Graves病患者糖耐量、糖化血红蛋白及胰岛素变化的研究

目的探讨Graves病患者糖代谢状况及糖化血红蛋白、胰岛素变化的临床意义.方法对86例Graves病患者作口服葡萄糖耐量试验(0GTr)、胰岛素释放试验、糖化血红蛋白(GHb)及甲状腺激素水平测定,并与正常人组及2型糖尿病组进行比较.结果Graves病患者合并糖代谢异常者占55.8%(30/86 18/86),GHb异常率占54.6%,其中糖耐量低减者占34.9%,呈糖尿病样者占20.9%,糖尿病样者餐后胰岛素明显升高.经抗甲亢6个月～1年,甲状腺激素恢复正常后,糖耐量低减组93.3%的患者血糖恢复正常,83.3%患者的GHb恢复正常;糖尿病样组28%的患者血糖恢复正常,餐后胰岛素仅16.7%恢复正常.结论Graves病患者应常规作OGTT、CHb检查,并定期随访,部分患者可进一步查糖负荷后胰岛素及谷氨酸脱羧酶抗体(GAD-Ab).

Study on changes of glucose tolerance,glycohemoglobin and insulin in Graves disease patients

Objective: To investigate the clinical significance on the changes of glycometablism, glycohemoglobin(GHb) and insulin in Graves disease patients. Methods: The 75g oral glucose tolerance tests (OGTT), insulin release tests, GHb and the concentration of serum thyroxin were detected in 86 Graves disease patients, and these indexes were compared with those of the normal group and type 2 diabetes group.Results: The abnormality rate of glycometabolism was 55.8% in Graves disease patients, and of GHb was 54.6%, 34.9% of the patients showed impaired glucose tolerance(IGT), 20.9% of the patients presented glucose tolerance compatible with diabetes(GTCD) who were found to be with obviously high postprandial insulin. After 6 months to 1 year's antithyroid treatment, in IGT group, 93.3% of patients showed normal blood glucose, and 83.3% showed normal GHb, in GTCD group only 28% of patients presented normal blood glucose and 16.7% presented normal postprandial insulin.Conclusions: It is suggested that a routine detection of OGTT, GHb and regularly following up these indexes are necessary for Graves disease patients, while the postprandial insulin and glutamate decarboxylase antibody (GAD-Ab) are also necessary detection for part of Graves disease patients.