2型糖尿病患者胰岛素敏感性与甲状腺激素相关性分析

摘要

目的：探讨2型糖尿病患者胰岛素敏感性与甲状腺激素水平的关系，分析甲状腺激素与2型糖尿病病理关系。方法选择86例2型糖尿病患者列为观察组，选取同期健康体检者72例为对照组。所有患者实施空腹血浆葡萄糖（FPG ）、餐后2 h血糖（2 h PG）及甲状腺激素检测，包括游离四碘甲状腺原氨酸（FT4）、游离三碘甲状腺原氨酸（FT3）、促甲状腺激素（TSH ），计算胰岛素敏感性指数（ISI），分析胰岛素敏感性与甲状腺激素水平的关系。结果观察组FT3、FT4、FT3／FT4、HOMA‐IR、ISI分别为（4．82±1．13）pmol／L、（13．12±4．36）pmol／L、0．39±0．08、2．94±0．37、－5．18±0．82，与对照组比较差异有统计学意义（P＜0．05），观察组TSH为（2．51±1．03）mU／L ，两组对比差异无统计学意义（P＞0．05）；整体指标 HOMA‐IR与FT3呈负相关（r＝－0．543，P＝0．000），与FT4呈正相关（r＝0．611，P＝0．000），ISI与FT3呈正相关（r＝0．551，P＝0．001），与FT4呈负相关（ r＝－0．599，P＝0．000）。结论甲状腺激素水平与胰岛素敏感性关系密切，甲状腺激素水平可能是2型糖尿病发病机制的部分病理原因。%Objective To investigate the relationship between the insulin sensitivity and the thyroid hormone levels in the pa‐tients with type 2 diabetes mellitus(T2DM ) to provide reference for the clinical diagnosis and treatment .Methods 86 patients with T2DM were selected as the observation group and contemporaneous 72 healthy persons were selected as the control group .All pa‐tients were detected the fasting plasma glucose (FPG) ,oral glucose tolerance test postprandial 2 h blood glucose (2 h PG) and thy‐roid hormons including free tetraiodothyronine (FT4) ,free triiodothyronine (FT3) and thyroid stimulating hormone (TSH) .The insulin sensitivity index (ISI) was calculated .The relationship between the insulin sensitivity with thyroid hormone levels was ana‐lyzed .Results FT3 ,FT4 ,FT3 /FT4 ,HOMA‐IR and ISI in the observation group were (4 .82 ± 1 .13) pmol /L ,(13 .12 ± 4 .36) pmol /L 0 .39 ± 0 .08 ,2 .94 ± 0 .37 and -5 .18 ± 0 .82 respectively ,which showing statistically significant differences compared with those in the control group(P<0 .05) ,the TSH level in the observation group was (2 .51 ± 1 .03) mU /L ,the difference between the two groups was not statistically significant (P> 0 .05);HOMA‐IR and FT3 had a negative correlation (r= -0 .543 ,P=0 .000) ,HOMA‐IR and FT4 had a positive correlation (r=0 .611 ,P=0 .000) ,ISI was positively correlated with FT3 (r=0 .551 ,P=0 .001) and negatively correlated with FT 4 (r= -0 .599 ,P=0 .000) .Conclusion The thyroid hormone levels are closely corre‐lated with the insulin sensitivity ,the thyroid hormone levels may be the partial pathological causes of T 2DM pathogenesis .