Division of Diabetes and Metabolism, Department of Internal Medicine, Iwate Medical University School of Medicine.
Tohoku J Exp Med. 2011 Jul;224(3):173-8. doi: 10.1620/tjem.224.173.
Associations of thyroid hormones with visceral obesity and insulin resistance in obese subjects with euthyroidism have been reported. However, there are no such reports in subjects with type 2 diabetes. The purpose of our study is to observe a relationship between thyroid hormones and components of metabolic syndrome (MetS) in type 2 diabetic subjects with euthyroidism defined by normal thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels. Subjects were 301 Japanese patients with type 2 diabetes. Serum TSH, FT4, free triiodothyronine (FT3), and variables related to MetS were measured. MetS was defined by the Japanese criteria and the criteria of the National Cholesterol Education Program modified for Asians. We found that serum FT3 levels were significantly and positively associated with BMI, visceral fat area, systolic and diastolic blood pressure, estimated glomerular filtration rate, serum triglyceride, and urine C peptide as a marker of insulin production, whereas negatively with age and HbA1c. In contrast, fewer numbers of variables were associated with serum TSH and FT4 levels. By a multiple regression analysis, FT3 level was independently associated with components of MetS such as visceral fat area, systolic blood pressure, and fasting blood glucose levels. On the other hand, the presence of these MetS components was independently associated with FT3 levels and urine C peptide. In conclusion, these results suggest a significant relationship between serum FT3 levels and components of MetS in type 2 diabetic subjects with euthyroidism, and imply a role of FT3 in MetS in type 2 diabetes.
已有研究报道，甲状腺激素与甲状腺功能正常的肥胖人群内脏型肥胖和胰岛素抵抗相关。然而，在 2 型糖尿病患者中尚无此类报道。我们的研究目的是观察甲状腺功能正常（促甲状腺激素 TSH 和游离甲状腺素 FT4 水平正常）的 2 型糖尿病患者中，甲状腺激素与代谢综合征（MetS）各组分之间的关系。研究对象为 301 例日本 2 型糖尿病患者，检测了血清 TSH、FT4、游离三碘甲状腺原氨酸（FT3）以及与 MetS 相关的变量。MetS 采用日本标准和亚洲人改良的美国国家胆固醇教育计划标准进行定义。结果显示，血清 FT3 水平与 BMI、内脏脂肪面积、收缩压和舒张压、估算肾小球滤过率、血清三酰甘油和尿 C 肽（胰岛素生成的标志物）呈显著正相关，与年龄和糖化血红蛋白（HbA1c）呈显著负相关。相比之下，血清 TSH 和 FT4 水平与较少的变量相关。多元回归分析显示，FT3 水平与 MetS 的各组分如内脏脂肪面积、收缩压和空腹血糖水平独立相关。另一方面，这些 MetS 组分的存在与 FT3 水平和尿 C 肽独立相关。综上，这些结果表明甲状腺功能正常的 2 型糖尿病患者的血清 FT3 水平与 MetS 的各组分显著相关，提示 FT3 在 2 型糖尿病的 MetS 中发挥作用。
