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目的探讨女性Ⅱ型糖尿病患者绝经后血清性激素水平及其与糖脂代谢的相关性。方法选择温州医科大学附属黄岩医院2014年6月-2015年6月收治的绝经后Ⅱ型糖尿病患者100例作为糖尿病组,同期健康绝经女性100例作为对照组,糖尿病组根据胰岛素抵抗指数分为胰岛素抵抗组和非胰岛素抵抗组。测定两组患者空腹血糖、空腹胰岛素、糖化血红蛋白(GHb)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)、睾酮(T)、雌二醇(E2)、孕激素、垂体泌乳素(PRL)、促黄体生成素(LH)、促卵泡刺激素(FSH)水平。结果糖尿病组患者空腹血糖、空腹胰岛素、GHb、T、PRL、LDL-C和TC均高于对照组(P<0.05),HDL-C、E2、LH、FSH均低于对照组(P<0.05)。胰岛素抵抗组空腹血糖、空腹胰岛素、GHb高于非胰岛素抵抗组(P<0.05),胰岛素抵抗组HDL-C、TG、E2水平低于非胰岛素抵抗组(P<0.05)。糖尿病患者中E2水平与空腹胰岛素呈负相关(P<0.05),PRL与HDL-C呈正相关(P<0.05)。结论女性绝经后Ⅱ型糖尿病患者存在性激素水平和糖脂代谢异常,性激素水平异常和胰岛素抵抗及脂代谢异常有一定关系。
Objective To investigate the relationship between serum sex hormone levels and glucose and lipid metabolism in postmenopausal women with type Ⅱ diabetes mellitus. Methods 100 cases of type Ⅱ diabetes mellitus were treated in Huangyan Hospital Affiliated to Wenzhou Medical University from June 2014 to June 2015 as diabetes mellitus group and 100 healthy menopausal women as control group. Diabetes mellitus patients were divided into three groups according to insulin resistance index: insulin Resistance group and non-insulin resistance group. Fasting blood glucose, fasting insulin, glycosylated hemoglobin (GHb), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC) , Testosterone (T), estradiol (E2), progestin, pituitary prolactin (PRL), luteinizing hormone (LH) and follicle stimulating hormone (FSH). Results The levels of fasting blood glucose, fasting insulin, GHb, T, PRL, LDL-C and TC in diabetic group were significantly higher than those in control group (P <0.05) ). Fasting blood glucose, fasting insulin and GHb in insulin resistance group were higher than those in non-insulin resistance group (P <0.05). HDL-C, TG and E2 levels in insulin resistance group were lower than those in non-insulin resistance group (P <0.05). The level of E2 in diabetic patients was negatively correlated with fasting insulin (P <0.05), while the level of serum HDL-C was positively correlated with PRL (P <0.05). Conclusions Female patients with type 2 diabetes mellitus have abnormal sex hormone levels, abnormal glucose and lipid metabolism, abnormal sex hormone levels, and insulin resistance and abnormal lipid metabolism.