清晨血清皮质醇水平与2型糖尿病患者糖代谢指标及胰岛β细胞功能的相关性研究  

the Association of Morning Serum Cortisol with Glucose Metabolism and Isletβ-cell Function in Patients with Type 2 Diabetes Mellitus

作　　者：邸亚男 王志勇 董林[4] 尚巍 汪峰 DI Yan-an;WANG Zhi-yong;DONG Lin;SHANG Wei;WANG Feng(Clinical Laboratory of Peking University Third Hospital,Beijing,100091,China;Clinical Laboratory of Beifang Section of Peking University Third Hospital,Beijing,100089,China;Clinical Laboratory of Taixing people’s Hospital affiliated to Bengbu Medical College,JiangsuT aizhou,225400,China;Endocrinology Department of Taixing people’s Hospital affi liated to Bengbu Medical College,Jiangsu Taizhou,225400,China)

机构地区：[1]北京大学第三医院检验科,北京100191 [2]北京大学第三医院北方院区检验科,北京100089 [3]蚌埠医学院附属泰兴市人民医院检验科,江苏泰州225400 [4]蚌埠医学院附属泰兴市人民医院内分泌科,江苏泰州225400

出　　处：《中华养生保健》2022年第12期4-8,共5页CHINESE HEALTH CARE

基　　金：蚌埠医学院科技发展基金项目(BYKY18164)。

摘　　要：目的观察2型糖尿病(T2DM)患者、首次确诊为T2DM且未治疗患者及健康对照者的清晨空腹血清皮质醇水平,并分析其与糖代谢指标和胰岛β细胞功能的关系。方法选择2019年9月~2020年9月于蚌埠医学院附属泰兴市人民医院内分泌科就诊的T2DM患者59例作为T2DM组,首次确诊T2DM且未治疗组患者26例,从蚌埠医学院附属泰兴市人民医院体检人群中选择年龄和性别等方面相匹配的表面健康成人34例作为健康对照组。所有受试对象均在清晨空腹条件下,采集静脉血5 mL,分别进行糖化血红蛋白(HbA1c)、空腹血糖(FPG)、胰岛素(FINS)、C-肽、皮质醇的检测,并以稳态模型公式计算胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能(HOMA-β)。所有数据采用MedCalc 15.2.2统计学软件进行处理。结果ANOVA分析发现,各组清晨血清皮质醇水平差异有统计学意义(P<0.05);Student-Newman-Keuls检验进行组间两两比较显示,首次确诊T2DM且未治疗组清晨血清皮质醇水平较T2DM组和健康对照组高,差异有统计学意义(P<0.05);Mann-Whitney检验显示,HbA1c<7.0%组清晨血清皮质醇水平显著低于HbA1c>7.0%组,差异有统计学意义(P<0.05);在T2DM患者中,Spearman相关性分析显示,清晨血清皮质醇水平与FPG和HbA1c呈正相关,与HOMA-β呈负相关,但未发现其与年龄、FINS、C-肽和HOMA-IR等指标间有相关性。结论清晨血清皮质醇与T2DM患者的多种糖代谢指标包括空腹血糖、HbA1c和胰岛β细胞功能存在相关性,且在血糖水平控制较差的T2DM患者和首次确诊为T2DM且未治疗患者中,具有较高的皮质醇水平。Objective To observe the morning serum cortisol levels in patients with type 2 diabetes mellitus(T2DM),patients with first-diagnosed and untreated type 2 diabetes mellitus(T2DM)and healthy controls,and to analyze the relationship between serum cortisol and glucose metabolism and isletβ-cell function.Methods 59 patients with T2DM were selected and 26 patients were diagnosed as T2DM for the fi rst time and did not treated in Taixing people’s Hospital affi liated to Bengbu Medical College from September 2019 to September 2020,and 34 healthy adults matched in age and sex were selected as the control group.In the morning,fasting venous blood samples were collected to detect glycosylated hemoglobin(HbA1c),blood glucose(FPG),insulin(FINS),C-peptide and cortisol,and insulin resistance index(HOMA-IR)and isletβ-cell function(HOMA-β)were calculated by steady-state model formula.All data were processed by statistical software MedCalc 15.2.2.Results ANOVA analysis showed that there was significant difference in morning serum cortisol levels among groups(P<0.05);Student-Newman-Keuls test showed that morning serum cortisol levels in first-diagnosed and untreated T2DM group were signifi cantly higher than those in T2DM group and healthy control group(P<0.05);Mann-Whitney test showed that morning serum cortisol level in HbA1c<7.0%group was signifi cantly lower than that in HbA1c>7.0%group(P<0.05).In patients with T2DM,Spearman correlation analysis showed that serum cortisol level in the morning was positively correlated with FPG and HbA1c,and negatively correlated with HOMA-β,but no correlation was found between serum cortisol level and age,FINS,C-peptide and HOMA-IR.Conclusion There is a correlation between early morning serum cortisol and many glucose metabolic indexes in patients with T2DM,including fasting blood glucose,HbA1c and isletβ-cell function,and there is a higher level of cortisol in patients with poorly controlled T2DM and fi rst-diagnosed and untreated T2DM.

关 键 词：2型糖尿病 皮质醇 胰岛素抵抗指数 胰岛Β细胞功能 相关性 

分 类 号：R193[医药卫生—卫生事业管理]