2型糖尿病并发肥胖症患者血浆促肾上腺皮质激素水平及临床意义分析

Plasma Level of Adrenocorticotropic Hormone and Clinical Significance in Type 2 Diabetes Mellitus Patients with Obesity

目的:探讨2型糖尿病(T2DM)并发肥胖症患者的血浆促肾上腺皮质激素(ACTH)水平及临床意义。方法:选取2019年1月至2021年6月期间我院收治的102例T2DM合并肥胖患者为研究对象,归为肥胖组,同时选取同期我院收治的100例未合并肥胖的T2DM患者为非肥胖组,同期在我院体检的95例健康成人作为对照组。比较三组空腹血糖(FPG)、空腹胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、稳态模型胰岛素抵抗指数(HOMA-IR)、血浆ACTH水平、骨密度(BMD)。采用Pearson相关性分析和多元线性回归探讨T2DM合并肥胖患者血浆ACTH水平与各指标的相关性。结果:肥胖组的BMI、FPG、FINS、HOMA-IR、TG、TC、ACTH均显著高于另外两组,BMD显著低于另外两组,且无肥胖组的BMI、FPG、FINS、HOMA-IR、TG、TC、ACTH均显著高于对照组,BMD显著低于对照组,差异有统计学意义(P<0.05)。Pearson相关性分析表明肥胖组患者的血浆ACTH水平与BMI、FPG、FINS、HOMA-IR、TG、TC均呈显著正相关,与BMD呈显著负相关(P<0.05)。多元线性回归结果表明BMI、FPG、HOMA-IR、BMD是肥胖组患者的血浆ACTH水平的独立影响因素(P<0.05)。结论:T2DM合并肥胖患者的血浆ACTH水平明显升高,与糖脂代谢紊乱、骨密度降低有关。

Objective:To investigate the Plasma adrenocorticotropic hormone(ACTH)level and clinical significance of type 2 diabetes mellitus(T2DM)patients with obesity.Methods:102 T2DM patients with obesity treated in our hospital from January 2019 to June 2021 were selected as the research object and classified as the obesity group.At the same time,100 T2DM patients without obesity treated in our hospital in the same period were selected as the non-obesity group,and 95 healthy adults who underwent physical examination in our hospital in the same period were selected as the control group.Fasting blood glucose(FPG),fasting insulin(fins),triglycerides(TG),total cholesterol(TC),homeostasis model insulin resistance index(HOMA-IR),plasma ACTH level and bone mineral density(BMD)were compared among the three groups.Pearson correlation analysis and multiple linear regression were used to explore the correlation between plasma ACTH level and various indexes in T2DM patients with obesity.Results:BMI,FPG,FINS,HOMA-IR,TG,TC and ACTH in obese group were significantly higher than those in the other two groups,and BMD was significantly lower than those in the other two groups.BMI,FPG,FINS,HOMA-IR,TG,TC and ACTH in non-obese group were significantly higher than those in the control group,and BMD was significantly lower than that in the control group(P<0.05).Pearson correlation analysis showed that the plasma ACTH level in obese patients was significantly positively correlated with BMI,FPG,FINS,HOMA-IR,TG and TC,and negatively correlated with BMD(P<0.05).Multiple linear regressions showed that BMI,FPG,HOMA-IR and BMD were the independent influencing factors of plasma ACTH level in obese patients(P<0.05).Conclusion:The plasma ACTH level of T2DM patients with obesity significantly increased,which was related to the disorder of glucose and lipid metabolism and the decrease of bone mineral density.