Alexander C M, Kaptein E M, Lum S M, Spencer C A, Kumar D, Nicoloff J T
J Clin Endocrinol Metab. 1982 Feb;54(2):362-6. doi: 10.1210/jcem-54-2-362.
The effects of diabetes mellitus on serum thyroid hormone parameters were studied in 54 patients divided into 4 groups. Treated asymptomatic patients (group I) had normal thyroid values which did not correlate with serum or urinary glucose. Untreated nonketoacidotic patients (group II) showed a mild persistent depression in T3 and an elevation in rT3. Patients with ketoacidosis with a brief history of symptoms (group III) had a moderate T3 decrease and a mild rT3 elevation which quickly resolved with treatment. Ketoacidotic patients with a long history of symptoms (group IV) had marked depression of T3 and elevation of rT3 which was only partially rectified by treatment. Serum T4 was generally normal, except for a minimal decrease on the day after admission, probably resulting from rehydration and a subsequent increase associated with an increase in TSH. We concluded that thyroid hormone parameters were not influenced by variations in serum glucose, but seemed to reflect the effects of a preexisting catabolic state, ketoacidosis, or both.
对54例患者进行分组研究糖尿病对血清甲状腺激素参数的影响。接受治疗的无症状患者（第一组）甲状腺值正常，与血清或尿糖无关。未经治疗的非酮症酸中毒患者（第二组）T3呈轻度持续性降低，反T3升高。有短暂症状史的酮症酸中毒患者（第三组）T3中度降低，反T3轻度升高，治疗后迅速恢复。有长期症状史的酮症酸中毒患者（第四组）T3显著降低，反T3升高，治疗仅部分纠正。血清T4一般正常，入院后第一天有轻微降低，可能是由于补液，随后随着促甲状腺激素升高而升高。我们得出结论，甲状腺激素参数不受血清葡萄糖变化的影响，但似乎反映了先前存在的分解代谢状态、酮症酸中毒或两者的影响。
