| Objective:By comparing the hyperthyroidism patients with normal glucose tolerance in 24-hour mean blood glucose level(24h MBG),the maximum amplitude of glycemic excursions(LAGE),one hour before meals average blood glucose(before meals 1h MBG),average blood sugar two hours after meals(after meals 2h MBG) changes in the characteristics of patients with hyperthyroidism analyzed 24-hour ambulatory blood glucose changes of the spectrum.Methods:Selection in April 2014-December 2014,shanxi large hospital endocrinology admitted the Graves of 30 patients with hyperthyroidism for hyperthyroidism group,the male 11,female 19 cases,aged 18 to 66 years old, average age(37.3±13.8).Selection in the same period in shanxi large hospital physical examination center of health check-up 30 cases as control group,the male 15 cases,15 cases were female,aged 22 to 67 years old,average age(38.8±12.8). Group members are all normal glucose tolerance,and eliminate the sugar metabolism with disease. By medical personnel to collect two groups of patient’s age,systolic blood pressure(SBP), diastolic blood pressure(DBP),measure the height, body weight, body mass index(BMI). Rick participants fasting for 10 hours,extraction of venous blood, using AU5421 automatic biochemical analyzer test blood triglycerides(TG),total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C). Using the US Medtronic(Medtronic Mini Med Company) produced CGMS Gold MMT-722 W glucose monitoring system for all subjects for 24-hour ambulatory blood glucose monitoring. CGMS glucose sensing probe, glucose recorder, a signal extractor, software and other components. By monitoring its inter subcutaneous tissue fluid glucose concentration reflects the blood glucose level, the sensing probe is placed abdominal subcutaneous glucose recorder connected through a wire probe, a receiving electric signals every 10 seconds, every 24 hours automatically recorded, stored blood glucose level 288, available 24 hours a sugar spectrum. Enter at least four times a day while fingertip capillary blood glucose values corrected. All subjects were wearing the day of admission glucose monitoring equipment, blood sugar interception unified spectrum6:00 am to 6:00 of the third day. During mealtime consistent monitoring of all subjects(Breakfast 7:00-7:30, lunch 12:00-12:30, dinner 6:00-6:30), avoid the use of snacks,exercise and glucose metabolism of drugs. Observation of blood sugar throughout the day spectrum calculated and compared 24 h MBG, LAGE, 1h before meals and after meals 2h average blood glucose levels, patients with hyperthyroidism get 24-hour ambulatory blood glucose spectrum. Using EXCEL software data entry, processing and analysis of data SPSS13.0 statistical software. Age, SBP, DBP, TC, HDL-C, LDL-C, 24 h MBG, LAGE,before meals 1h MBG, after meals 2h MBG as mean±standard deviation( x ±s) between the two groups were compared using independent sample t test, P<0.05 is on behalf of the significant differences.Results:1. General Clinical data hyperthyroidism group and the control group comparison:(1) Compared with the control group, SBP increased hyperthyroidism group(111.87 ±7.12 vs.120.60±16.43), the difference was obviously significant(P <0.05);(2) Comparing the two groups,age(38.8±12.8vs.37.3±13.8),BMI(22.35±2.2vs.21.9±3.3), DBP(74.40±5.91 vs.76.07±8.02) were not obviously significant(P>0.05).2. Hyperthyroidism Patients with glucose spectrum change characteristics:(1) Spectral characteristics of sugar in patients with hyperthyroidism before and after a meal: hyperthyroidism group and the control group, slightly lower than the control group, fasting blood glucose and postprandial blood glucose levels are elevated compared with the control group. Specific performance 15 minutes after meal blood sugar rise slowly, peaked at 60 minutes after a meal and blood sugar rapidly, increasing by a big margin. 60 minutes after the sugar begins to drop, but were higher. 180 minutes postprandial blood glucose is somewhat elevated compared with the control group, 240 minutes postprandial blood glucose level is restored to fasting.(2) Spectral characteristics of glucose in patients with hyperthyroidism night: the emergence of the control group at 0:00 when a blood sugar low, at about 3.5mmol/l or so,and then was increased at night to maintain blood glucose at 3.5~5mmol/l; hyperthyroid group 0 blood glucose trough disappears each time point was no significant change in blood glucose levels at night to maintain blood glucose at 4.5~4.8mmol/l.3. Hyperthyroidism group and the control group average blood glucose levels before and after meals comparison:Compared with the control group,2hMBG(6.0±0.8vs.7.0±0.7) hyperthyroidism group after breakfast,before lunch 1h MBG(5.2±0.5vs.5.5±0.8),2h MBG(5.3±0.4vs.6.5±0.9) After lunch, dinner before 1h MBG(5.3±0.6vs.6.2±1.1), 2h MBG were increased after dinner(5.6±0.5vs.6.5±1.3),the differences were statistically significant(P<0.05); hyperthyroidism group before breakfast 1h MBG lower(4.9±0.2vs.5.2±0.6), the difference was obviously significant(P<0.05).4. Hyperthyroidism group and the control group 24 h MBG and LAGE comparison:Compared with the control group, hyperthyroidism group 24 h MBG(5.8±0.5vs.6.7±0.8),LAGE(3.7±0.8 vs.5.3±1.3), the differences were obviously significant(P <0.05).5. Lipid metabolism hyperthyroidism group and the control group comparison:Compared with the control group, hyperthyroidism group TC(4.26±0.45 vs.2.44 ±0.48),TG(1.06±0.32 vs.0.78±0.35),HDL-C(1.26±0.11 vs.0.95±0.22),LDL-Cdecreased(2.21±0.27 vs. 1.23±0.22), the differences were obviously significant(P <0.05).Conclusion:Blood glucose in patients with hyperthyroidism spectrum changes, loss of normal glucose tolerance should circadian rhythms. Lower than the normal fasting blood glucose,postprandial blood glucose increased compared with normal glucose tolerance and postprandial hyperglycemia rapidly, by a big margin, and reached a peak postprandial 1h,4h around postprandial blood glucose levels returned to pre-dinner night blood sugar due to excessive thyroid hormone the body, making the 0:00 low blood sugar disappeared. |
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