Department of Applied Physiology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Pawinskiego 5 str., 02-106, Warsaw, Poland.
Endocrinology Outpatient Department, Masovian Hospital Bródno, Kondratowicza 8 str., 03-242, Warsaw, Poland.
Endocrine. 2021 Jan;71(1):96-103. doi: 10.1007/s12020-020-02334-0. Epub 2020 May 13.
Hypothyroidism is associated with a lower metabolic rate, impaired glucose tolerance, and increased responsiveness of sympathetic nervous system to glucose ingestion. The Levothyroxine (LT4) monotherapy is the standard treatment for hypothyroidism; however to what extent this treatment restores the patients' metabolism has not been verified. The aim of this study was to test the hypothesis that standard LT4 therapy may not restore proper metabolic response to carbohydrate ingestion.
Energy expenditure, glucose tolerance, and catecholamine response to glucose ingestion were compared in 18 subjects with pharmacologically compensated hypothyroidism (PCH) and controls, at baseline and during oral glucose tolerance test conditions.
Metabolic rate was significantly lower in PCH (P < 0.0001). Glucose tolerance was decreased in this group with no differences in insulin resistance indicators between both groups. Adrenergic activity (P < 0.05) as well as adrenergic reaction to glucose ingestion (P < 0.001) were stronger in PCH.
Standard treatment for hypothyroidism does not restore the normal metabolic reaction to carbohydrate which is observed in healthy people.
甲状腺功能减退与代谢率降低、葡萄糖耐量受损以及交感神经系统对葡萄糖摄入的反应性增加有关。左甲状腺素（LT4）单药治疗是甲状腺功能减退的标准治疗方法；然而，这种治疗在多大程度上恢复了患者的代谢功能尚未得到验证。本研究旨在验证以下假设，即标准 LT4 治疗可能无法恢复对碳水化合物摄入的适当代谢反应。
在基线和口服葡萄糖耐量试验条件下，比较了 18 名药物治疗甲状腺功能减退症患者（PCH）和对照组的能量消耗、葡萄糖耐量以及儿茶酚胺对葡萄糖摄入的反应。
PCH 患者的代谢率明显降低（P<0.0001）。该组葡萄糖耐量降低，但两组之间的胰岛素抵抗指标无差异。肾上腺素能活性（P<0.05）以及肾上腺素对葡萄糖摄入的反应（P<0.001）在 PCH 中更强。
甲状腺功能减退症的标准治疗方法并不能恢复健康人群对碳水化合物的正常代谢反应。
