Type 2 Diabetes Patients Serum Cortisol Levels Of Change With Insulin Resistance And Clinical Analysis

Objective 1 .To explore the change of the plasma cortisol levels in patients with type 2 diabetes, and with which the insulin resistance is correlated.2. to analyse the correlation of cortisol and metabolic indices ;3. to analyse whether there is correlation between the cortisol and diabetes, complications.Methods 107 patients with type 2 diabetes was collected in endocrine division of our hospital from april 2009 to January 2010, and divided into two groups:diabetes without complication(51) and diabetes with chronic complications (56 ), All participants are extracted cubits bloods on fasting in the morning, determinate fasting plasma glucose (FPG) and postprandial glucose (2HPG 2h, triglycerides (TG), total cholesterol (TC), hemoglobin a1c (HbA1c), insulin, index inspection above are determined in our laboratory. Calculate insulin resistance index according to homa-ir calculated. cubits venous was extracted on 8a.m and 4 p.m. respectively to determinate cortisol (F) ,witch was analysed by Radioimmunoassay (RIA), and measure the height, weight, and calculate body mass index (BMI), measure The waist, hip circumference, compute waist-hip ratio. 31 physical health are set up as normal control group, who have not family history of diabetes.Results 1. There is statistical significance(P < 0.05) in FPG merger, 2HPG, TC and TG, insulin resistance index, cortisol in 8 am and 4 p.m. and WHR between the group of Type 2 diabetes without complications and the normal control group , between the group type 2 diabetes with chronic complications.all the index above in both groups is higher significantly than the normal control group. 2. There is statistical significance(P < 0.05). in plasma cortisol 8 am and 4 p.m. WHR, TG HbA1c, insulin resistance index between the group of Type 2 diabetes with chronic complications and the group without.All the index above was higher in former group than later.there is positive correlation between cortisol at 8:00am and FPG HbA1c, TC and TG, BMI, WHR, insulin resistance index,.The above relating factors was analysed by multiple stepwise regression, insulin resistance index, FPG enter aregression equation and have a close correlation. 3. There is positive correlation between cortisol at 8am and FPG,HbA1c, TC, TG, BMI, WHR, insulin resistance index in the group of Type 2 diabetes without chronic complications. The above relating factors was analysed by multiple stepwise regression, insulin resistance index, FPG enter aregression equation and have a close correlation.Conclusions 1. Type 2 diabetes sufferers appear a certain degree of HPA axis function disorder, mainly the cortisol at 8am and 4 p.m is increased evidently and there is disorders of the circadian cortisol secretion. The cortisol secretion at 4pm is fifty percentage more than at 8am. 2.Probabily the increasement of plasma cortisol which occurs in groups of Type 2 diabetes with chronic complications and without is closely related to insulin resistance. 3. The cortisol at 8:00am, and 4pm is significantly higher in group of Type 2 diabetes with chronic complications than in the group without., probabily the increasement of plasma cortisol is related to the Chronic complications of diabetes mellitus .4. It may has a degree clinical significance to control the sugar control of T2DM patients through suppressing or reducing increased F ,which has effect on T2DM patients .