抑郁症伴或不伴糖尿病患者过夜小剂量地塞米松抑制试验的对照研究

目的 探讨下丘脑-垂体-肾上腺轴(HPA)功能异常在抑郁症患者伴发的糖尿病发病机制中的意义.方法 首次诊断为糖尿病的抑郁症患者(病例组)、正常血糖稳态的抑郁症患者(对照组)各40例,于药物治疗前测定空腹血糖、糖负荷后2 h血糖,并行过夜小剂量(1 mg)地塞米松抑制试验.结果 (1)病例组抑制前8:00、16:00及...

Overnight low-dose dexamethasone suppression test in depressed patients with or without diabetes:a clinical control study

Objective To explore the possible role of hypothalamic-pituitary-adrenal axis(HPA) dysfunction in mechanism of diabetes in depressive patients.Methods Two groups including depressed patients with newly diagnosed diabetes(case group,n=40),depressed patients with normal glucose homeostasis(control group,n=40)were included,and undertook overnight low-dose dexamethasone (1 mg)suppression test(LDDST)and fasting plasma glucose,2 h plasma glucose after 75 g glucose loading measurement before medication.Results The plasma cortisol levels in case group at baseline time point of 8:00 and 16:00,and 8:00 after 1 mg dexamethasone were significantly higher than that in control group[(608±266)nmol/L VS.(499±199)nmol/L;(409±176)nmol/L vs.(299±148)nmol/L;(382±257)nmol/L VS.(232±182)nmol/L;P=0.042,0.003,0.004 respectively ].The escaped suppression rates in LDDST were significantly more in case group than control group(72%vs.42%,P=0.007).Plasma cortisol levels at 8:00 before and after dexamethasone were positively correlated with fasting plasma glucose in case group(r=0.392,0.470;both P<0.05).Conclusion Depressed patients with diabetes have much severe dysfunction of the HPA axis which may play an important role in the pathomechanism of diabetes in depression.