Objective To investigate the changes of glucose metabolism and the effect of hyperthyroidism on insulin sensitivity in patients with hyperthyroidism. Methods From January 2012 to December 2014, 68 patients with hyperthyroi-dism were enrolled, according to oral glucose tolerance test ( OGTT) , the patients were divided into glucose tolerance impair-ment group (IGT group, n =32) and normal glucose tolerance group (NGT group, n =36), and compared with healthy con-trols (NC group, n =30), the fasting plasma glucose (FPG), postprandial 2 h blood glucose (2 h PG), free three iodine thyroid original ammonia acid ( FT3 ) , free thyroxine( FT4 ) , thyroid stimulating hormone ( TSH) , and calculate the insulin re-sistance index ( HOMA-IR) and insulin sensitivity index ( HOMA-IS) were detected. Results IGT group’ s FPG and OGTT at each time point’ s glucose load were significantly higher than those of the NGT group and NC group ( F =63. 65, F=95. 84, F =71. 36, F =137. 48, P <0. 05), NGT group’s OGTT at 2h, 3h glucose load was significantly higher than that of NC group ( P <0. 05), FPG, OGTT 1-hour glucose load had no significant difference from NC groups ( P >0. 05);IGT group HOMA-IR was significantly higher than that in NGT group, NC group, HOMA-IS significantly reduced ( F =52. 32, F =13. 71, P <0. 05). Compared with before treatment, after treatment, hyperthyroidism patients FT3, FT4, FPG, 2 h PG and HOMA-IR were significantly decreased,TSH,HOMA-IS significantly increased ( P <0. 05). Pearson correlation analysis showed that HOMA-IR and TSH were negative correlated ( r = -0. 568, P <0. 05), positively correlated with 2 HPG ( r =0. 625, P <0. 05), HOMA IS and TSH was positively correlated ( r = 0. 554, P <0. 05), and were negative correlated with 2h PG ( r = -0. 487, P <0. 05). Conclusion Hyperthyroidism patients often accompanied with disorders of glucose metabolism,insulin sensitivity decreased,in the treatment of hyperthyroidism,strengthen the monitoring of blood sugar and prevent complications occurred are necessary.%目的：探讨甲状腺功能亢进患者糖代谢的变化及甲状腺功能亢进对胰岛素敏感性的影响。方法收集2012年1月—2014年12月收治的甲状腺功能亢进患者68例,根据口服葡萄糖耐量试验( OGTT),将患者分为葡萄糖耐量受损组( IGT组, n =32例),糖耐量正常组( NGT组, n =36例),并与健康体检者( NC组, n =30例)比较,检测各组空腹血糖(FPG)、餐后2 h血糖(2 h PG)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素( TSH),并计算胰岛素抵抗指数( HOMA-IR)和胰岛素敏感指数( HOMA-IS)。结果 IGT组FPG及OGTT各时间点糖负荷均明显高于NGT组、NC组( F =63.65、95.84、71.36、137.48, P <0.05),NGT组OGTT 2h、3h糖负荷显著高于NC组( P <0.05),而FPG、OGTT 1h糖负荷与NC组间均无显著性差异( P >0.05)；IGT组HOMA-IR明显高于NGT组、NC组,HOMA-IS则明显降低( F =52.32、13.71, P <0.05)。与治疗前比较,治疗后甲状腺功能亢进患者FT3、FT4、FPG、2 h PG及HOMA-IR均明显降低,TSH、HOMA-IS明显升高( P <0.05)。 Pearson相关分析结果表明,HOMA-IR与TSH呈负相关( r =-0.568, P <0.05)、与2 hPG呈正相关( r =0.625, P <0.05),HOMA-IS与TSH呈正相关(r =0.554, P <0.05)、与2 h PG呈负相关( r =-0.487, P <0.05)。结论甲状腺功能亢进患者常伴有糖代谢紊乱,胰岛素敏感性降低,在积极治疗甲状腺功能亢进的同时,需加强血糖监测,预防并发症的发生。
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