2型糖尿病患者下丘脑-垂体-肾上腺轴激素水平与糖脂代谢关系的研究  

Relationship of HPA-axis function with gluco-and lipo-metabolism in T2DM patients

作　　者：周珺[1] 张汝学[1] 贾正平[1] 罗晓红[2] 姜一真[2] 李静[1] 

机构地区：[1]兰州军区兰州总医院药材科,730050 [2]兰州军区兰州总医院内分泌科,730050

出　　处：《中国糖尿病杂志》2012年第11期843-845,共3页Chinese Journal of Diabetes

基　　金：国家自然科学基金资助项目(30772773;81173620);甘肃省自然科学基金资助项目(3ZS051-A25-078)

摘　　要：目的了解T2DM患者的下丘脑-垂体-肾上腺(HPA)轴状况,探讨其HPA轴功能与血糖、血脂的关系。方法测定75例T2DM患者清晨HPA轴各激素、血糖及血脂水平,并进行比较。结果 T2DM患者清晨血清皮质醇(C)、促肾上腺皮质激素(ACTH)、促肾上腺皮质激素释放激素(CRH)均高于健康对照组,差异有统计学意义(P<0.01);50～59岁T2DM患者清晨HPA轴各激素水平较其他年龄组高,≥70岁T2DM患者的HPA轴各激素水平为各年龄组中最低。T2DM患者的C水平与FPG(r=0.240)、C-P水平(r=0.0276)呈正相关,与HDL-C(r=-0.225)呈负相关(P<0.05),与载脂蛋白比值(apoAI/B,r=0.367)呈显著正相关(P<0.01);ACTH与FPG(r=0.312)和TG水平(r=0.293)呈显著正相关(P<0.001),与载脂蛋白AI(apoAI,r=0.284)呈正相关(P<0.05);CRH与FPG(r=0.242)和apoAI/B(r=0.328)呈正相关(P<0.05),与HDL-C(r=-0.265)呈负相关(P<0.05)。结论 T2DM的HPA轴功能亢进与糖脂代谢关系密切。Objective To study the status of the HPA （hypothalamus-pituitary-adrenal） axis in the T2DM patients and explore the relationship of HPA axis function with glycometabolism and lipometabolism in these patients. Methods Seventy-five T2DM patients were enrolled. Serum cortisol, ACTH, CRH, Fins, C-P, FPG, 2 hPG, and HbA1 c, as well as plasma glucose and lipid levels, were assayed and analyzed. Results The levels of eortisol（C）, ACTH, and CRH of the T2DM patients were all higher than those of the controls （P〈0.01）. All hormone levels of HPA axis were higher in the T2DM patients aged 50-59 years than in of other age groups, while those of the T2DM patients aged ≥70 were the lowest in comparing with other groups. The level of cortis01 was positively related with FPG （r= 0. 240）,C-P （r=-0. 0276）, and apoAI/B （P〈0. 05 or 0.01）, but negatively related with HDL-C （r= -0. 225, P〈0. 05）. The level of ACTH was positively related with apoAI （r=0. 284, P〈0.05）, and significantly in a positive relation with FPG （r=0. 312） and TG （r=0. 293, P〈0. 01）. The level of CRH was positively related with FPG （r=0. 242） and apoAI/B （r= 0. 328, P〈0. 05）, but negatively related with HDL-C （r= --0. 265, P〈0.05）. Conclusion The hyperfunctioning of HPA axis is closely related with the glycometabolism and lipometabolism in T2DM patients.

关 键 词：糖尿病 2型 HPA轴 相关性 

分 类 号：R587.1[医药卫生—内分泌]