甲状腺功能亢进症患者胰岛素抵抗对血糖的影响
Influence of insulin resistance on plasma glucose in patients with hyperthyroidism

目的：探讨甲状腺功能亢进症患者胰岛素抵抗对空腹及餐后血糖的影响。方法：选择行OGTT+胰岛素释放试验的120例甲状腺功能亢进症患者作为观察组，选取门诊同期体检的40例健康人作为对照组，比较两组的胰岛素抵抗指数（HOMA？？IR）、空腹血糖（FPG）、空腹胰岛素（FINS）、餐后2 h血糖及餐后2 h胰岛素等指标的差异。根据HMOA？？IR或葡萄糖与胰岛素曲线下面积比值将甲状腺功能亢进症患者分为胰岛素抵抗组（n=69）及非胰岛素抵抗组（n=51），比较两组的游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、FPG、餐后2 h血糖和HOMA？？IR水平的差异。结果：观察组FINS、餐后2 h胰岛素和HOMA？？IR高于对照组（t=13.451、8.171和13.807,P＜0.05）。57.5%（69/120）的甲状腺功能亢进症患者伴有胰岛素抵抗。胰岛素抵抗组FPG、餐后2 h血糖和HOMA？？IR较非胰岛素抵抗组高（t=13.197、9.206和16.100,P＜0.05）。结论：甲状腺功能亢进症患者较健康人群更易发生胰岛素抵抗；合并胰岛素抵抗的甲状腺功能亢进症患者的血糖较未合并胰岛素抵抗的患者高。
Aim: To investigate the influence of insulin resistance on fasting and postprandial plasma glucose in patients with hyperthyroidism.Methods: Retrospective analysis of 120 patients with hyperthyroidism as observation group and 40 healthy individuals as control group was performed. Comparing the difference in the fasting plasma glucose(FPG),fasting insulin(FINS),2 h postprandial glucose(2 h PG),2 h postprandial insulin(2 h FINS) and insulin resistance index(HOMA？？IR) between the 2 groups.According to HOMA？？IR or the ratio area of insulin to glucose, the observation group was allocated into insulin resistance group and non？？insulin resistance group.Comparing the glucose and thyroid hormones between the two groups. Results: FINS,2 h FINS,and HOMA？？IR were higher in observation group than those in control group（t=13.451,8.171,13.807,P＜0.05）.There were 57.5%（69/120）patients with hyperthyroidism had insulin resistances.The FPG,2 h PG, and HOMA？？IR in insulin resistance group were higher than those in non？？insulin resistance group（t=13.197,9.206,16.100,P＜0.05）.Conclusion: The patients with hyperthyroidism are more likely to have insulin resistance than healthy people. The plasma glucose in hyperthyroidism patients with insulin resistance is higher than those without