皮质醇测定在2型糖尿病患者中的应用

Application of Cortisol Determination in Patients with Type 2 Diabetes Mellitus

目的:研究不同腰围的2型糖尿病(T2DM)患者皮质醇水平的变化,并探讨T2DM患者皮质醇水平测定的临床意义。方法:选择T2DM患者96例、非糖尿病对照者71例,根据腰围将受试者分为非腹型肥胖组(男<90 cm,女<80 cm)与腹型肥胖组(男≥90 cm,女≥80 cm)。检测晨8时血皮质醇水平、24 h尿游离皮质醇、葡萄糖代谢指标、血脂谱等,计算胰岛素抵抗指数(HOMA-IR)等指标。结果:T2DM组患者与非糖尿病对照组相比,晨8时血皮质醇及24 h尿游离皮质醇均明显增高(P<0.01);腹型肥胖组血尿皮质醇水平明显高于非腹型肥胖组(P<0.01);对糖尿病组HOMA-IR的相关分析表明,HOMA-IR与体重指数、腰围、空腹血糖、24 h尿游离皮质醇水平相关。结论:糖尿病患者皮质醇水平较非糖尿病者高,腹型肥胖可增加皮质醇水平,尿皮质醇水平与胰岛素抵抗指数HOMR-IR成正相关,皮质醇测定对T2DM有着非常重要的意义。

Objective： To analyze the variation of cortisol in patients of type 2 diabetes mellitus （T2DM） with different waist circumference （ WC）, and to investigate the clinical significance of cortisol determination in type 2 diabetes mellitus. Methods ： Ninety six cases with T2DM and 71 normal controls were enrolled. The subjects were divided into non - abdominal obesity group （WC 〈 90 cm for male,and WC 〈80 cm for female） and abdominal obesity group （WC i〉 90 cm for male,and WC ~ 80 cm for female ）. The level of serum cortisol at 8 a. m. , the 24 - hour urinary free cortisol, glucose metabolism, and lipid profile were assayed. And insulin resistance index （ HOMA - IR） was assessed. Results： The level of serum cortisol at 8 a, m. and the 24 hours urinary free cortisol in cases with T2DM were significantly higher than in controls. The hematuria cortisol levels in ab- dominal obesity group were also significantly higher than in non - abdominal obesity group. HOMA - IR was significantly associ- ated with BMI, WC, FPG and 24 -hour urinary free cortisol in patients with T2DM. Conclusion： The levels of cortisol in pa- tients with T2DM are higher than in controls. Abdominal obesity can increase the level of cortisol. The urinary free cortisol is positively correlated with HOMA - IR. The determination of cortisol is significant in T＇2DM.