Korean Diabetes Journal 1974;2(1):5-11.
Studies of Blood Glucose , plasma Insulin , and Free Fatty Acid Levels During Oral Glucose Loading in Thyrotoxicosis
Kyun Ill Yoon , Bong Sub Shim , Kap Bum Huh , Sang Yong Lee , Yong Soo Kim , Je Hyun Kim
원저 : 갑상선 기증항진증에서의 경구 당부하시 혈당 , 혈장인슐린 및 유리지방산 농도에 관한 연구
윤견일 , 심봉섭 , 허갑범 , 이상용 , 김용수 , 김제현
Abstract
An abnormal oral glucose tolerance curve is a common accompaniment of thyrotoxicosis. The increaeed frequency of diabetes mellitus in hyperthyroidism and the adverse effect of hyperthyroidmm an patients with diabetes mellitus is we1t established- The mechanisrn coatribeting to thii impaired carbohydrate tolerance is unclear. Glucose tolerance is dependent upon the interaction of tissue sensitivity to insulin and the magnitude af insulin secretion. During the hyperthyroid state, tissue sensitiuity to insulin has been variabIy reported to be increased (Elrick et al., 1961), or decreased (Doar et al., 1969). The result of insulin secretion studies have also been qeite varied; decreased (Renauld et ak, 1971), normel (HaIes and Hyams, 1964), or in creased (Doar et al., l969). The mechanism of glucose and free fatty acid (FFA) have been shown to be ipterrelated in such a way that either may reduce the oxidation of the other (Randle et al.1963), Hales and Hyams (1964) advanced the hypothesis that the reduced glucose tolerance in thyrotoxic patients was secondary to an increased concentrition af FFA in plasma. The present study investigations were carried out with the object of determining whether there was any relationship among the impairment af glucose tolerance, plasma insulin and plasma FFA concentrations. The blood glucose, plasma insulin, and plasma FFA concentrations during 50 gm, oral glucose loading were measured in 8 normal and l2 thyrotoxic subjects to study the glucose metabolism in thyrotoxicosis. Following were the results: By Wilkerson's criteria, eight of twelve thyrotoxic subjects (67 percent) had abnormally high glucose level after oral glucose loading. In comparing with control group, the mean blood glueose level of thyrotoxic patients after oral glucose Ioading was significantly elevated in comparing with that af control subjects. 2. The mean plasma insulin concentrations were not significantly different between two groups, but the postprandial one hour value was significantly increased in thyrotoxic group, 3. The fasting mean plasme FFA level of thyrotoxic group was 1. 8 times higher than that of controJ group and after glucose loading plasma FFA concentration decreased more rapidly in thyrotoxic group. In view of the above experimental findings, the mechanism of abnormal carbohydrate metabolism in the patients with thyrotoxicosis may be interpreted as deficiency of insulin effectivity than that of insulin secretion.


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