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选取未经治疗的弥漫性毒性甲状腺肿 (Graves病 ,简称GD) 4 0例、健康者 11例 ,行口服葡萄糖耐量 胰岛素释放试验后 ,用化学发光法测血清胰岛素、C肽 (C P)值 ,用ELISA法测血清真胰岛素 (TI)值 ,并分析Graves病患者胰岛素、真胰岛素变化与糖耐量的关系。结果 :GD组空腹血糖 (BG)明显增高 (P <0 .0 0 1) ,葡萄糖刺激后基础免疫活性胰岛素 (IRI)明显增高 (P <0 .0 2 7) ,真胰岛素有升高但不明显 ,∑IRI/∑BG在GD组明显增加 ,游离三碘甲腺原氨酸(FT3 )与多个时点血清胰岛素、C肽、真胰岛素呈显著负相关。说明GD患者在治疗前存在高血糖与高胰岛素血症并存的胰岛素抵抗状态 ;GD患者真胰岛素相对不足 ,胰岛素的生物效应减低并随GD病情加重而趋于明显
40 cases of Graves disease (GD) and 11 cases of healthy volunteers were enrolled in this study. Serum insulin and C-peptide (CP) were measured by chemiluminescence after oral glucose tolerance insulin release test. Serum real insulin (TI) was measured by ELISA, and the relationship between insulin and true insulin and glucose tolerance was analyzed. Results: Fasting plasma glucose (BG) in GD group was significantly higher than that in control group (P <0.01), basal immune active insulin (IRI) significantly increased after glucose stimulation (P <0. 027) Obviously, ΣIRI / ΣBG increased significantly in GD group, while free triiodothyronine (FT3) showed a significant negative correlation with serum insulin, C-peptide and true insulin at different time points. Indicating GD patients in the presence of hyperglycemia and hyperinsulinemia before coexisting with insulin resistance state; GD true insulin relative insufficiency, the biological effects of insulin decreased and with the severity of the GD became more pronounced