Pandolfi C, Pellegrini L, Dedè A
I Divisione Medica, Ospedale Maggiore, Lodi (Milano).
Minerva Endocrinol. 1996 Jun;21(2):63-5.
Because thyroid hyperfunction "per sè" can induce impaired glucose tolerance in 2-57% of patients, we have studied glycaemic and insulinaemic response to oral glucose load (OGTT) in this condition. Glycaemic and insulinaemic curves after oral glucose (100 g), the respective secretory areas (AUC-G and AUC-IRI) have been determined in 13 hyperthyroid patients (8 Graves disease, 4 multinodular toxic goiters and 1 Plummer's adenoma) and in 16 healthy control subjects. AUC-G, AUC-IRI and median values of G and IRI in most of considered times have resulted significantly greater in hyperthyroid patients. This study has confirmed the impact of thyroid hyperfunction on carbohydrate metabolism, but has not proved an impaired insulin secretion as previously reported in Literature. In conclusion, we believe that: a) hyperthyroidism is associated with greater circulating levels of G and IRI, b) hyperinsulinaemia in addition to hyperglycaemia suggests that insulin-resistance is underlying in this condition.
由于甲状腺功能亢进“本身”可导致2%至57%的患者出现糖耐量受损，我们研究了这种情况下口服葡萄糖负荷试验（OGTT）的血糖和胰岛素反应。在13例甲状腺功能亢进患者（8例格雷夫斯病、4例多结节毒性甲状腺肿和1例普卢默腺瘤）和16例健康对照者中，测定了口服葡萄糖（100克）后的血糖和胰岛素曲线、各自的分泌面积（AUC-G和AUC-IRI）。在大多数所考虑的时间点，甲状腺功能亢进患者的AUC-G、AUC-IRI以及血糖和胰岛素的中位数均显著更高。本研究证实了甲状腺功能亢进对碳水化合物代谢的影响，但未证实如先前文献报道的胰岛素分泌受损。总之，我们认为：a）甲状腺功能亢进与更高的血糖和胰岛素循环水平相关，b）除高血糖外的高胰岛素血症表明这种情况下存在胰岛素抵抗。
