2型糖尿病患者下丘脑垂体肾上腺轴的功能研究

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1、重庆医科大学硕士研究生学位论文THESTUDYoFTHEHYPoTHALAMIC—PITUITARY—ADRENALAⅪSFUCTIoNINTYPE2DL墟ETESMELLITUSPATIENTSABSTRACTObjective：Tostudythealmmdfunctionofthehypothalamic--pituitary--adrenal(HPA)axisintype2diabetesmellitus(T2DM)pafiemsbyobservingtheconcentrationofmorningcortisolandmomingsalivarycortisolres

2、ponsetoawakening．Methods：Thestudysubjectsweredividedintothreegroups，controlgroup(normalglucose)，IGRgroup(IGTand／orIFG)andT2DMgroup．Onanordinaryworkingday,salivarycortisolsampleswerecollectedimmediatelyafterawakeningand15minutesthereafter．Allsubjectsacceptedanoralglucosetolerancetestroutinelyt

3、oassayfastingplasmaglucose，2hoursplasmaglucose，fastingplasmainsulinandfastingplasmacortisol，andtheirmedicalhistoryandgeneralclinicalcharacteristics，suchasbodyheight,bodyweight，waistcircumference，hipcircumference，systolicbloodpressureanddiastolicbloodpressure，werecollected．Morningcortisolconce

4、ntrations(salivaandplasma)andMSCR(momingsalivarycortisolrise)ofthethreegroupswerecompared．MSCR=15minutessalivarycortisol—salivarycortisolafterawakening．5重庆医科大学硕士研究生学位论文Results：1)MSCRintheT2DMgroupwassignificantlylowerthanthatinthenormalcontrolgroup(P<0．05)，andtherewasnosignificantdifferencebe

5、tweentheIGRgroupandthenormalcontrolgroup．2)Thereweresignificantdifferencesofplasmacortisolat8amamongthethreegroups(P<0．01)，andthatintheIGRgroupWasthehighest，theT2DMgroupwasthenextandthenormalcontrolgroupwasthelowest．3、StepwiseregressionanalysisindicatedageandHOMA-IRhadsignificantassociationsw

6、itIlMSCR．Conclusion：T2DMpatientshavealteredregulationoftheHPAaxis．TheHPAdysfunctioninT2DMisasfollows：1)MSCRis10werthanthatinthenormalcontrolgroup．2、Plasmacortisolat8amishigherthanthatinthenormalcontrolgroup．Keywords：Type2Diabetesmellitus，Cortisol，Saliva,Hypothalamic—pituitary—adrenal(HPA)axis

7、6重庆医科大学硕士研究生学位论文2型糖尿病患者下丘脑一垂体一肾上腺轴的功能研究肿置2型糖尿病是糖尿病的主要类型，约占95％，其病因及发病机制不十分清楚，现一般认为是具有强烈的遗传易感性或为多遗传异质性疾病，胰岛素抵抗与胰岛素分泌缺陷(包括两者的相互作用)是2型糖尿病发病机制的两个基本环节和特征【lJ。胰岛素抵抗的原因是多方面的，升血糖激素的不恰当分泌可能是其原因之一吲，如生长激素、胰高血糖素、儿茶酚胺及皮质醇等胰岛素拮抗激素的升高均可导致胰岛素抵抗。近年来有许多有关糖尿病患者皮质