Ohguni S, Notsu K, Kato Y
Department of Medicine, Shimane Medical University, Izumo.
Intern Med. 1995 May;34(5):339-41. doi: 10.2169/internalmedicine.34.339.
Insulin sensitivity, metabolic clearance rate of insulin (MCR-I) and basal posthepatic insulin delivery rate (BIDR) were investigated by means of euglycemic clamp technique in 8 normal subjects and 8 patients with hyperthyroid Graves' disease. The mean (+/- SD) steady-state glucose infusion rate (SSGIR) was lower in hyperthyroid Graves' patients than in normal subjects (228.9 +/- 57.0 vs. 290.9 +/- 49.4 mg/m2/min, p < 0.05). Both MCR-I and BIDR were higher in hyperthyroid Graves' patients than in normal subjects (1162.9 +/- 517.1 vs. 463.5 +/- 103.9 ml/m2/min, p < 0.005; 17.7 +/- 12.6 vs. 3.6 +/- 0.9 mU/m2/min, p < 0.01, respectively). Plasma free T4 levels showed a close correlation with MCR-I (r = 0.77, p < 0.05) and BIDR (r = 0.81, p < 0.05), respectively, in Graves' patients. These findings indicate that hyperthyroidism is characterized by not only a decrease in insulin sensitivity, but also an increase in basal insulin secretion and the metabolic clearance rate of insulin, which are correlated with plasma free T4 levels.
采用正常血糖钳夹技术，对8名正常受试者和8名甲状腺功能亢进Graves病患者的胰岛素敏感性、胰岛素代谢清除率（MCR-I）和肝后基础胰岛素释放率（BIDR）进行了研究。甲状腺功能亢进Graves病患者的平均（±标准差）稳态葡萄糖输注率（SSGIR）低于正常受试者（228.9±57.0对290.9±49.4mg/m²/min，p<0.05）。甲状腺功能亢进Graves病患者的MCR-I和BIDR均高于正常受试者（1162.9±517.1对463.5±103.9ml/m²/min，p<0.005；17.7±12.6对3.6±0.9mU/m²/min，分别为p<0.01）。在Graves病患者中，血浆游离T4水平分别与MCR-I（r = 0.77，p<0.05）和BIDR（r = 0.81，p<0.05）密切相关。这些发现表明，甲状腺功能亢进不仅表现为胰岛素敏感性降低，还表现为基础胰岛素分泌增加和胰岛素代谢清除率增加，且这些变化与血浆游离T4水平相关。
