激素性糖尿病发病机制研究进展  

Research progress of pathogenesis of glucocorticoid induced diabetes mellitus

作　　者：张书印 丁选胜[2] 方芸[1] ZHANG Shu-yin;DING Xuan-sheng;FANG Yun(Nanjing Drum Tower Hospital, Jiangsu Nanjing 210008, China;China Pharmaceutical University, Jiangsu Nanjing 211198, China)

机构地区：[1]南京鼓楼医院,江苏南京210008 [2]中国药科大学,江苏南京211198

出　　处：《中国医院药学杂志》2018年第12期1338-1341,共4页Chinese Journal of Hospital Pharmacy

摘　　要：糖皮质激素在临床上使用广泛,但是其带来的不良反应却不可忽视,激素性糖尿病作为糖皮质激素使用常见的不良反应严重影响了激素的使用,糖皮质激素诱导胰岛素抵抗是目前公认的激素性糖尿病的发病机制,糖皮质激素可以通过抑制胰岛素信号通路,减少脂联素、骨钙素的分泌,增加5羟色胺(5-HT)分泌等多种途径诱导胰岛素的抵抗。此外激素还可以通过抑制胰高血糖素样肽-1(GLP-1)、葡萄糖依赖性促胰岛素多肽(GIP)的作用减少胰岛素的分泌造成糖代谢紊乱,进一步发展为激素性糖尿病。Glucocorticoid is used widely for its potent anti-inflammatory effects.However,the adverse reactions cannot be ignored,such as glucocorticoid induced diabetes mellitus.Glucocorticoid induced insulin resistance is a generally accepted mechanism of glucocorticoid induced diabetes mellitus.Glucocorticoid can inhibit insulin signaling pathway,reduce the secretion of adiponectin and osteocalcin,and increase the 5-HT secretion,which cause insulin resistance.In addition,glucocorticoid can reduce the secretion of insulin by inhibiting GLP-1 and GIP,which leads to the disorder of glucose metabolism,or even diabetes.

关 键 词：糖皮质激素 胰岛素抵抗 激素性糖尿病 

分 类 号：R969[医药卫生—药理学]