Bagchi N, Palaniswami N, Desai H, Felicetta J, Brown T R
Department of Medicine, Wayne State University, Detroit, MI.
Metabolism. 1988 Jul;37(7):669-71. doi: 10.1016/0026-0495(88)90088-1.
The responses to TRH and bovine TSH (bTSH) were compared in 19 men with uncontrolled type II diabetes mellitus and eight healthy control subjects. Baseline serum TSH, T3 and T4 were similar in both groups and the rise of serum TSH, T3 and T4 following the intravenous (IV) administration of TRH (500 micrograms) was not significantly different. Diabetic subjects showed a blunted response to the subcutaneous (sc) administration of bTSH (5 U) when their maximal serum T3 and T4 values were compared with controls (T4, 9.4 +/- 0.3 v 12.3 +/- 1.1 micrograms/dL, P less than .005; T3, 185 +/- 9 v 233 +/- 17 ng/dL, P less than .025; diabetic v control). When the response to bTSH was examined in seven patients after 4 to 5 days of strict glycemic control, the maximal T3 response was found to increase in six, and the maximal T4 response in five. These data show that the thyroidal secretory response to large doses of TSH is decreased in uncontrolled diabetes mellitus and that strict glycemic control frequently improves the response.
对19名未控制的II型糖尿病男性患者和8名健康对照者比较了他们对促甲状腺激素释放激素（TRH）和牛促甲状腺激素（bTSH）的反应。两组的基础血清促甲状腺激素（TSH）、三碘甲状腺原氨酸（T3）和甲状腺素（T4）相似，静脉注射（IV）TRH（500微克）后血清TSH、T3和T4的升高无显著差异。将糖尿病患者皮下注射（sc）bTSH（5 U）后的最大血清T3和T4值与对照组比较时，糖尿病患者的反应减弱（T4，9.4±0.3对12.3±1.1微克/分升，P＜0.005；T3，185±9对233±17纳克/分升，P＜0.025；糖尿病患者对对照组）。在7例患者严格血糖控制4至5天后检查对bTSH的反应时，发现6例患者的最大T3反应增加，5例患者的最大T4反应增加。这些数据表明，未控制的糖尿病患者对大剂量TSH的甲状腺分泌反应降低，严格的血糖控制常常可改善这种反应。
