Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China.
Curr Med Sci. 2020 Feb;40(1):69-77. doi: 10.1007/s11596-020-2148-6. Epub 2020 Mar 13.
Thyroid hormones have a specific effect on glucose-induced insulin secretion from the pancreas. We aimed to investigate the association between euthyroid hormones and islet beta-cell function in general population and non-treated type 2 diabetes mellitus (T2DM) patients. A total of 5089 euthyroid participants (including 4601 general population and 488 non-treated T2DM patients) were identified from a cross-sectional survey on the prevalence of metabolic diseases and risk factors in East China from February 2014 to June 2016. Anthropometric indices, biochemical parameters, and thyroid hormones were measured. Compared with general population, non-treated T2DM patients exhibited higher total thyroxine (TT4) and free thyroxine (FT4) levels but lower ratio of free triiodothyronine (T3):T4 (P<0.01). HOMA-β had prominently negative correlation with FT4 and positive relationship with free T3:T4 in both groups even after adjusting for age, body mass index (BMI) and smoking. When analyzed by quartiles of FT4 or free T3:T4, there were significantly decreased trend of HOMA-β going with the higher FT4 and lower free T3:T4 in both groups. Linear regression analysis showed that FT4 but not FT3 and free T3:T4 was negatively associated with HOMA-β no matter in general population or T2DM patients, which was independent of age, BMI, smoking, hypertension and lipid profiles. FT4 is independently and negatively associated with islet beta-cell function in euthyroid subjects. Thyroid hormone even in reference range could play an important role in the function of pancreatic islets.
甲状腺激素对胰腺葡萄糖诱导的胰岛素分泌有特定的影响。我们旨在研究甲状腺激素与一般人群和未经治疗的 2 型糖尿病(T2DM)患者胰岛β细胞功能之间的关系。
从 2014 年 2 月至 2016 年 6 月,在中国东部进行的一项关于代谢性疾病和危险因素患病率的横断面调查中,共确定了 5089 名甲状腺功能正常的参与者(包括 4601 名一般人群和 488 名未经治疗的 T2DM 患者)。测量了人体测量指标、生化参数和甲状腺激素。与一般人群相比,未经治疗的 T2DM 患者的总甲状腺素(TT4)和游离甲状腺素(FT4)水平较高,但游离三碘甲状腺原氨酸(T3):T4 比值较低(P<0.01)。
在两组中,HOMA-β 与 FT4 呈明显负相关,与游离 T3:T4 呈正相关,即使在调整年龄、体重指数(BMI)和吸烟后也是如此。
按 FT4 或游离 T3:T4 的四分位数分析,两组 HOMA-β 随着 FT4 升高和游离 T3:T4 降低呈明显下降趋势。线性回归分析表明,FT4 而不是 FT3 和游离 T3:T4 与 HOMA-β 呈负相关,无论在一般人群还是 T2DM 患者中均如此,这与年龄、BMI、吸烟、高血压和血脂谱无关。FT4 与甲状腺功能正常的受试者的胰岛β细胞功能独立且呈负相关。即使在参考范围内,甲状腺激素也可能在胰岛功能中发挥重要作用。