应激对2型糖尿病患者神经内分泌相关激素的影响

目的探讨应激状态下2型糖尿病患者胰岛素抵抗(IR)加重的机制。方法根据患者有无合并应激状态分为应激组和对照组。采用葡萄糖氧化酶法、化学发光免疫测定法测定两组患者血浆空腹血糖(FPG)、空腹胰岛素(FINS)水平以及血清皮质醇、生长素(GH)、促卵泡激素(FSH)、黄体生成素(LH)、睾酮(T)、雌二醇(E2)水平的变化。采用Hom amodel:Hom a-IR=(FPG×FINS)/22.5计算胰岛素抵抗指数。结果与对照组相比,应激组的FPG、FINS、皮质醇、GH显著升高(P<0.05),T、E2、FSH、LH显著降低(P<0.05)。Hom a-IR与皮质醇、GH呈正相关(P<0.05),与T、E2呈负相关(P<0.05)。结论应激加重IR的机制可能与神经内分泌相关激素的紊乱有关。

Effects of stress on related hormones of neuroendocrine in type 2 diabetic patients

Objective To explore the mechanisms of worsened insulin resistance during severe stress in type 2 diabetic patients.Methods Patients were divided into!stress group and control group according to stress or stressless state.Plasma levels of fasting glucose,fasting insulin as well as the serum levels of cortisol,GH,FSH,LH,T and E_(2) were measured by means of glucose oxidase assay,chemoillumioimmunologic assay,respectively.Insulin resistance index was measured by Homa model index.Results The plasma levels of fasting glucose,fasting insulin and Homa-IR in stress group were higher than those of control group(all P<0.05).The serum levels of cortisol and GH increased signficantly,otherwise,the serum levels of FSH,LH,T and E_(2)decreased significantly in the stress group compared with the control group(all P<0.05).The Homa-IR index has positive correlation with cortisol and GH and negative correlation with T and E_(2).Conclusion The mechanisms of worsened insulin resistance probably related to the disorder of neuroendocrine hormone during severe stress in diabetes.