2型糖尿病患者皮质醇水平与高敏C反应蛋白的相关性研究

Correlations between Cortisol Levels and C-reactive Protein in Type 2 Diabetic Patients

目的探讨2型糖尿病（T2DM）患者皮质醇水平与高敏C反应蛋白（hs-CRP）的关系。方法以2008年5月—2009年11月在我院内分泌科住院治疗的98例T2DM患者为病例组,按病程分为3个亚组：A组〈5年,B组5~14年,C组≥15年;以同期在我院体检的98例健康体检者为对照组。AM 8：00时测定受试对象的血促肾上腺皮质激素（ACTH）、血皮质醇、24 h尿游离皮质醇（UFC）及hs-CRP水平。结果 （1）T2DM组血ACTH、皮质醇和UFC水平均明显高于对照组,差异有统计学意义（P〈0.01）;（2）T2DM患者血ACTH、皮质醇和UFC水平随糖尿病病程延长而升高,但3个亚组间血ACTH、皮质醇水平间差异无统计学意义（P〉0.05）;C组UFC水平明显高于A组,差异有统计学意义（P〈0.01）;C组hs-CRP水平明显高于A、B两组,差异均有统计学意义（P〈0.05）;（3）偏相关分析显示ACTH、皮质醇、UFC与hs-CRP间无相关关系（r值分别为0.152、0.189和0.118,P〉0.05）。结论 T2DM患者血ACTH、皮质醇、UFC、hs-CRP水平较正常人群明显升高,T2DM患者皮质醇水平与hs-CRP无相关关系。

Objective To investigate the correlations between cortisol levels and inflammatory reactions in type 2 diabetic（T2DM） patients.Methods Ninety-eight hospitalized patients from our department between May 2008 and November 2009 were enrolled and divided into 3 subgroups according to courses of the disease（group A,less than 5 years;group B,5 years or more but less than 15 years;group C,15 years or more）.Meanwhile,98 cases of healthy subjects underwent medical examinations in the same hospital were enrolled as controls.Levels of plasma adreno-cortico-tropic-hormone（ACTH） and Cortisol（Cor）,urinary free cortisol（UFC）,and high-sensitivity C-reactive protein（hs-CRP） were measured in all subjects at 8 a.m.in the morning.Results Levels of plasma ACTH,Cor,and UFC in the T2DM group were higher than those in the control group with significant differences（P〈0.01）.Plasma ACTH,Cor,and UFC increased in the T2DM group as the disease course extended.However,no significant differences in plasma ACTH and Cor levels were noted among the three subgroups（P〈0.05）,while UFC levels in group C were significantly higher than those in group A（P〈0.01）.CRP levels in group C were significantly higher than those in group A and B（P〈0.05）.Partial correlation analysis showed that ACTH,Cor,and UFC levels were not correlated with CRP levels.Conclusion Levels of plasma ACTH,plasma Cor,UFC and CRP in type 2 diabetic patients are significantly higher than those in healthy subjects and increase as the disease course extends.Cortisol level in type 2 diabetic patients is not correlated with CRP.