McCulloch A J, Johnston D G, Burrin J M, Hodson A W, Clark F, Waugh C, Orskov H, Alberti K G
Clin Endocrinol (Oxf). 1981 Dec;15(6):607-19. doi: 10.1111/j.1365-2265.1981.tb00707.x.
To investigate the influence of thyroid hormones on intermediary metabolism in man, hormone and metabolite profiles were obtained over a 12-h period of normal meals and activity in eight hypothyroid subjects before and during thyroxine replacement therapy, and in sixteen matched controls. The fasting blood glucose concentration and the mean 12-h blood glucose concentration were normal in hypothyroid subjects but the blood glucose response to breakfast was exaggerated. Fasting blood lactate and pyruvate levels were normal but post-prandial hyperlactataemia and hyperpyruvicaemia were found and mean 12 h values for lactate (hypothyroid 1.80 +/- 0.06 v. control 0.77 +/- 0.03 mmol/l, P less than 0.01) and pyruvate (0.10 +/- 0.01 v. 0.08 +/- 0.003 mmol/l, P less than 0.01) were elevated. Blood alanine concentrations were elevated only in the evening. Although plasma non-esterified fatty acid levels were normal, fasting blood glycerol levels were decreased (0.06 +/- 0.01 v 0.08 +/- 0.01 mmol/l, P less than 0.001) and this decrease persisted throughout the 12-h period. Blood total ketone body concentrations did not differ from controls, but, as for plasma NEFA and blood glycerol, the normal preprandial rise in concentration was absent. Serum insulin, glucagon and growth hormone concentrations did not differ from control values at any time. Six months of thyroxine (T4) treatment produced a rise in blood glycerol concentration (mean 12 h value during T4 therapy, 0.06 +/- 0.01; before T4 therapy, 0.04 +/- 0.005 mmol/l; P less than 0.01) but not to control values (0.08 +/- 0.01 mmol/l). Concentrations of glucose and other gluconeogenic precursors were unaltered by therapy but the insulin response to meals and the mean 12 h serum insulin concentration were increased.
为研究甲状腺激素对人体中间代谢的影响，在8名甲状腺功能减退患者进行甲状腺素替代治疗之前和期间以及16名匹配的对照者正常饮食和活动的12小时期间，获取了激素和代谢物谱。甲状腺功能减退患者的空腹血糖浓度和12小时平均血糖浓度正常，但对早餐的血糖反应增强。空腹血乳酸和丙酮酸水平正常，但餐后出现高乳酸血症和高丙酮酸血症，乳酸的12小时平均值（甲状腺功能减退患者1.80±0.06对比对照组0.77±0.03 mmol/L，P<0.01）和丙酮酸（0.10±0.01对比0.08±0.003 mmol/L，P<0.01）升高。血丙氨酸浓度仅在晚上升高。虽然血浆非酯化脂肪酸水平正常，但空腹血甘油水平降低（0.06±0.01对比0.08±0.01 mmol/L，P<0.001），且这种降低在整个12小时期间持续存在。血总酮体浓度与对照组无差异，但与血浆非酯化脂肪酸和血甘油一样，餐前浓度正常升高不存在。血清胰岛素、胰高血糖素和生长激素浓度在任何时候与对照值均无差异。六个月的甲状腺素（T4）治疗使血甘油浓度升高（T4治疗期间的12小时平均值，0.06±0.01；T4治疗前，0.04±0.005 mmol/L；P<0.01），但未达到对照值（0.08±0.01 mmol/L）。治疗后葡萄糖和其他糖异生前体的浓度未改变，但对餐的胰岛素反应和12小时平均血清胰岛素浓度增加。
