ObjectiveTo analyze the relationship between thyroid function and blood glucose level and insulin resistance in patients with type 2 diabetes mellitus,and to explore the possible role of thyroid function in the development of diabetes.Methods80 type 2 diabetic patients with normal thyroid function treated in our hospital from June 2014 to June 2015 were selected as the observation group,and another 80 cases of the health examination people at the same period were selected as the control group. The fasting blood glucose(FPG),postprandial 2H blood glucose(2hPG), free tetraiodothyronine(FT4),free triiodothyronine(FT3),thyroid stimulating hormone(TSH),and insulin resistance index(HOMA-IR) and insulin sensitivity index(ISI)were detected and calculated. After six months of continuous treatment,the blood glucose levels remained normal in the observation group and the changes of thyroid hormone levels were detected.ResultsThe indexes of 2hPG,FT3,FT4,HOMA-IR and FPG in the observation group were significantly higher than those in the control group,and the index of ISI was significantly lower than that in the control group. The differences above were significant(P<0.05). The indexes of FT3 and FT4 were significantly positively correlated with the indexes of FPG, 2hPG,HOMA-IR,but the index of ISI was significantly negative correlation. The correlation above was significant(P<0.05). The observation group The indexes of FT4 and FT3 in the observation group were significantly decreased after 6 months of treatment and maintenance of blood glucose level. ConclusionsThyroid hormone levels can effectively assess the level of blood glucose in patients with type2 diabetes but with normal thyroid function, and the levels of FT3 and FT4 are related to insulin resistance. The changes of thyroid function may be closely related to the occurrence and development of type2 diabetes.%目的：分析2型糖尿病患者甲状腺功能与血糖水平及胰岛素抵抗的关系，探讨甲状腺功能在糖尿病发生发展中的可能作用。方法纳入2014年6月至2015年6月接受治疗的首诊、甲状腺功能正常的2型糖尿病患者80例为观察组，同期健康体检对象80例为对照组。检测空腹血糖（FPG）、餐后2h血糖（2hPG）、游离四碘甲状腺原氨酸（FT4）、游离三碘甲状腺原氨酸（FT3）、促甲状腺激素（TSH）、胰岛素抵抗指数（HOMA-IR）、胰岛素敏感性指数（ISI）。观察组持续控制治疗6个月，维持血糖水平正常，检测其甲状腺激素水平变化。结果观察组FPG、2hPG、FT3、FT4、HOMA-IR明显高于对照组，ISI明显低于对照组，差异均有统计学意义（P<0.05）；FT3及FT4均与FPG、2hPG、HOMA-IR呈明显正相关，与ISI呈明显负相关，差异均有统计学意义（P<0.05）；治疗6个月且维持血糖水平正常时，观察组FT3、FT4均有明显下降。结论甲状腺激素水平可有效评估甲状腺功能正常的2型糖尿病患者血糖水平，且FT3及FT4水平提升与胰岛素抵抗有一定相关性，甲状腺功能改变与2型糖尿发生与发展密切相关，能够反映患者预后。
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