Effect of sleep status on thyroid hormone and blood glucose level in hyperthyroidism complicated with diabetes

Abstract

Objective To observe the effects of different sleep status on thyroid secretion and glucose metabolism in hyperthyroidism patients complicated with diabetes mellitus. Methods From March 2014 to August 2017, 288 hyperthyroidism patients complicated with diabetes in the People's Hospital of Zhuji were selected as study objects.The fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), serum free three iodine thyroid (FT3), free four iodine thyroid (FT4) and thyroid stimulating hormone (TSH) levels were measured.The patients were grouped according to sleep time( 7-8h in 72 cases, >8h in 56 cases), sleep quality[pittsburgh sleep quality index (PSQI) score 12-17 points in 54 cases, >17 points in 46 cases] and nap time(no nap in 63 cases, 2h in 36 cases), and the levels of FPG, HbA1c, FT3, FT4 and TSH among groups were compared. Results There were statistically significant differences in FPG, HbA1c, FT3, FT4 and TSH levels among the groups with different sleep quality PSQI scores (F=12.725, 15.682, 7.026, 9.258 and 6.147; P=0.000, 0.000, 0.000, 0.000 and 0.000). Comparison of FPG, HbA1c, FT3, FT4 and TSH levels in the different sleep time groups, although there were statistically significant differences in the levels of 7-8h groups (all P 7-8h group had no statistically significant differences (all P>0.05). There were statistically significant differences in the levels of FPG, HbA1c, FT3, FT4 and TSH among the patients with different nap time (F=10.925, 14.008, 9.607, 11.120 and 7.251; P=0.000, 0.000, 0.000, 0.000 and 0.000). The sleep quality PSQI score was negatively correlated with the levels of FPG, HbA1c, FT3 and FT4 in patients with hyperthyroidism and diabetes mellitus (r=-0.856, -0.879, -0.816 and -0.849; P=0.001, 0.000, 0.011 and 0.004), and was positively correlated with TSH (r=0.757, P=0.021). The nap time was positively correlated with the levels of FPG, HbA1c, FT3 and FT4 in patients with hyperthyroidism and diabetes mellitus (r=0.867, 0.855, 0.793, 0.844, P=0.000, 0.000, 0.014, 0.003), and was negatively correlated with TSH (r=-0.802, P=0.012); but the nocturnal sleep time was not correlated with the levels of FPG, HbA1c, FT3, FT4 and TSH in patients with hyperthyroidism and diabetes mellitus (P>0.05). Conclusion To improve the quality of sleep, sleep at night security appropriate time and increase the sleep midday can effectively reduce the level of blood glucose in diabetic patients with hyperthyroidism and thyroid hormone secretion, improve glucose metabolism and thyroid function. Key words: Hyperthyroidism; Diabetes mellitus; Sleep; Blood glucose; Thyroxine