Characteristics of Islet β-cell Functions in Chinese Patients With Graves' Disease
Condition: Graves Disease
MeSH terms: Graves Disease
Study type: Observational

Summary: 
      Patients with GD often present with glucose dysregulation, which, according to most studies,
      is associated with islet β-cell dysfunctions, enhanced gluconeogenesis and insulin resistance
      (IR). Current studies focus mainly on IR, and a few that investigate islet β-cell functions
      show inconsistent results. This study examined the characteristics of glucose dysregulation
      in Chinese patients with GD, and furthermore evaluated the effects of thyroid dysfunction on
      islet β-cell functions and subsequently the carbohydrate metabolism.
    

Detailed description: 
      Thyroid dysfunction is closely associated with glucoregulation. Carbohydrate metabolism can
      be affected with decreased levels of thyroid hormone (TH), even more so with an elevated TH
      level. Epidemiological data shows that 2%-57% of patients with Graves' Disease (GD) present
      with glucose dysregulation, which might also be related to the changes in islet β-cell
      functions in patients with GD. The incidence of GD has comparable variations geographically,
      with possibly different underlying mechanisms, such as an excessive intake of iodine
      resulting in an aggravation of autoimmune reactions from thyroid and consequently an
      increment in incidence of GD. The same might also be true in glucoregulation and islet β-cell
      functions in patients with GD. This study aims to examine the characteristics of
      glucoregulation and islet β-cell functions in patients with GD in different areas of China,
      using early-phase insulin secretion index (△I30/△G30), glucose area under curve(GAUC) and
      insulin area under curve(INSAUC).
    

Intervention name(s): Methimazole
Intervention type(s): Drug
Intervention description(s): All enrolled subjects with GD were treated with methimazole. The initial dose for the GA1 and GB1 sungroups were 30 mg/d (10 mg, tid), TH levels were tested every month, and the dose was titrated accordingly over a period of 2-3 months, the dose was then decreased to 15-20 mg/d and thyroid function was monitored periodically until it eventually reached the maintenance dose of 2.5 mg-5.0 mg/d. The dose and adjustment method for GA2 and GB2 were the same with GA1 and GB1, while the dose for GA3 and GB3 was gradually decreased to 2.5-5.0 mg/d. All subjects underwent a treatment course over a period of 6 months.
Other intervention name(s): Thyrozol
Intervention MeSH terms: Methimazole
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        A total of 283 outpatients, aged 22 to 55 years old(mean age 39±4 years), of whom 41 were
        male and 242 were female (M/F=1/5.90), were enrolled for the study from Qilu Hospital of
        Shandong University and Shandong Jiaotong Hospital between June, 2011 and June, 2014. An
        additional 45 age-matched healthy checkup subjects were included in the normal control
        group (NC). Patients with a medical history of diabetes, pancreatitis and other related
        conditions and positive family histories as well as medication history of glucocorticoid
        and anti-diabetic agents were excluded.