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甲状腺功能对曲安西龙在人体致糖尿病作用的影响。口服葡萄糖负荷后的血糖、胰岛素及生长激素变化模式。

The influence of thyroid function on the diabetogenic action of triamcinolone in man. Glucose, insulin and growth hormone patterns after on oral glucose load.

作者信息

Zamrazil V, Nedvĭdková J, Felt V, Nĕmec J, Havelka J

出版信息

Horm Metab Res. 1976 Jul;8(4):282-6. doi: 10.1055/s-0028-1093636.

Abstract

In subjects with varying thyroid function (12 hypothyroid, 11 euthyroid and 12 hyperthyroid) an oral glucose tolerance test was performed without sensitization (OGTT) and after sensitizing with triamcinolone (TGTT). The blood glucose, serum immunoreactive insulin (IRI) and growth hormone (HGH) levels were assessed. In hypothyroid subjects a marked deterioration of the glucose tolerance was found during the TGTT as compared with OGTT, a reduction of the glucose disappearance index (GDI) and almost unchanged IRI values. The decrease of insulinogenic index (II) was not significant. In euthyroid subjects the decrease of glucose tolerance after triamcinolone was only mild, GDI values remained unaltered, IRI values and II increased. In hyperthyroid persons the decrease of glucose tolerance during TGTT was even less pronounced than in the euthyroid group, although the IRI value increased only on fasting. No significant differences of HGH pattern were observed in any group. In our patients the diabetogenic effect of triamcinolone was inversely related to the saturation with thyroid hormones and an increased response of insulin to glucose load was observed only in euthyroidism. In hyperthyroidism the participation of non-insular factors in the mechanism of maintaining the glucose tolerance after triamcinolone should be assumed.

摘要

对甲状腺功能各异的受试者(12例甲状腺功能减退、11例甲状腺功能正常和12例甲状腺功能亢进)进行了未致敏口服葡萄糖耐量试验(OGTT)以及用曲安西龙致敏后的口服葡萄糖耐量试验(TGTT)。评估了血糖、血清免疫反应性胰岛素(IRI)和生长激素(HGH)水平。在甲状腺功能减退的受试者中,与OGTT相比,TGTT期间葡萄糖耐量显著恶化,葡萄糖消失指数(GDI)降低,IRI值几乎未变。胰岛素生成指数(II)的降低不显著。在甲状腺功能正常的受试者中,曲安西龙后葡萄糖耐量的降低仅为轻度,GDI值保持不变,IRI值和II升高。在甲状腺功能亢进的患者中,TGTT期间葡萄糖耐量的降低甚至比甲状腺功能正常组更不明显,尽管IRI值仅在空腹时升高。在任何组中均未观察到HGH模式的显著差异。在我们的患者中,曲安西龙的致糖尿病作用与甲状腺激素饱和度呈负相关,仅在甲状腺功能正常时观察到胰岛素对葡萄糖负荷的反应增加。在甲状腺功能亢进时,应假定非胰岛因素参与了曲安西龙后维持葡萄糖耐量的机制。

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