2型糖尿病患者的下丘脑-垂体-肾上腺轴功能研究

The study of the hypothalamic-pituitary-adrenal axis fuction in type 2 diabetes mellitus patients

目的:探讨2型糖尿病患者下丘脑-垂体-肾上腺(HPA)轴的功能改变。方法:比较正常对照组、IGR组(糖耐量减低和(或)空腹血糖受损)和2型糖尿病组的一般临床特征、早晨皮质醇浓度(唾液和血)及清晨唾液皮质醇升高值(MSCR)。结果:1)2型糖尿病组MSCR低于正常对照组,差异有统计学意义(P<0.05)。2)晨8时血浆皮质醇各组间差异均有统计学意义(P<0.01),表现为IGR组最高,其次为2型糖尿病组。3)多元逐步回归分析提示年龄和HOMA-IR对MSCR有影响。结论:2型糖尿病患者存在HPA轴调节功能的紊乱,表现为MSCR低于正常人而晨8时血浆皮质醇高于正常人。

Objective：To investigate the function of the hypothalamic-pituitary-adrenal （HPA） axis in type 2 diabetic patients. Methods：Subjects were divided into three groups：control group （normal glucose）,IGR group （IGT and/or IFG） and T2DM group. General clinical characteristics, morning cortisol concentrations （saliva and plasma） and MSCR （morning salivary cortisol rise） of the three groups were compared. Resu/ts： 1 ） MSCR in the T2DM group was significantly lower than that in the control group （P〈0.05） ;2） there were significant differences in plasma cortisol at 8 am. among the three groups （P〈0.01）,with the highest level in the IGR and the next in the T2DM;3） stepwise regression analysis indicated age and HOMA-IR had significant associations with MSCR. Conclusion：MSCR is lower and plasma cortisol at 8 am is higher in T2DM patients than that in the normal group,which suggests T2DM patients have altered regulation of the HPA axis.