Mano T, Kawakubo A, Yamamoto M
Department of Internal Medicine, Anjo Kosei Hospital, Aichi, Japan.
Nagoya J Med Sci. 1994 Mar;57(1-4):61-8.
To clarify the impairment of carbohydrate metabolism in hyperthyroidism, we performed the oral glucose tolerance test (OGTT) and glucagon tolerance test in ten patients with hyperthyroidism due to Graves' disease (GD) and in ten normal subjects. During OGTT, glucose and insulin values in the GD patients were twice as high as those in the normals. The ratio of cumulative net plasma glucose [sigma PG (0-120 minutes)] and insulin [sigma IRI (0-120 minutes)] was 0.83 +/- 0.14 and 1.14 +/- 0.25 in the GD patients and normals, respectively. During the glucagon tolerance test, plasma glucose showed lower peaks in the GD patients than in the normals. C-peptide reached a peak value at 6 min in the GD patients and at 10 min in the normals. Cyclic AMP response in the GD patients was three times greater than that in the normals. A smaller insulinogenic index and a smaller sigma PG/sigma IRI ratio in the GD patients suggest that the secretion of insulin in GD patients does not meet the demand despite the higher insulin values observed during OGTT. Greater response of cAMP, smaller and earlier peaks of C-peptide and smaller response of glucose to glucagon in the GD patients may suggest a rapid insulin turnover and a reduction of glycogen storage in the liver with hyperthyroidism.
为了阐明甲状腺功能亢进症患者碳水化合物代谢的损害情况，我们对10例格雷夫斯病（GD）所致甲状腺功能亢进症患者和10名正常受试者进行了口服葡萄糖耐量试验（OGTT）和胰高血糖素耐量试验。在OGTT期间，GD患者的血糖和胰岛素值是正常人的两倍。GD患者和正常人累积净血浆葡萄糖[σPG（第０至120分钟）]与胰岛素[σIRI（第０至120分钟）]的比值分别为0.83±0.14和1.14±0.25。在胰高血糖素耐量试验期间，GD患者的血浆葡萄糖峰值低于正常人。GD患者的C肽在6分钟时达到峰值，正常人在10分钟时达到峰值。GD患者的环磷酸腺苷（cAMP）反应比正常人高3倍。GD患者较小的胰岛素生成指数和较小的σPG/σIRI比值表明，尽管在OGTT期间观察到胰岛素值较高，但GD患者胰岛素的分泌仍不能满足需求。GD患者cAMP反应增强、C肽峰值较小且出现较早以及葡萄糖对胰高血糖素的反应较小，这可能提示甲状腺功能亢进症患者胰岛素周转迅速且肝脏糖原储备减少。
