Title: Clinical Significance of the Hypothalamic-Pituitary-Adrenal Axis Abnormalities in Patients with Type 2 Diabetes Mellitus
Abstract: Objective The purpose of the study is to look into the clinical significance of hypothalamo-pituitary-adrenal(HPA) axis abnormalities in patients with type 2 diabetes mellitus.Methods Oral glucose tolerance test(OGTT) was performed in 127 type 2 diabetic patients with the insulin index(ISI),homeostatic model assessment-insulin resistance(HOMA-IR),area under the curve of glucose(AUCG) and insulin(AUCI) calculated.At the same time,plasma cortisol,urinary cortisol,and plasma ACTH were detected in these patients with the results compared with those of 65 non-diabetic controls.Results(1)The prevalence of HPA axis abnormalities were 22.8%(29/127) in patients with type 2 diabetes mellitus and 10.8%(7/65) in normal controls.Indices of HPA axis function including plasma cortisol at 8:00 and at 16:00,daily average plasma cortisol and urinary free cortisol were higher in patients with type 2 diabetes than in controls(P0.05).(2)Diabetic patients with HPA axis abnormalities displayed higher fasting plasma glucose(FPG),2 h-postprandial plasma glucose(2 h PPG) and AUCG than patients without HPA axis abnormalities(P0.05).After adjusted for sex,age,BMI and waist circumference,FPG,2 h PPG and AUCG were shown to be positively correlated with plasma and urinary cortisol levels(P0.05).Multiariate stepwise regression analysis showed that AUCG was among the independent related factors of plasma cortisol at 8:00 and at 16:00 and daily average cortisol;2 h PPG was among the independent related factors of plasma cortisol at 24:00 and urinary free cortisol.Conclusion Our study indicates that patients with type 2 diabetes mellitus exhibit a significantly higher prevalence of HPA axis abnormalities.Glucose elevation and HPA axis abnormalities are reciprocal causations in patients with type 2 diabetes mellitus.
Publication Year: 2011
Publication Date: 2011-01-01
Language: en
Type: article
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