血浆促肾上腺皮质激素、皮质醇水平与1型糖尿病患儿糖化血红蛋白水平的相关性研究  

Correlation between the levels of plasma adrenocorticotropic hormone,cortisol and glycosylated hemoglobin level in children with type 1 diabetes mellitus

作　　者：焦丽华 厉红[1] 刘建丽[1] JIAO Li-hua;LI Hong;LIU Jian-li(Department of Pediatrics,Tangshan Maternal and Child Health Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]唐山市妇幼保健院儿内科,河北唐山063000

出　　处：《中国儿童保健杂志》2021年第4期377-380,共4页Chinese Journal of Child Health Care

基　　金：2020年度河北省医学科学研究课题计划(20201470)。

摘　　要：目的分析促肾上腺皮质激素(ACTH)、皮质醇(CORT)与1型糖尿病(T1DM)患儿糖化血红蛋白(HbA1c)水平的相关性,为T1DM的临床诊断提供科学依据。方法选择2014年1月—2018年12月在唐山市妇幼保健院内分泌科就诊的T1DM患儿105例为T1DM组,另选同期在本院健康体检儿童105例作为对照组,采用酶联免疫吸附法检测各观察对象在1 d内各时间点(8:00、16:00、24:00)的血浆ACTH、CORT水平,Pearson相关分析法分析T1DM患儿血浆ACTH、CORT日平均水平与空腹血糖(FPG)、HbA1c等指标相关性,Logistic回归分析影响T1DM发病的因素。结果与对照组比较,T1DM组患儿甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、FPG与HbA1c水平显著升高,高密度脂蛋白胆固醇(HDL-C)水平降低,差异有统计学意义(P<0.05);T1DM组患儿血浆ACTH、CORT在8:00、16:00、24:00表达水平和日平均水平显著高于对照组,差异均有统计学意义(P<0.05);相关性分析显示,T1DM患儿血浆ACTH、CORT日平均表达水平与血浆FPG、HbA1c呈正相关(r_(ACTH)=0.717、0.585、r_(CORT)=0.636、0.696,P<0.01);Logistic回归分析显示ACTH、CORT是T1DM患儿发病的独立危险因素。结论ACTH、CORT在T1DM患儿血浆中高表达,其与HbA1c有一定相关性,是T1DM患儿发病的独立危险因素,可作为T1DM血糖控制好有效的评价指标。Objective To Analyze the correlation between adrenocorticotropic hormone(ACTH),cortisol(CORT)and glycated hemoglobin(HbA1 c)levels in children with type 1 diabetes mellitus(T1 DM),so as to provide scientific evidence for the clinical diagnosis of T1 DM.Methods A total of 105 T1 DM children hospitalized in the Department of Endocrinology of Tangshan Maternal and Child Health Hospital from January 2014 to December 2018 were selected as the T1 DM group,and meanwhile 105 healthy children were selected as the control group.The levels of plasma ACTH and CORT at different time points(8:00,16:00 and 24:00)were measured by enzyme-linked immunosorbent assay(ELISA).Pearson method was used to analyze the correlation between the daily average levels of ACTH,CORT and fasting blood glucose(FPG),HbA1 c and other indicators.In addition,Logistic regression analysis was used to analyze the risk factors of T1 DM.Results Compared with those in the control group,the levels of triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL-C),FPG and HbA1 c were significantly increased in T1 DM group(P<0.05),while the level of high-density lipoprotein(HDL-C)was decreased(P<0.05).The expression level of ACTH and CORT at 8:00,16:00 and 24:00,and the daily average levels in plasma of T1 DM group were significantly higher than those in control group(P<0.05).Correlation analysis showed that the daily average expression levels of ACTH and CORT were positively correlated with FPG and HbA1 c(r_(ACTH)=0.717,0.585,r_(CORT)=0.636,0.696,P<0.01).Logistic regression analysis showed that ACTH and CORT were independent risk factors of T1 DM.Conclusions ACTH and CORT are highly expressed in plasma of T1 DM children,which are correlated with HbA1 c.As independent risk factors for the onset of T1 DM,ACTH and CORT may be used as potential markers for glycemic control of T1 DM.

关 键 词：促肾上腺皮质激素 皮质醇 1型糖尿病 糖化血红蛋白 

分 类 号：R725.8[医药卫生—儿科]