Cira Duygu Kalkan, Sari Ramazan, Ozdem Sebahat, Yilmaz Nusret, Bozkurt Selen
1 Akdeniz University, School of Medicine, Antalya, Turkey.
Ann Pharmacother. 2017 Aug;51(8):663-668. doi: 10.1177/1060028017707221. Epub 2017 Apr 28.
Incretin hormones (glucagon-like peptide-1 [GLP-1] and gastric inhibitory polypeptide [GIP]) may play a role in the development of glucose intolerance and hyperglycemia in patients with hyperthyroidism.
We aimed to assess both incretin levels and treatment-induced changes in incretin levels in those with hyperthyroidism.
A total of 24 subjects (12 with hyperthyroidism and 12 healthy) were enrolled in the study. Oral glucose tolerance test was performed and serum glucose, insulin GLP1, and GIP levels were evaluated at 0 (baseline), 30, 60, 90, and 120 minutes using ELISA. Measurements were repeated after euthyroidism was reached in subjects with hyperthyroidism.
The baseline glucose level was higher in those with hyperthyroidism compared with controls ( P = 0.03). GLP-1 and GIP responses to oral glucose load did not differ significantly between those with hyperthyroidism and controls. Peak GLP-1 and GIP levels were reached in both groups at 60 and 90 minutes, respectively. Areas under the curve (AUCs) for GLP1 and GIP were similar in those with hyperthyroidism and controls. Although GLP-1 and GIP levels did not change before and after antithyroid treatment in subjects with hyperthyroidism, time to peak GLP-1 and GIP levels were reached at 30 minutes after euthyroid state was achieved. Reversal of hyperthyroid to euthyroid status did not induce significant changes in AUCs for incretins.
The findings of the present study suggest that the total incretin response to oral glucose load is preserved in patients with hypertyhroidism, but peak incretin responses may change after achieving euthyroid state.
肠促胰岛素激素(胰高血糖素样肽-1[GLP-1]和胃抑制多肽[GIP])可能在甲状腺功能亢进患者糖耐量异常和高血糖的发生发展中起作用。
我们旨在评估甲状腺功能亢进患者的肠促胰岛素水平以及治疗引起的肠促胰岛素水平变化。
本研究共纳入24名受试者(12名甲状腺功能亢进患者和12名健康人)。进行口服葡萄糖耐量试验,并在0(基线)、30、60、90和120分钟时使用酶联免疫吸附测定法评估血清葡萄糖、胰岛素、GLP-1和GIP水平。甲状腺功能亢进患者达到甲状腺功能正常后重复测量。
与对照组相比,甲状腺功能亢进患者的基线血糖水平更高(P = 0.03)。甲状腺功能亢进患者和对照组对口服葡萄糖负荷的GLP-1和GIP反应无显著差异。两组的GLP-1和GIP峰值水平分别在60和90分钟时达到。甲状腺功能亢进患者和对照组的GLP-1和GIP曲线下面积(AUC)相似。虽然甲状腺功能亢进患者抗甲状腺治疗前后GLP-1和GIP水平没有变化,但在达到甲状腺功能正常状态后30分钟时达到GLP-1和GIP峰值水平。甲状腺功能亢进状态转变为甲状腺功能正常状态并未引起肠促胰岛素AUC的显著变化。
本研究结果表明,甲状腺功能亢进患者对口服葡萄糖负荷的总肠促胰岛素反应保持不变,但达到甲状腺功能正常状态后肠促胰岛素峰值反应可能会发生变化。