IMPAIRED GLUCOSE-TOLERANCE AND INSULIN INSENSITIVITY IN PRIMARY HYPERPARATHYROIDISM
IMPAIRED GLUCOSE-TOLERANCE AND INSULIN INSENSITIVITY IN PRIMARY HYPERPARATHYROIDISM
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DOI：
10.1111/j.1365-2265.1994.tb02442.x
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发表时间：
1994-01-01
影响因子：
3.2
通讯作者：
BOULTON, AJM
中科院分区：
文献类型：
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作者：
KUMAR, S;OLUKOGA, AO;BOULTON, AJM
目的原发性甲状旁腺功能亢进（PHPT）患者中糖尿病患病率高。然而，目前尚不清楚这是否与PHPT的代谢异常或这些患者中葡萄糖耐受不良的其他危险因素的存在有关。我们研究的目的是确定没有其他糖尿病危险因素的PHPT患者是否发生葡萄糖耐受不良和胰岛素不敏感。设计没有其他糖尿病危险因素的PHPT患者与年龄和体重指数（BMI）匹配的健康受试者相比的葡萄糖代谢的横断面研究。血压正常的PHPT患者和11名年龄和BMI匹配的健康受试者。测量连续输注葡萄糖试验用于评估葡萄糖耐量。在1小时连续输注葡萄糖（5 mg/kg理想体重/min）期间测量血浆葡萄糖和胰岛素;通过数学建模从葡萄糖和胰岛素数据推导出胰岛素敏感性和β细胞功能。结果PHPT患者在葡萄糖输注结束时血糖水平（中位数9.0（四分位数范围8.1-9.8）mmol/l）高于对照组（7.9（7.1-8.9）mmol/l），P < 0.01。
OBJECTIVE A high prevalence of diabetes mellitus has been shown in patients with primary hyperparathyroidism (PHPT). However, it is unclear whether this is related to the metabolic abnormalities in PHPT or to the presence of other risk factors for glucose intolerance in these patients. The aim of our study was to determine whether glucose intolerance and insulin insensitivity occur in subjects with PHPT who do not have other risk factors for diabetes mellitus.DESIGN Cross-sectional study of glucose metabolism in PHPT patients without other risk factors for diabetes mellitus, compared to age and body mass index (BMI) matched healthy subjects.SUBJECTS Nineteen non-obese, non-diabetic, normotensive patients with PHPT and 11 age and BMI matched healthy subjects.MEASUREMENTS The continuous infusion of glucose test was used to assess glucose tolerance. Plasma glucose and insulin were measured during a 1-hour continuous infusion of glucose (5 mg/kg ideal body weight/min); insulin sensitivity and beta-cell function were derived from the glucose and insulin data by mathematical modelling. Pasting serum concentrations of parathyroid hormone, ionized calcium and 1,25-dihydroxyvitamin D (1,25(OH)(2)D) were measured in all subjects.RESULTS PHPT patients attained higher plasma glucose levels at the end of the glucose infusion (median 9.0 (interquartile range 8.1-9.8) mmol/l) than did controls (7.9 (7.1-8.9) mmol/l, P