| Objective: To set up the reference interval of salivary cortisol at different collecting time of 8:00,16:00,0:00 of northeast Sichuan area. Study on the change of salivary cortisol、plasma cortisol in patients with type 2 diabetes mellitus and factors affecting the cortisol. Evaluate the correlation between SC and PC and discuss SC instead of PC to be a line of the clinical value of screening indicators. To explore whether hot pot had effect on the secretion of SC and PC.Methods: 60 healthy volunteers were recruited as normal subjects, 65 endocrinology patients with type2 diabetes mellitus(diagnosis accord with the WHO diagnostic criteria in 1999) in our hospital were recruited as disease control group,31 people were recruited voluntarily from normal subjects to eat hot pat. Saliva and blood samples were collected at 08:00,16:00,00:00. Salivary cortisol of eating hot pot group were collected at 00:00,08:00 and blood of eating hot pot group were collected at08:00.Salivary cortisol and plasma cortisol were detected by Electrochemiluminescence immunoassay. We measured fasting blood glucose(FBG), plasma lipid( including TC,TG,LDL-C,HDL-C), Hb A1 C,Hcy, hs-CRP of type2 diabetes and normal group on empty stomach. To analyzing the change of the cortisol levels in patients with type2 diabetes and the correlation between the clinical indicators. To explore the cortisol whether there is a change after eating the hot pat.Results:1. The results of salivary cortisol in normal group at 08:00,16:00,00:00 were(0.1807±0.07013)ug/d L,(0.0600±0.00475)ug/d L,(0.0310±0.00236) ug/d L,The results of plasma cortisol in normal group at 08:00,16:00,00:00 were(13.4452±0.45730)ug/d L(6.2803±0.31455)ug/d L,(2.1273±0.18304)ug/d L; The results of salivary cortisol in type2 diabetes at 08:00,16:00,00:00 were(0.4766±0.02286)ug/d L,(0.1551±0.01115)ug/d L,(0.1472±0.01157)ug/d L, The results of plasma cortisol in type2 diabetes at 08:00,16:00,00:00 were(16.5577±0.46403)ug/d L,(9.3586±0.50970)ug/d L,(5.1422±0.51391)ug/d L.2. In normal group and type2 diabetes group, salivary cortisol and plasma cortisol at the same time were at good correlation, and has significant linear correlation with r values were(r=0.554,r=0.481,r=0.671,P<0.01 the normal group),(r=0.635,r=0.621,r=0.671,P<0.01 the type2 diabetes group).3. Electrochemical immune luminescence method in northeast Sichuan saliva cortisol 95% reference range for normal adults at 08:00,16:00,00:00 were 0.0432-0.3182ug/d L、0.0507-0.0693 ug/d L、0.0264-0.0356 ug/d L。4. Salivary cortisol and plasma cortisol of type2 diabetes group were higher than the normal control group. The higher plasma cortisol and salivary cortisol concentrations were positively associated with Hb A1C、TG、TC、LDL-C、FBG. And FBG is the strongest factor associated with plasma cortisol and salivary cortisol.5. The patients of T2 DM display abnormal circadian rhythms of cortisol secretion.6. The PC and SC levels after eating hot pot were higher than before eating it.After eating hot pot,the PC values of 08:00 on the second day were significantly increased compared with the PC values of 08:00 of the day before.In addition, there was no significant difference in SC value between 08:00 and 00:00 before and after eating hot pot.Conclusions:1. Salivary cortisol and plasma cortisol at the same collecting time were in significant correlation. It can consider to set up our laboratory saliva cortisol normal reference range. Using the method of determination of salivary cortisol concentration instead of plasma cortisol as a line of screening related diseases diagnosis index.2. The cortisol level in type 2 diabetic group was higher than that in normal control group, and there was a disturbance in the circadian rhythm of cortisol secretion in some patients with type 2 diabetes. Speculated that type 2 diabetes occurrence may be associated with high levels of cortisol, there may be due to type 2 diabetes patients with long-term high blood glucose damage the hypothalamic pituitary adrenal axis(HPA) axis of normal function, caused by cortisol secreting rhythm disturbance, cortisol and glucose, lipid metabolism have certain correlation.3. Hot pot may affect the secretion of cortisol, suggesting not to eat it before the determination of cortisol. |
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