131例库欣综合征患者的糖代谢特点分析  

Clinical analysis of glucose dysbolism in 131 cases with Cushing's syndrome

作　　者：周兴建[1,2] 杨国庆[1] 李芳[2] 欧阳金枝[1] 王先令[1] 巴建明[1] 窦京涛[1] 母义明[1] 

机构地区：[1]解放军总医院内分泌科,北京100853 [2]湖北医药学院附属襄阳医院内分泌科

出　　处：《中国糖尿病杂志》2014年第4期313-316,共4页Chinese Journal of Diabetes

摘　　要：目的分析库欣综合征(CS)患者的临床资料,了解CS继发糖代谢异常的特点。方法回顾性分析131例CS患者年龄,病程,BMI,BP,FPG,2hPG,血钾(K),血脂和血、尿皮质醇等指标。结果研究对象中,合并糖尿病者60例,IGT者22例。Pearson相关性分析显示,CS患者年龄、病程、TG、00:00和08:00血皮质醇与FPG呈正相关(r=0.260、0.140、0.400、0.530、0.450,P<0.05),HDL-C、K与FPG呈负相关(r=-0.260、-0.340,P<0.05)。Logistic回归分析显示,年龄、病程、00:00血皮质醇水平是CS患者发生糖尿病的危险因素。在CS继发糖尿病患者中,以FPG为诊断标准,45%患者确诊,55%患者漏诊。结论年龄、病程、00:00血皮质醇是CS患者发生糖代谢异常的危险因素,建议CS患者采用75g OGTT筛查糖代谢异常。Objective To analyze the clinical data of patients with Cushing＇s syndrome,to further understand the clinical features of Cushing＇s syndrome with abnormal glucose metabolism.Methods Age,duration,BMI,blood pressure,FPG,2 hPG,serum potassium,blood lipids,blood and urine cortisol in 131 patients with Cushing＇s syndrome were retrospectively analyzed.Result The study included 131 cases with Cushing syndrome,60 cases with diabetes mellitus,22 cases with IGT.Pearson correlation analysis showed that age,duration,TG,00：00 and 08：00 cortisol levels were positively correlated with FPG （r=0.260,0.140,0.400,0.530,0.450,P〈0.05）,HDL-C and serum potassium were negatively correlated with FPG （r =-0.260,-0.340,P〈 0.05） in Cushing＇s syndrome patients.Logistic regression analysis showed that age,duration and plasma cortisol levels at 00：00 were risk factors for diabetes.If Cushing syndrome-induced diabetes mellitus is diagnosed with FPG as diagnostic criteria,only 45% of the patients were diagnosed,and 55% were missed.Conclusion Age,duration and plasma cortisol levels at 00：00 are risk factors for Cushing＇s syndrome-induced diabetes mellitus.The 75 g OGTT should be used to screen the secondary diabetes in Cushing＇s syndrome.

关 键 词：库欣综合征 继发糖尿病 糖耐量减低 

分 类 号：R586[医药卫生—内分泌]