Kabadi U M, Premachandra B N, Maayan M
Acta Diabetol Lat. 1982 Jul-Sep;19(3):233-42. doi: 10.1007/BF02624683.
In several pathophysiologic states, i.e., cirrhosis of liver, protein calorie malnutrition, starvation, carbohydrate deprivation, etc., thyroid hormone metabolism is reported to be altered with a decrease in serum T3 and a reciprocal increase in TR3. Uncontrolled diabetes mellitus is a similar state in which glucose does not enter the cells causing cellular starvation and hyperglycemia ensues. Therefore, serum T4, T3, RT3, T3-resin uptake, TSH, and glucose were determined after an overnight fast in 94 male diabetics (aged 28 to 85 years) during a routine follow-up visit to the outpatient clinic and 24 healthy male adults (aged 24 to 81 years). Glycosylated hemoglobin concentrations were measured as well in normal subjects and 16 newly discovered diabetics. In normal subjects, no significant relationships between fasting plasma glucose and T3 and RRT3 levels were observed. In diabetics there was a significant positive (r = 0.611; p less than 0.001) correlation between glucose and RT3. Similarly, a significant negative relationship was observed between glucose and T3 (r = 0.491; p less than 0.001). T4, free T4, T3-resin uptake, and TSH were normal in diabetics. In 16 newly discovered diabetics, with fasting plasma glucose greater than 200 mg/dl, serum T3 rose (96 +/- 5 to 128 +/- 5 ng/dl) and RT3 declined (26.3 +/- 10.4 +/- 1.4 ng/dl) on improvement of hyperglycemia (fasting plasma glucose less than 140 mg/dl) after intensive therapy for 6 to 8 weeks. Glycosylated hemoglobin levels declined as well (14.6 +/- 0.9% to 9.3 +/- 0.7%). These data indicate: (1) thyroid hormone metabolism may be altered in diabetes mellitus with a fall in serum T3 and a reciprocal rise in RT3; and (2) T3 and RT3 concentrations may serve as indicators of metabolic control in diabetes mellitus.
在几种病理生理状态下，即肝硬化、蛋白质热量营养不良、饥饿、碳水化合物缺乏等，据报道甲状腺激素代谢会发生改变，血清T3降低，反T3（RT3）相应升高。未控制的糖尿病是一种类似的状态，其中葡萄糖无法进入细胞，导致细胞饥饿并继而出现高血糖。因此，在94名男性糖尿病患者（年龄28至85岁）于门诊进行常规随访期间，以及24名健康男性成年人（年龄24至81岁）过夜禁食后，测定了血清T4、T3、RT3、T3树脂摄取、促甲状腺激素（TSH）和葡萄糖。还测量了正常受试者以及16名新发现的糖尿病患者的糖化血红蛋白浓度。在正常受试者中，未观察到空腹血糖与T3和反T3水平之间存在显著相关性。在糖尿病患者中，葡萄糖与反T3之间存在显著正相关（r = 0.611；p < 0.001）。同样，葡萄糖与T3之间存在显著负相关（r = 0.491；p < 0.001）。糖尿病患者的T4、游离T4、T3树脂摄取和TSH均正常。在16名新发现的空腹血糖大于200 mg/dl的糖尿病患者中，经过6至8周的强化治疗，高血糖得到改善（空腹血糖低于140 mg/dl）后，血清T3升高（从96±5至128±5 ng/dl），反T3降低（从26.3±1.4至10.4±1.4 ng/dl）。糖化血红蛋白水平也下降（从14.6±0.9%降至9.3±0.7%）。这些数据表明：（1）糖尿病患者的甲状腺激素代谢可能会发生改变，血清T3降低，反T3相应升高；（2）T3和反T3浓度可作为糖尿病患者代谢控制的指标。
