NIDDM患者血清性激素变化与胰岛素抵抗的关系

为探讨非胰岛素依赖型糖尿病（ＮＩＤＤＭ） 患者血清性激素变化及其与胰岛素抵抗的关系， 应用放射免疫法检测了６０ 例５０ 岁以上ＮＩＤＤＭ 患者血清雌二醇 （Ｅ２）、睾酮（Ｔ） 等性激素水平。结果： 男性患者Ｅ２ 升高， Ｔ呈下降趋势， Ｅ２／Ｔ比值显著高于正常对照 （Ｐ＜ ０． ０５）； 女性患者Ｅ２ 较对照组显著降低（Ｐ＜ ０． ０１）， Ｔ略高于正常， Ｅ２ ／Ｔ比值平衡失调。Ｅ２、Ｅ２／Ｔ与空腹血糖 （ＦＢＧ）、空腹胰岛素（ＦＩｎｓ） 呈正相关， 与胰岛素敏感性（ＩＳ） 呈负相关。认为ＮＩＤＤＭ 患者存在严重的性激素失调及胰岛素抵抗， 在“胰岛素抵抗—糖代谢紊乱—性激素内环境失衡”之间， 可能有规律性的内在联系。

Relationship between Serum Sex Hormone Levels and Insulin Resistance in NIDDM Patients

The serum sex hormones including estradiol(E 2)and testosterone(T)were examined by using radioimmunoassay in 60 patients(above 50 years of age)with non insulin dependent diabetes mellitus(NIDDM) to study their correlation with insulin resistance. The results showed that E 2 level and E 2/T ratio were obviously increased with the decrease of T in male patients with NIDDM as compared with controls( P <0.05), while E 2/T ratio and E 2 level were significantly decreased with the increase of T in female patients with NIDDM as compared with controls( P <0.01). E 2 and E 2/T were positively related with fast blood glucose(FBG) and fast serum insulin(FIns), but was negatively with insulin sensitivity(IS). It was suggested that there might be a tight internal relation among insulin resistance, glucose metabolic disorder, and dysequilibrium of inner environment of sex hormones. Severe sex hormone imbalance and insulin resistance existed in the NIDDM patients.