Wang Yin-man, Ling Yan, Gao Xin
Department of Internal Medicine, Fudan University, Shanghai, China.
Zhonghua Yi Xue Za Zhi. 2013 Apr 9;93(14):1084-8.
To explore the effects of thyroid hormone on islet β cell function among type 2 diabetics with normal thyroid function.
A total of 266 type 2 diabetics with normal thyroid function were recruited. Their clinical, biochemical parameters and thyroid related hormones were measured. And acute insulin response (AIR) was examined by arginine stimulating test.
The serum levels of triiodothyronine (T3) ((1.49 ± 0.03), (1.59 ± 0.03), (1.70 ± 0.04) µmol/L) and free triiodothyronine (FT3) ((4.01 ± 0.08), (4.37 ± 0.09), (4.44 ± 0.07) pmol/L) were significantly different among tertile groups of AIR (both P < 0.01) while those of thyroxine (T4), free thyroxine (FT4) and thyroid stimulating hormone (TSH) showed no significant differences among tertile groups of AIR (all P > 0.05). A significant positive correlation existed between lnAIR and T3, FT3 (r = 0.303, 0.302, both P < 0.01). T4 and FT4 were not correlated with lnAIR (both P>0.05). AIR was significantly different among tertile groups of T3 ((2.38 ± 0. 12), (2.64 ± 0.12) and (3.03 ± 0.10) mU/L) and FT3 ((2.34 ± 0.11), (2.69 ± 0.13), (2.99 ± 0.10) mU/L, P < 0.01). AIR were not significantly different among tertile groups of T4, FT4 and TSH (all P > 0.05). Multivariate linear regression demonstrated that T3 and FT3 level were independently associated with AIR (β = 0.686, 95% CI 0.289-0.884, P = 0.001, β = 0.296, 95% CI 0.125-0.467, P = 0.01).
Significant positive associations exist between serum T3, FT3 and AIR in type 2 diabetics with normal thyroid function. Serum T3 and FT3 may be the independent risk factors of predicting islet beta cell function in type 2 diabetics with normal thyroid function. However, it remains to be determined whether or not normal physiological concentrations of T3 and FT3 are protective factors for islet β cell functions among type 2 diabetics.
探讨甲状腺激素对甲状腺功能正常的2型糖尿病患者胰岛β细胞功能的影响。
共纳入266例甲状腺功能正常的2型糖尿病患者。测量其临床、生化参数及甲状腺相关激素。通过精氨酸刺激试验检测急性胰岛素反应(AIR)。
在AIR三分位数组中,血清三碘甲状腺原氨酸(T3)((1.49 ± 0.03)、(1.59 ± 0.03)、(1.70 ± 0.04) μmol/L)和游离三碘甲状腺原氨酸(FT3)((4.01 ± 0.08)、(4.37 ± 0.09)、(4.44 ± 0.07) pmol/L)有显著差异(均P < 0.01),而甲状腺素(T4)、游离甲状腺素(FT4)和促甲状腺激素(TSH)在AIR三分位数组中无显著差异(均P > 0.05)。lnAIR与T3、FT3之间存在显著正相关(r = 0.303、0.302,均P < 0.01)。T4和FT4与lnAIR无相关性(均P>0.05)。在T3三分位数组((2.38 ± 0. 12)、(2.64 ± 0.12)和(3.03 ± 0.10) mU/L)和FT3三分位数组((2.34 ± 0.11)、(2.69 ± 0.13)、(2.99 ± 0.10) mU/L,P < 0.01)中,AIR有显著差异。在T4、FT4和TSH三分位数组中,AIR无显著差异(均P > 0.05)。多变量线性回归表明,T3和FT3水平与AIR独立相关(β = 0.686,95%CI 0.289 - 0.884,P = 0.001,β = 0.296,95%CI 0.125 - 0.467,P = 0.01)。
甲状腺功能正常的2型糖尿病患者血清T3、FT3与AIR之间存在显著正相关。血清T3和FT3可能是预测甲状腺功能正常的2型糖尿病患者胰岛β细胞功能的独立危险因素。然而,T3和FT3的正常生理浓度是否为2型糖尿病患者胰岛β细胞功能的保护因素仍有待确定。