老年糖耐量受损患者血清皮质醇表达与能量代谢及微血管病变的相关性  

Correlation of Serum Cortisol Expression with Energy Metabolism and Microvascular Lesions in Elderly Patients with Impaired Glucose Tolerance

作　　者：海伟丽 李铁[2] HAI Weili;LI Tie(Department of Endocrinology,Huludao Central Hospital Affiliated to Dalian Medical University,Huludao 125000,China;Department of Endocrinology,Central Hospital Affiliated to Shenyang Medical College,Shenyang 110021,China)

机构地区：[1]大连医科大学附属葫芦岛市中心医院内分泌科,辽宁葫芦岛125000 [2]沈阳医学院附属中心医院内分泌科,沈阳110021

出　　处：《医学综述》2022年第10期2070-2074,共5页Medical Recapitulate

摘　　要：目的分析老年糖耐量受损患者血清皮质醇表达与能量代谢及微血管病变的关系。方法选取2017年1月至2019年3月在大连医科大学附属葫芦岛市中心医院健康体检诊断为糖耐量受损的83例老年患者作为观察组,选取同期健康体检糖耐量正常的85例老年人作为对照组。比较两组受试者的血清皮质醇水平和能量代谢指标[静态能量消耗(REE)、呼吸商(RQ)、蛋白质氧化率(PRO%)、碳水化合物氧化率(CHO%)及脂肪氧化率(FAT%)]变化,分析血清皮质醇水平与能量代谢指标、血管内皮生长因子(VEGF)水平的相关性,及不同血清皮质醇水平与微血管病变发生的关系。结果观察组的体质指数、空腹胰岛素水平、空腹血糖、餐后2 h血糖均显著高于对照组(P<0.01)。观察组的血清皮质醇水平、REE、PRO%、FAT%均显著高于对照组[(317±45)nmol/L比(249±34)nmol/L、(1596±149)kcal/d比(1542±145)kcal/d、(21.9±2.7)kcal/(kg•d)比(16.4±2.0)kcal/(kg•d)、(41±8)kcal/(kg•d)比(35±7)kcal/(kg•d)](P<0.05或P<0.01),RQ、CHO%显著低于对照组[(0.75±0.03)比(0.80±0.02)、(33±9)kcal/(kg•d)比(36±7)kcal/(kg•d)](P<0.01)。血清皮质醇水平与REE、PRO%、FAT%、VEGF呈正相关,与RQ、CHO%呈负相关(P<0.05或P<0.01)。高水平皮质醇组的微血管病变发生率、VEGF水平高于低水平皮质醇组[60.00%(27/45)比31.58%(12/38)、(319±36)ng/L比(268±30)ng/L](P<0.05或P<0.01)。结论血清皮质醇表达水平与老年糖耐量受损患者的能量代谢和微血管病变有一定的相关性,其水平升高可能与老年糖耐量受损的发病有关。Objective To analyze the relationship of serum cortisol expression with energy metabolism and microvascular disease in elderly patients with impaired glucose tolerance.Methods A total of 83 elderly patients with impaired glucose tolerance diagnosed by physical examination in Huludao Central Hospital Affiliated to Dalian Medical University from Jan.2017 to Mar.2019 were included as an observation group,and 85 elderly patients with normal glucose tolerance during the same period were included as a control group.The changes of serum cortisol level and energy metabolism indexes[resting energy expenditure(REE),respiratory quotient(RQ),protein oxidation rate(PRO%),carbohydrate oxidation rate(CHO%)and fat oxidation rate(FAT%)]were compared between the two groups,to analyze the correlation of serum cortisol level with energy metabolism index and vascular endothelial growth factor(VEGF),and the relationship between different serum cortisol levels and microvascular lesions.Results The body mass index,fasting insulin level,fasting plasma glucose and 2-hour post-meal blood glucose of the observation group were significantly higher than those of the control group(P<0.01).The levels of serum cortisol,REE,PRO%and FAT%in the observation group were significantly higher than those in the control group[(317±45)nmol/L vs(249±34)nmol/L,(1596±149)kcal/d vs(1542±145)kcal/d,(21.9±2.7)kcal/(kg•d)vs(16.4±2.0)kcal/(kg•d),(41±8)kcal/(kg•d)vs(35±7)kcal/(kg•d)](P<0.05 or P<0.01),while RQ and CHO%were significantly lower than those in the control group[(0.75±0.03)vs(0.80±0.02),(33±9)kcal/(kg•d)vs(36±7)kcal/(kg•d)](P<0.01).Serum cortisol level was positively correlated with REE,PRO%,FAT%and VEGF,and negatively correlated with RQ and CHO%(P<0.05 or P<0.01).The incidence of microangiopathy and VEGF level in the high-level cortisol group were higher than those in the low-level cortisol group[60.00%(27/45)vs 31.58%(12/38),(319±36)ng/L vs(268±30)ng/L](P<0.05 or P<0.01).Conclusion The expression level of serum cortisol has a

关 键 词：糖耐量受损 老年患者 血清皮质醇 能量代谢 微血管病变 

分 类 号：R587.1[医药卫生—内分泌]