2型糖尿病患者胰岛素抵抗和胰岛β细胞功能与性激素水平的关系

Clinical study on the relationship between sex hormone and pancreatic β-cell function,insulin-resistance in type 2 diabetes

目的 探讨 2型糖尿病患者性激素水平与胰岛 β细胞功能和胰岛素抵抗 (IR)的关系。方法 75例 2型糖尿病患者 (男 39例 ,女 36例 )和 5 0例正常对照组 (男 2 6例 ,女 2 4例 ) ,用放免法测定睾酮 (T)和雌二醇 (E2 ) ,酶联免疫法测定真胰岛素 (Trueinsulin ,TI) ,HOMA计算IR和胰岛 β细胞功能并进行比较。结果 2型糖尿病男性T水平与HOMA IR、HOMA β值分别呈显著负、正相关 ,E2 为非显著性相关 ;女性T水平与HOMA IR、HOMA β值分别呈显著正、负相关 ,E2 为显著负、正相关。结论 2型糖尿病患者存在性激素紊乱 ,且与IR、β细胞功能相关。T、E2 分别是男、女性的保护性激素 ,补充保护性激素可能与 2型糖尿病患者在降低IR和提高胰岛 β细胞功能方面有积极意义。

Objective To study the relationship between the levels of sex hormone and the insulin-resistance(IR) as well as pancreatic β-cell function in type 2 diabetes,to discuss the possible significance of supplying sex hormone for treatment of type 2 diabetes.Methods 75 cases of patients with type 2 diabetes(39 men and 36 women)and 50 normal controls(26 men and 24 women)were involved.The concentration of testosterone(T) and estradiol (E_2) were determined by RIA as well as the insulin (TI)was measured by ELISA and calculating the IR and pancreatic β-cell function(β). Results Sex hormone of the patients with type 2 diabetes were abnormal.In men the concentration of T was significantly correlated with IR and β ( r= -0.43, r= 0.51, P< 0.01),but that of E_2 was not.While in women,that of T was significantly correlated with IR and β( r= 0.45, r= -0.60, P< 0.01);that of E_2 was significantly correlated with IR and β( r= -0.40, P< 0.05; r= 0.51, P< 0.01). Conclusion The levels of sex hormone in patients with type 2 diabetes were clinical significantly related with IR,β.T is protective hormone in men while E_2 in women;they may have clinical significance in supplying with sex hormone in treatment of type 2 diabetes.