Lattanzi V, Ciampolillo A, Di Venere M, Giorgino R
Boll Soc Ital Biol Sper. 1984 Jul 31;60(7):1355-61.
Plasma TSH, total and free T3 and T4, reverse T3, blood pH, HbAlc, ketonuria and glycosuria were evaluated in 8 subjects with diabetic ketoacidosis, in 54 diabetics of group 1 and group 2 without severe metabolic derangement and in 10 control women. The diabetics with ketoacidosis showed before intensive therapy low T3, total and free, and high reverse T3 concentrations as compared to controls (unpaired t-test, p less than 0.001). After one day of intensive therapy the decrease of hyperglycemia and pH increase (p less than 0.001, paired t-test), glycosuria and ketonuria are not related to significant variations of iodothyronines and TSH. The significant variations (paired t-test, p less than 0.001) in total and free T3 and in reverse T3 concentrations were found only six days after remission of ketoacidosis. In diabetics (type 1 and 2) without recent history of ketoacidosis no differences were found in mean total and free T3 and T4, in reverse T3 and in plasma concentrations although mean blood glucose and HbAlc were statistically different (t-test, p less than 0.001). The changes in serum T3 (total and free) and reverse T3 are useful indicators of total metabolic control during the management of diabetic ketoacidosis.
对8例糖尿病酮症酸中毒患者、54例无严重代谢紊乱的1型和2型糖尿病患者以及10名对照女性进行了血浆促甲状腺激素（TSH）、总三碘甲状腺原氨酸（T3）、游离T3、总甲状腺素（T4）、游离T4、反三碘甲状腺原氨酸（reverse T3）、血pH值、糖化血红蛋白（HbAlc）、尿酮体和尿糖检测。与对照组相比，糖尿病酮症酸中毒患者在强化治疗前总T3、游离T3水平较低，反T3浓度较高（非配对t检验，p<0.001）。强化治疗一天后，血糖下降、pH值升高（配对t检验，p<0.001），尿糖和尿酮体与甲状腺素和TSH的显著变化无关。仅在酮症酸中毒缓解六天后，总T3、游离T3和反T3浓度才出现显著变化（配对t检验，p<0.001）。在近期无酮症酸中毒病史的糖尿病患者（1型和2型）中，尽管平均血糖和HbAlc有统计学差异（t检验，p<0.001），但总T3、游离T3、T4、反T3和血浆浓度的平均值无差异。血清T3（总T3和游离T3）和反T3的变化是糖尿病酮症酸中毒治疗期间总体代谢控制的有用指标。
