[The mechanism of thyroid hormone abnormalities in patients with diabetes mellitus].

In order to clarify the mechanism of impaired thyroid hormone levels in patients with diabetes mellitus, thyroid hormone, thyroid hormone binding inhibitor (THBI), inhibitor of extrathyroidal conversion of T4 to T3 (IEC) and free fatty acid (FFA) were examined. In addition, TRH test was performed on 9 diabetic patients showing poor control of plasma glucose before and after glycemic control. Before glycemic control, fasting plasma glucose and HbA1c were significantly higher than after glycemic control (P < 0.05). T3 and the T3/T4 ratio significantly increased and rT3 significantly decreased after glycemic control (P < 0.05). THBI index and plasma FFA level significantly decreased and %T3 production (IEC) significantly increased after glycemic control (P < 0.05). The response of TSH to TRH significantly increased after glycemic control. In conclusion, (1) the presence of THBI, (2) the presence of IEC, and (3) dysfunction of the hypothalamo-hypophysial-thyroid axis are considered to be involved in abnormal thyroid function in diabetic patients.