二甲双胍对甲状腺功能的影响

二甲双胍作为一个经典的抗高血糖药物,在临床应用已走过了50余年的辉煌历史.近年来,有研究显示,二甲双胍对甲状腺功能减退症(甲减)患者的血清促甲状腺素(TSH)具有抑制作用,但不影响游离甲状腺素的水平,对于无甲状腺疾病的糖尿病患者的TSH水平亦无明显影响.推测可能与药物的相互作用、体重的改变、下丘脑-垂体-甲状腺轴的调节等因素有关,但尚缺乏令人信服的理论依据.虽然如此,这一意外的发现有可能对临床工作产生深远的影响,如二甲双胍有望作为甲状腺癌术后的辅助治疗措施.

The effects of metformin on thyroid function

As a classie antihyperglycemic drug,metformin has been widely used for more than 50 years.Recently,it has been reported that it is able to interfere with thyroid hormone profile,as shown by a decrease in the serum levels of thyrotropin(TSH)in hypothyroid patients without change of free thyroxines.In addition,metformin has no effect on circulating thyroid function parameters in euthyroid diabetic patients.This finding may be related to drug to drug interactions,changes in body weight,regulation of the hypothalamuspituitary-thyroid axis,and other factors;but it still needs a convincing theoretical basis.Nevertheless,this accidental discovery is likely to have a profound impact on clinical work,for example,metformin is expected to be a complementary means for postoperative treatment of thyroid cancer.