McCulloch A J, Home P D, Heine R, Ponchner M, Hanning I, Johnston D G, Clark F, Alberti K G
Clin Endocrinol (Oxf). 1983 Apr;18(4):327-33. doi: 10.1111/j.1365-2265.1983.tb00576.x.
Sensitivity to porcine insulin has been compared in overnight fasted hyperthyroid and control subjects using a euglycaemic clamp technique. Basal values for blood glucose, lactate, pyruvate, alanine, serum insulin and C-peptide were similar in the two groups, whilst blood glycerol (hyperthyroid 0.11 +/- 0.02 (mean +/- S.E.) vs. control 0.06 +/- 0.01 mmol/l, P less than 0.01) and blood 3-hydroxybutyrate (0.28 [0.03-0.79, range ]vs 0.09 [0.01-0.29 ]mmol/l, P less than 0.05) were increased in hyperthyroidism. During the 2 hour insulin infusion (0.05 U/kg/h), serum insulin plateaued at the same level (44 +/- 4 vs 44 +/- 1 mU/l) and insulin metabolic clearance rates were similar (1.21 +/- 0.10 vs 1.25 +/- 0.03 l/min). Serum C-peptide levels also decreased by similar amounts (40 +/- 8 vs 47 +/- 6%). The amount of glucose infused to maintain euglycaemia was identical during the second hour of insulin infusion (290 +/- 50 vs 330 +/- 30 mg/kg) as were the increments in lactate and pyruvate concentrations. Blood glycerol values decreased in both groups although values in hyperthyroid patients remained significantly higher than in controls. 3-Hydroxybutyrate concentrations fell to similar values in the two groups. These findings suggest that insulin-stimulated glucose metabolism and inhibition of ketogenesis are normal in hyperthyroidism.
采用正常血糖钳夹技术，对过夜禁食的甲状腺功能亢进患者和对照组受试者的猪胰岛素敏感性进行了比较。两组的血糖、乳酸、丙酮酸、丙氨酸、血清胰岛素和C肽的基础值相似，而甲状腺功能亢进患者的血甘油（甲状腺功能亢进组0.11±0.02（均值±标准误），对照组0.06±0.01 mmol/l，P<0.01）和血3-羟基丁酸（0.28[0.03 - 0.79，范围]对0.09[0.01 - 0.29]mmol/l，P<0.05）升高。在2小时胰岛素输注期间（0.05 U/kg/h），血清胰岛素达到相同的平台水平（44±4对44±1 mU/l），胰岛素代谢清除率相似（1.21±0.10对1.25±0.03 l/min）。血清C肽水平也下降了相似的幅度（40±8对47±6%）。在胰岛素输注的第二小时，为维持正常血糖而输注的葡萄糖量相同（290±50对330±30 mg/kg），乳酸和丙酮酸浓度的增加也相同。两组的血甘油值均下降，尽管甲状腺功能亢进患者的值仍显著高于对照组。两组的3-羟基丁酸浓度降至相似的值。这些发现表明，在甲状腺功能亢进症中，胰岛素刺激的葡萄糖代谢和酮体生成的抑制是正常的。
