甲状腺功能亢进对2型糖尿病患者血清IGF-1及骨代谢指标的影响

doi:10.3969/j.issn.1671-7171.2023.04.018

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摘要【目的】探讨甲状腺功能亢进(简称甲亢)对2型糖尿病(T2DM)患者血清胰岛素样生长因子-1(IGF-1)及骨代谢指标的影响。【方法】选取铜川矿务局中心医院2017年2月至2022年2月收治的77例T2DM合并甲亢患者(观察组),另选取同期铜川矿务局中心医院收治的70例单纯T2DM患者(对照组)。比较两组血糖[空腹血糖(FPG)、糖化血红蛋白(HbA1c)]、甲状腺功能指标[游离三碘甲状腺原氨酸(FT₃)、游离甲状腺素(FT₄)、促甲状腺激素(TSH)]指标、胰岛素样生长因子[胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子-2(IGF-2)]水平、骨代谢指标[骨特异性碱性磷酸酶(BAP)、N-端中段骨钙素(N-MID-OT)、总1型胶原氨基端延长肽(T-P1NP)、β-胶原特殊序列(β-CTX)]、1,25二羟维生素D₃[1,25(OH)₂D₃]、不同部位[第2～4腰椎(L_2~4)、Ward's三角、股骨颈、大转子区]骨密度。【结果】观察组FPG、FT₃、FT₄ 、BAP、N-MID-OT、T-P1NP、β-CTX水平显著高于对照组(P<0.05),TSH、IGF-1、IGF-2、1,25(OH)₂D₃水平显著低于对照组(P<0.05);两组HbA1c水平比较,差异无统计学意义(P>0.05)。观察组L_2~4、Ward's三角、股骨颈、大转子区骨密度显著低于对照组(P<0.05)。【结论】T2DM合并甲亢患者血糖及甲状腺激素水平异常升高,血清IGF-1降低,骨代谢异常,骨密度减少,临床需监测患者骨代谢情况,从而预防骨质疏松的发生。

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	石艳红
	李海明

关键词 ：糖尿病,2型, 甲状腺功能亢进症, 胰岛素样生长因子Ⅰ/血液, 骨和骨组织/代谢

Abstract：【Objective】 To investigate the effects of hyperthyroidism on serum insulin-like growth factor-1 (IGF-1) and bone metabolism in patients with type 2 diabetes. 【Methods】 Seventy-seven patients with type 2 diabetes mellitus complicated with hyperthyroidism admitted to the Central Hospital of Tongchuan Mining Administration from February 2017 to February 2022 were enrolled in the observation group,and 70 patients with type 2 diabetes mellitus without hyperthyroidism admitted to Central Hospital of Tongchuan Mining Bureau during the same period were considered as the control group. Blood glucose [fasting blood glucose (FPG),glycosylated hemoglobin (HbA1c)] and thyroid function [free triiodothyronine (FT₃),free thyroxin (FT₄),thyroid stimulating hormone (TSH)] indexes of the two groups were detected and compared. The levels of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-2 (IGF-2) were detected and compared between the two groups. Bone metabolism indexes of the two groups were detected and compared,including bone specific alkaline phosphatase (BAP),n-terminal osteocalcin (N-MID-OT),total type 1 collagen amino terminal prolongating peptide (T-P1NP),β-crosslaps (β-CTX),1,25 dihydroxyvitamin D₃[1,25(OH)₂D₃]. Bone mineral density levels were measured in different parts of patients in the two groups:the 2nd-4th lumbar spine (L_2-4),Ward's triangle,neck of femur,and greater trochanteric area. 【Results】 The levels of FPG,FT₃,BAP,N-MID-OT,T-P1NP,β-CTX and FT₄ in the observation group were significantly higher than those in the control group (P<0.05),while the levels of TSH,TSH,IGF-1,IGF-2 and 1,25(OH)₂D₃ in the observation group was significantly lower than those in the control group (P<0.05). There was no significant difference in HbA1c level between the two groups (P>0.05). The bone mineral densities of L_2-4,Ward's triangle,neck of femur and greater trochanter in the observation group were significantly lower than those in control group (P<0.05). 【Conclusion】 The levels of blood glucose and thyroid in type 2 diabetes patients with hyperthyroidism are higher than those in patients without hyperthyroidism. Patients with T2DM have lower serum IGF-1,abnormal bone metabolism,and lower bone mineral density lower than those in patients without hyperthyroidism. Clinical monitoring of bone metabolism is necessary to prevent the occurrence of osteoporosis.

Key words： Diabetes Mellitus,Type 2 Hyperthyroidism Insulin-Like Growth Factor I/BL Bone and Bones/ME

收稿日期: 2022-08-25

中图分类号:

R587.1

通讯作者: * E-mail:530769262@qq.com

引用本文:

石艳红, 李海明. 甲状腺功能亢进对2型糖尿病患者血清IGF-1及骨代谢指标的影响[J]. 医学临床研究, 2023, 40(4): 547-549.
SHI Yan-hong, LI Hai-ming. Effects of Hyperthyroidism on Serum IGF-1 and Bone Metabolism Indexes in Type 2 Diabetes Mellitus. JOURNAL OF CLINICAL RESEARCH, 2023, 40(4): 547-549.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.04.018 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I4/547