2型糖尿病患者血清皮质醇浓度的变化

目的　了解 2型糖尿病患者血清皮质醇分泌的变化及其对胰岛素敏感性的影响。方法　用RIA法测定 6 0例新发 2型糖尿病患者 (肥胖及非肥胖者各 30例 )晨 8时、下午 4时以及口服糖耐量试验期间血清皮质醇浓度的变化 ,同时作血清葡萄糖浓度及胰岛素浓度测定。 40例健康者为正常对照组。结果　①肥胖的 2型糖尿病患者晨 8时及下午 4时血清皮质醇浓度均高于同BMI的正常对照组 (P <0 0 5 )。②肥胖的 2型糖尿病组口服糖耐量试验期间血清皮质醇浓度不下降并有轻度升高 ,而非肥胖组及对照组服糖后血清皮质醇浓度则明显下降。③糖尿病患者血清皮质醇浓度与胰岛素敏感指数呈负相关 (r =- 0 34 ,P <0 0 1)。结论　肥胖的 2型糖尿病存在一定程度的肾上腺皮质分泌功能的异常。

Changes of serum cortisol concentration in type 2 diabetic patients

Objective　To assay serum cortisol concentration in type 2 diabetic patients and evaluate the relationship between serum cortisol concentration and insulin resistance. Methods　Serum cortisol concentrations were measured at 8 am, 4 pm and during oral glucose tolerance test(OGTT) in 60 newly-onset type 2 diabetic patients and 40 healthy subjects using RIA. Results　① Sernm cortisol concentrations were elevated in obese type 2 diabetic patients at 8 am and 4 pm as compared with non-obese patients and normal controls. ② Changes of serum cortisol concentration during OGTT were different between obese type 2 diabetic and non-obese patients: serum cortisol concentrations were decreased after glucose administration in non-obese patients but not in obese patients. ③ In type 2 diabetic patients, serum cortisol concentrations were negatively correlated with insulin sensitivity index (r=-0.34, P<0.01). Conclusion　There is some degree of abnormal in cortisol secretion in obese type 2 diabetic patients.