甲亢患者的胰岛功能变化及与胰岛素抵抗的相关性分析

目的探究甲状腺功能亢进患者的胰岛功能变化及与胰岛素抵抗的相关性。方法选取2017年7月-2018年6月在海南省人民医院接受治疗的110例甲状腺功能亢进患者列为甲亢组,另选取110例同时期在海南省人民医院体检健康者作为对照组。检测并比较两组受试者的空腹血糖(FPG)、基础胰岛素(FINS)、餐后2 h血糖(2hPG)及餐后2 h胰岛素(2hINS)水平,并计算胰岛B细胞功能指数(HOMA-B)、胰岛素抵抗指数(HOMA-IR)及胰岛素敏感指数(ISI)。结果甲亢组患者出现糖耐量异常68例,占比61.82%,其中21例糖耐量异常达到糖尿病标准;甲亢组患者的FPG、2hPG、2hINS及HOMA-IR水平均显著高于对照组,ISI与HOMA-B水平均明显低于对照组,差异均有统计学意义(P<0.05);用Pearson检验相关性得出,甲亢组患者HOMA-B(P<0.001)与HOMA-IR呈负相关。结论甲状腺功能亢进患者普遍伴有糖代谢异常、胰岛功能损伤及胰岛素抵抗,其胰岛B细胞功能损伤与胰岛素抵抗有关,即HOMA-B与HOMA-IR呈负相关,因此治疗中应注重监测血糖及甲状腺功能,兼顾协同进而达到满意疗效。

Correlation between islet function and insulin resistance in patients with hyperthyroidism

Objective To explore the relationship between insulin resistance(IR) and islet function in patients with hyperthyroidism. Methods Totally 110 patients with hyperthyroidism treated in Hainan Provincial People’s Hospital from July 2017 to June 2018 were selected as hyperthyroidism group, and 110 healthy persons who underwent physical examination in our hospital at the same time were selected as control group. The levels of fasting blood glucose (FPG), basic insulin (FINS), postprandial 2 h blood glucose (2hPG) and postprandial 2 h insulin (2hINS) were measured and compared between the two groups. The islet B cell function index(HOMA-B), insulin resistance index(HOMA-IR) and insulin sensitivity index (ISI) were calculated. Results There were 68 cases of abnormal glucose tolerance in hyperthyroidism group, accounting for 61.82%, of which 21 cases met the diabetes criteria; FPG, 2hPG, 2hINS and HOMA-IR levels in hyperthyroidism group were significantly higher than those in control group, and ISI and HOMA-B levels were significantly lower than those in control group (P<0.05); Pearson test showed that HOMA-B in hyperthyroidism group (P<0.001) was negative correlation with HOMA-IR. Conclusions Hyperthyroidism patients are generally accompanied by abnormal glucose metabolism, impaired islet function and insulin resistance. The impairment of islet B cell function is related to insulin resistance, that is, HOMA-B is negatively correlated with HOMA-IR. Therefore, attention should be paid to monitoring blood sugar and thyroid function in the treatment, and synergy should be taken into account to achieve satisfactory results.