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亚临床甲状腺功能减退患者的胰岛素抵抗和血糖水平

Insulin Resistance and Glucose Levels in Subjects with Subclinical Hypothyroidism.

作者信息

Khan Sikandar Hayat, Fazal Nadeem, Ijaz Aamir, Manzoor Syed Mohsin, Asif Naveed, Rafi Tariq, Yasir Muhammad, Niazi Najmusaquib Khan

机构信息

Department of Pathology PNS Hafeez, Islamabad.

Department of Medicine PNS Hafeez, Islamabad.

出版信息

J Coll Physicians Surg Pak. 2017 Jun;27(6):329-333.

Abstract

OBJECTIVE

To compare insulin resistance and glycemic indicators among subjects with euthyroidism and subclinical hypothyroidism.

STUDY DESIGN

Comparative cross-sectional study.

PLACE AND DURATION OF STUDY

Department of Pathology and Medicine, PNS Hafeez, Islamabad, in collaboration with the Department of Chemical Pathology and Endocrinology at the Armed Forces Institute of Pathology (AFIP), Rawalpindi, from December 2015 to September 2016.

METHODOLOGY

Subjects referred for executive screening of apparently healthy population (without any known history of diabetes, hypertension, heart disease or other chronic ailments), were included. Subjects were grouped as euthyroidism and subclinical hypothyroidism.

RESULTS

Median (IQR) insulin resistance indices including fasting insulin and Homeostasis Model Assessment for Insulin Resistance in subjects with group-1 (n=176, 87%, Thyroid Stimulating Hormone: 0.5 - 3.5 mIU/L) and group-2 (n=26, 13%, Thyroid Stimulating Hormone: 3.51 - 15 mIU/L) were 7.6 (6.70) vs. 11.4 (13.72, p=0.040) and 1.77 (1.79) vs. 2.8 (3.07, p=0.071). The median differences for fasting plasma glucose were 5.0 (1.0) in group-1 vs. 5.0 (1.47) for Group-2 [p=0.618], and glycated hemoglobin was 5.60 (1.1) vs. 5.60 (1.7, p=0.824). Homeostasis Model Assessment for beta sensitivity index in paradox showed slightly higher values for group-2 [median (IQR) 86.67 (92.94)] than group-1 [111.6 (189.64, p= 0.040)].

CONCLUSION

Measures of insulin resistance including Homeostasis Model Assessment for Insulin Resistance and fasting insulin levels were significantly different between subjects with euthyroidism and having subclinical hypothyroidism.

摘要

目的

比较甲状腺功能正常和亚临床甲状腺功能减退患者的胰岛素抵抗和血糖指标。

研究设计

比较性横断面研究。

研究地点和时间

2015年12月至2016年9月,伊斯兰堡PNS哈菲兹病理与医学系与拉瓦尔品第武装部队病理研究所(AFIP)化学病理学和内分泌学系合作进行。

方法

纳入前来进行明显健康人群(无任何已知糖尿病、高血压、心脏病或其他慢性疾病史)行政筛查的受试者。受试者分为甲状腺功能正常组和亚临床甲状腺功能减退组。

结果

第1组(n = 176,87%,促甲状腺激素:0.5 - 3.5 mIU/L)和第2组(n = 26,13%,促甲状腺激素:3.51 - 15 mIU/L)受试者的胰岛素抵抗指数中位数(IQR),包括空腹胰岛素和胰岛素抵抗稳态模型评估,分别为7.6(6.70)对11.4(13.72,p = 0.040)以及1.77(1.79)对2.8(3.07,p = 0.071)。第1组空腹血糖中位数差异为5.0(1.0),第2组为5.0(1.47)[p = 0.618],糖化血红蛋白分别为5.60(1.1)对5.60(1.7,p = 0.824)。胰岛素抵抗稳态模型评估的β敏感性指数在第2组[中位数(IQR)86.67(92.94)]略高于第1组[111.6(189.64,p = 0.040)]。

结论

甲状腺功能正常和亚临床甲状腺功能减退患者之间,胰岛素抵抗指标包括胰岛素抵抗稳态模型评估和空腹胰岛素水平存在显著差异。

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