidism patients recheck OGTT and OGIRT. Results:The fasting plasma glucose(FPG),OGTT 2 h plasma glucose(2hPG),the insulin and the HOMA-IR of group A were significantly increased to group C(P < 0.01), the ISI of group A significantly reduced to group C(P < 0.01). The OGTT of group A prompted 80 cases had abnormal glucose metabolism. The FPG、2hPG of group A were lower to group C. There were no obvious difference between group B and group C in the FTNS、2hINS、ISI (P > 0.05),the HOMA-IR of group A was significantly higher to group C (P < 0.05),the HOMA-β of group B was lower to group C (P < 0.05). After treated for six months,the OGTT and OGIRT for the 80 cases of glucometabolic profile of patients with hyperthyoridism were significantly lower in the FPG、2hPG、2hINS、HOMA-IR (P < 0.01) and raised in the HOMA-β and HOMA-IS (P < 0.01)than pretherapy. Group B was improved in the HOMA-IR and HOMA-β, but was no difference in the FPG、2hPG、2hINS (P > 0.05) than pretherapy. Conclusions: The patients with thyroid dysfunction always followed status of glucose metabolism and insulin resistence ,the effects of hypothyroidism on glucose metabolism of no clinical significance.