Association of thyroid hormones and insulin resistance in elderly patients with type 2 diabetes mellitus / 医学研究生学报

ABSTRACT

Objective The variation of serum thyroid hormones within the euthyroid range may be associated with insulin sensitivity.The study was to investigate whether the variation of thyroid hormones within the euthyroid range could influence insulin sensitivity in elderly patients with type 2 diabetes mellitus (T2DM). Methods 200 elderly inpatients and outpatients with type 2 diabetes were collected from September 2013 to May 2014 in our hospital for T2DM group.150 normal controls with normal glucose metabolism were taken as the control group.Blood samples were collected after 75g oral glucose tolerance test(OGTT) on all the re-search objects.Questionaire survey, physical examination and related metabolic index test were also done on them .Chemilumines-cence method were applied to detect their insulin, thyroid stimulating hormone(TSH), FT3 and FT4. Results FT3 levels were significantly lower in T2DM group than in control group[(4.05 ±0.27 )pmol/L vs (4.61 ±0.5)pmol/L), P<0.05].TSH levels were significantly higher in T2DM group than in control group[(2.75 ±1.07) IU/mL vs (2.28 ±0.89) IU/mL, P<0.05], while there was no significant difference as to FT4 levels between these two groups.All subjects were divided into three groups according to the tertiles of FT3 level, Matsuda index of high FT3 level group were significantly higher in comparison to middle and low FT3 level groups, while there was no significant difference as to HOMA-IR in the three groups.FT3 levels were negatively correlated with HO-MA-IR and positively correlated with Matsuda index .After stepwise regression analysis, there was significant positive association be-tween FT3 and Matsuda index. Conclusion Thyroid hormone especially FT3 is significantly associated with insulin resistance .FT3 may participate in the development of type 2 diabetes, which pro-vides a new treatment for T2DM.