不同甲状腺功能状态下脂联素与胰岛素抵抗的关系

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目的研究不同甲状腺功能状态人群血浆脂联素的平均水平,探讨脂联素与胰岛素抵抗及甲状腺激素的关系。方法于2004年12月至2005年6月采用竞争性酶联免疫吸附法检测56例甲亢患者、30例甲减患者和44名健康时照者的空腹血浆脂联素水平,测量游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)、促甲状腺激素(TSH)、空腹血糖(FPG)、空腹胰岛素(Fins)及血脂,计算体重指数(BMI)及胰岛素抵抗指数(HOMA-IR)。结果甲亢组脂联素水平升高,甲减组与对照组相比差异无显著性。脂联素与 FT_4(r=0.36,P<0.01)、HOMA-IR(r=0.23,P<0.05)呈正相关,与 TSH(r=-0.27,P<0.05)、FPG(r=-0.29,P<0.01)、BMI(r=-0.35,P<0.01)、TG(r=-0.31,P<0.05)、LDL-C(r=-0.32,P<0.05)均呈负相关。结论甲亢患者脂联素水平升高,FT_4是影响脂联素的最显著因素,甲状腺激素对甲亢患者的胰岛素抵抗也起重要作用。 Objective To study the average plasma levels of adiponectin in different thyroid function populations and to explore the relationship between adiponectin and insulin resistance and thyroid hormones. Methods From December 2004 to June 2005, the levels of fasting plasma adiponectin in 56 cases of hyperthyroidism, 30 cases of hypothyroidism and 44 healthy controls were measured by competitive enzyme-linked immunosorbent assay. Free triiodothyronine (FT_3), free thyroxine (FT_4), thyrotropin (TSH), fasting blood glucose (FPG), fasting insulin (Fins) and blood lipids were calculated. Body mass index (BMI) and insulin resistance index (HOMA-IR) . Results Hyperthyroidism group increased adiponectin, hypothyroidism group compared with the control group no significant difference. Adiponectin was positively correlated with FT_4 (r = 0.36, P <0.01) and HOMA-IR (r = 0.23, P <0.01), BMI (r = -0.35, P <0.01), TG (r = -0.31, P <0.05) and LDL-C (r = -0.32, P <0.05). Conclusion The level of adiponectin is elevated in patients with hyperthyroidism. FT_4 is the most significant factor affecting adiponectin. Thyroid hormone also plays an important role in insulin resistance in patients with hyperthyroidism.
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