Rashidi Homeira, Ghaderian Seyed Bahman, Latifi Seyed Mahmoud, Hoseini Forogh
Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran.
Diabetes Metab Syndr. 2017 Nov;11 Suppl 1:S57-S59. doi: 10.1016/j.dsx.2016.12.001. Epub 2016 Dec 14.
The aim of current study was to evaluate the function of thyroid during diabetic acidosis, just after the treatment and two weeks after the treatment. This was the analytic study. The study subjects included 20 patients, aged 18-36 years old, with type1 diabetes and diabetic ketoacidosis. All subjects were evaluated for thyroid function tests such as triiodothyronine (T3), thyroxine (T4), T3 resin uptake (T3RU), free T3 (FT3), free T4 (FT4) and thyroid stimulating hormone (TSH), before treatment. After completing DKA treatment and two weeks after discharge, the thyroid function tests were repeated on the subjects and the results were analyzed using paired T-test, ANOVA or repeated measure and Pearson correlation tests. the current study showed that the mean levels of T3 and T4 were at hyperthyroid range and lower than normal before the treatment and significantly increased after the treatment (P<0.001). The serum levels of T3RU, FT4 and T4 were at the normal range, but their mean level increased significantly following the treatment progression (P<0.001).A significant relationship was observed among blood pH and the serum levels of FT3 and T3, before the treatment; the lower pH, the lower levels of FT3 and T3. The results of the current study showed that DKA causes euthyroid sick syndrome. The disease complications were resolved two weeks after treatment and the severity of acidosis was the main factor to decrease the level of active form of thyroid hormones such as FT3 and T3.
本研究的目的是评估糖尿病酸中毒期间、治疗刚结束时以及治疗两周后的甲状腺功能。这是一项分析性研究。研究对象包括20名年龄在18 - 36岁之间的1型糖尿病合并糖尿病酮症酸中毒患者。所有受试者在治疗前均接受甲状腺功能测试,如三碘甲状腺原氨酸(T3)、甲状腺素(T4)、T3树脂摄取率(T3RU)、游离T3(FT3)、游离T4(FT4)和促甲状腺激素(TSH)。在完成糖尿病酮症酸中毒治疗及出院两周后,对受试者重复进行甲状腺功能测试,并使用配对t检验、方差分析或重复测量以及Pearson相关检验对结果进行分析。本研究表明,治疗前T3和T4的平均水平处于甲状腺功能亢进范围且低于正常水平,治疗后显著升高(P<0.001)。T3RU、FT4和T4的血清水平处于正常范围,但随着治疗进展其平均水平显著升高(P<0.001)。治疗前观察到血液pH值与FT3和T3的血清水平之间存在显著关系;pH值越低,则FT3和T3水平越低。本研究结果表明,糖尿病酮症酸中毒会导致正常甲状腺病态综合征。治疗两周后疾病并发症得到解决,酸中毒的严重程度是降低FT3和T3等甲状腺激素活性形式水平的主要因素。