临床治疗

　　2型糖尿病患者HPA轴激素水平与糖脂代谢的关系分析

　　周珺 张汝学 贾正平 罗晓红 姜一真 李静　　

      【摘要】目的：了解2型糖尿病患者(T2DM)的下丘脑-垂体-肾上腺 (HPA) 轴状况，探讨其HPA轴功能与血糖水平、血脂的关系。方法：测定75例T2DM患者早6:30的HPA轴各激素水平、血糖及血脂水平，进行统计学比较。结果：2型糖尿病患者清晨C、ACTH、CRH均高于健康对照组，差异有显著统计学意义(P<0.01);50-59岁T2DM清晨HPA轴各激素水平较其他年龄组高，≥70岁T2DM的HPA轴各激素水平为各年龄组中最低。T2DM的C水平与FBS(r=0.240)、C-P水平(r=0.0276)呈正相关，与HDL-C(r=-0.225)呈负相关(P≤0.05)，与apoAI/B(r=0.367)呈显著正相关(P≤0.001);ACTH与FBS(r=0.312)和TG水平(r=0.293)呈显著正相关(P≤0.001)，与apoAI(r=0.284)正相关(P≤0.05);CRH与FBS(r=0.242)和apoAI/B(r=0.328)正相关(P≤0.05)，与HDL-C(r=-0.265)呈负相关(P≤0.05)。结论：T2DM 的HPA轴亢进与糖脂代谢关系密切。

　　【关键词】2型糖尿病;HPA轴;相关性

　　Relationship of HPA-axis function with gluco- and lipo-metabolism in T2DM patients ZHOU Jun, ZHANG Ru-xue, JIA Zheng-ping, et al. Pharmacy College, Lanzhou University, Lanzhou 730050, China

　　Corresponding author: JIA Zheng-ping, E-mail: ?????

　　【Abstract】Objective To learn the status of the HPA axis in the T2DM patients and explore the relationship of HPA axis function with glycometabolism and lipometabolism in these patients.

Methods Seventy-five T2DM patients were enrolled. Their serum cortisol, ACTH, CRH, FINS, C-P, FBS, P2BS, and HbAlc, as well as plasma glucose and lipid levels, were assayed and computed with statistics. Results The levels of C, ACTH, and CRH of the T2DM patients were all higher than those of the controls, and the difference was statistically significant (P<0.01). All hormone levels of HPA axis of the T2DM patients aged 50-59 were higher than those of other age groups, while those of the T2DM patients aged ≥70 were the lowest in comparing with other groups. The level of cortisol was positively related with FBS (r=0.240) and C-P (r=0.0276), and significantly in a positive relation with apoAI/B (P≤0.001), but negatively related with HDL-C(r=-0.225) (P<0.05). The level of ACTH was positively related with apoAI (r=0.284) (P<0.05), and significantly in a positive relation with FBS (r=0.312) and TG (r=0.293) (P≤0.001). The level of CRH was positively related with FBS (r=0.242) and apoAI/B (r=0.328) (P≤0.05), but negatively related with HDL-C (r=-0.265) (P≤0.05). Conclusion The hyperfunctioning of HPA axis is closely related with the glycometabolism and lipometabolism in T2DM patients.

　　【Keywords】Diabetes Mellitus, Type 2; HPA axis; Relationship