Schlienger J L, Anceau A, Chabrier G, North M L, Stephan F
Diabetologia. 1982 Jun;22(6):486-8. doi: 10.1007/BF00282596.
Basal plasma levels of thyroxine (T4), triiodothyronine (T3) and reverse T3 were determined by radioimmunoassay in 44 control subjects, 44 Type 1 (insulin-dependent) and 39 Type 2 (non insulin-dependent) diabetic patients aged from 15 to 75 years. All were clinically euthyroid. The quality of diabetic control was assessed by the percentage of glycosylated haemoglobin. In both the diabetic groups there was a significant decrease in T3 and a rise in reverse T3 whereas T4 was normal. We found no significant differences between plasma thyroid hormone levels in Type 1 and Type 2 diabetic patients. In the poorly controlled diabetics (glycosylated haemoglobin greater than or equal to 12%), T3 was 90 +/- 5 ng/dl, which differed significantly from the level found in the better controlled patients (106 +/- 5 ng/dl, p less than 0.01). In the diabetic patients without associated illness, a negative linear correlation was found between T3 and glycosylated haemoglobin and a positive correlation between reverse T3/T3 and glycosylated haemoglobin. No correlation between T3 or reverse T3 and fasting blood glucose could be established. In conclusion, many diabetics showed a low T3 syndrome suggesting that there may be an impairment in the extrathyroidal conversion of T4 to T3. This may well be enhanced by a poor diabetic control (glycosylated haemoglobin greater than or equal to 12%).
采用放射免疫分析法测定了44名对照者、44名1型（胰岛素依赖型）和39名2型（非胰岛素依赖型）年龄在15至75岁之间的糖尿病患者的基础血浆甲状腺素（T4）、三碘甲状腺原氨酸（T3）和反三碘甲状腺原氨酸水平。所有患者临床甲状腺功能均正常。通过糖化血红蛋白百分比评估糖尿病控制质量。在两组糖尿病患者中，T3均显著降低，反三碘甲状腺原氨酸升高，而T4正常。我们发现1型和2型糖尿病患者的血浆甲状腺激素水平无显著差异。在控制不佳的糖尿病患者（糖化血红蛋白大于或等于12%）中，T3为90±5 ng/dl，与控制较好的患者（106±5 ng/dl，p<0.01）的水平有显著差异。在无相关疾病的糖尿病患者中，T3与糖化血红蛋白呈负线性相关，反三碘甲状腺原氨酸/ T3与糖化血红蛋白呈正相关。未发现T3或反三碘甲状腺原氨酸与空腹血糖之间存在相关性。总之，许多糖尿病患者表现出低T3综合征，提示甲状腺外T4向T3的转化可能存在损害。糖尿病控制不佳（糖化血红蛋白大于或等于12%）可能会加剧这种情况。
