| Objective: To explore the impact of thyroid dysfunction and changes in glucose metabolism and islet function in patients with hypothyroidism and hyperthyroidism.In order to provide a clinical reference for glucose metabolism therapy in patients with hyperthyroidism and hypothyroidism.Methods:1 From January 2014 to January 2016 in the Department of endocrinology of our hospital,collecting98 cases of patients with hyperthyroidism are chosen as hyperthyroidism group,139 hypothyroid patients as hypothyroidism group,93 cases of healthy volunteers as normal control group.2 Patients of hyperthyroidism group were given methimazole treatment for 6 months.Hypothyroidism group patients were treated with euthyrox for 6 months.3 Before treatment and after drugs treatment for 6 months,the thyroid function test(TSH,TT3,TT4,FT3,and FT4)was performed in each group by chemiluminescence immunoassay.The fasting blood glucose and fasting serum insulin were assayed in patients of three groups.The oral glucose tolerance test(OGTT)was performed.After taking 75 g glucose,the levels of blood glucose and postprandial plasma insulin were tested.And then homeostasis model assessment of insulin resistance(HOMA-IR)was calculated.The data were sorted and analyzed.4 All the experimental data were analyzed by SPSS 21.0 software.Measurement data was expressed as mean±SEM.The statistical significance of the differences were conducted using One-way ANOVA.If HOMA-IR,HOMA-?,HOMA-IS were shown the normal distribution,comparisons among the three groups used One-way ANOVA.If INS,HOMA-IRwere shown the non-normal distribution,whichever standard of testing statistical analysis of natural logarithms ?=0.05.Statistical significance was considered as a level of P<0.05.Results:1 The changes of thyroid function before and after treatmentAfter drug treatment,decreased TT3,TT4,FT3 and FT4,increased TSH were observed in patients of hyperthyroidism group.There was significantly statistical difference between before and after drug treatment of hyperthyroidism group.(the average value of TT3(7.82±1.37)nmol/Lvs(3.76±1.52)nmol/L,TT4(198.38±12.54)nmol/Lvs(87.17±9.63)nmol/L,FT3(8.91±0.67)pmol/Lvs(6.91±0.79)pmol/L,FT4(38.98±5.69)pmol/Lvs(30.96±2.23)pmol/ L and TSH(0.21±0.06)mIU/Lvs(1.79±0.13)mIU/L,P<0.05);After drug treatment,increased TT3,TT4,FT3 and FT4,decreased TSH were observed in patients of hypothyroidism group.There was significantly statistical difference between before and after drug treatment of hypothyroidis-m group.(the average value of TT3(1.15±0.23)nmol/Lvs(2.84±0.61)nmol/L,TT4(38.95±5.47)nmol/Lvs(56.32±4.73)nmol/L,FT3(1.08±0.05)pmol/Lvs(1.75±0.28)pmol/L,FT4(6.72±1.43)pmol/Lvs(10.24±1.96)pmol/L,and TSH(7.62±1.05)mIU/Lvs(3.87±0.16)mIU/L,P<0.05).2 three groups of blood glucose,insulin function determinationCompared to normal control group,the levels of fasting and postprandial plasma glucose?fasting and postprandial plasma insulin and HOMA-IR were increased in patients with hyperthyroidism.compared to normal control group.There was significantly statistical difference between hyperthyroidism group and normal control group.(The average value of FPG(5.68±0.23)mmol/Lvs(4.77±0.26)mmol/L,P<0.05;2hPG(7.85±0.31)mmol/Lvs(6.14±0.33)mmol/ L,P<0.05;FINS(12.86±3.52)uIU/mlvs(11.38±2.97)uIU/ml,P<0.05;2hINS(31.82±5.67)uIU/mlvs(20.63±5.15)uIU/ml,P<0.01;HOMA-IR(3.24±0.18)vs(2.41±0.19),P<0.05;Compared to normal control group,the levels of fasting and postprandial plasma glucose,fasting and postprandial plasma insulin and HOMA-IR were decreased in patients with hypothyroidism.compared to normal control group.There was significantly statistical difference between hypothyroidism group and normal control group.The average value of FPG(4.34±0.29)mmol/ Lvs(4.77±0.26)mmol/L,P<0.05;2hPG(5.77±0.27)mmol/Lvs(6.14± 0.33)mmol/L,P<0.05;FINS(10.23±3.29)uIU/mlvs(11.38±2.97)uIU/ml,P<0.05;2hINS(19.67±5.21)uIU/mlvs(20.63±5.15)uIU/ml,P<0.05;HOMA-IR(1.97±0.21)vs(2.41±0.19),P<0.05;3 The change of glucose metabolism in hyperthyroidism group before and after treatment;Hyperthyroidism group: Compared to before drug treatment in hyperthyroidism group,after drug treatment,decreased FPG,2hPG,FINS,2hINS,and HOMA-IR.There was significantly statistical difference between before and after drug treatment of hyperthyroidism group;the average value of FPG(5.68±0.23)mmol/Lvs(4.89±0.21)mmol/L,P<0.05;2hPG(7.85±0.31)mmol/Lvs(6.75±0.19)mmol/L,P<0.05;FINS(12.86±3.52)uIU/mlvs(10.36± 2.89)uIU/ml,P<0.05;2hINS(31.82±5.67)uIU/mlvs(23.51±3.65)uIU/ml,P<0.01;HOMA-IR(3.24±0.18)vs(2.25±0.24),P<0.05;4 The change of glucose metabolism in hypothyroidism group before and after treatment.Hypothyroidism group: Compared to before drug treatment in hypothyro-idism group,after drug treatment,increased 2hPG?FINS?2hINS,decreased HOMA-IR were observed in patients of hypothyroidism group.there was significantly statistical difference between before and after drug treatment of hypothyroidism group.But there was no significantly statistical difference on FBG between before and after drug treatment of hypothyroidism group;(the average value of FPG(4.34±0.29)mmol/Lvs(4.11±0.17)mmol/L,P>0.05;2h PG(5.77±0.27)mmol/Lvs(6.88±0.23)mmol/L,P<0.05;FINS(10.23±3.29)uIU/mlvs(11.38±2.37)uIU/ml,P<0.05;2hINS(19.67± 5.21)uIU/mlvs(22.19±3.37)uIU/ml,P<0.05;HOMA-IR(1.97±0.21)vs(1.12±0.15),P<0.01;Conclusions:1 Thyroid hormone can promote accelerated glucose metabolism,hyperthyroidism patients may be due to glucose metabolism disorders caused by blood sugar and even lead to the occurrence of diabetes.2 Hypothyroidism can slow down glucose metabolism and decrease blood glucose.3 Drug treatment can improve the function of islet in patients with hyperthyroidism and hypothyroidism. |
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