绝经后女性2型糖尿病患者性激素变化与胰岛素抵抗的关系

摘要

Objective to study the changes of sex hormone in postmenopausal women with type-2 diabetes mellitus and the relationship between sex hormones and insulin resistance.Methods 32 postmenopausal women with type-2 diabetes mellitus(group Ⅰ,57.8±3.7 years);25 postmenopausal women without diabetes mellitus(groupⅡ,58.3±3.2years) and 22 premenopausal women without diabetes mellitus as control(groupⅢ,40.9±2.6years) were selected to compare the serum Levels of estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T).plasma glucose(G),insulin (INS) and insulin sensistivity index (ISI).Results Analysis of variance demonstrated that menopause was associated with significantly higher serum levels of FSH,LH,T and lower serum levels of E2.Correelation analysis showed that serum E2 level was negatively correlated to serum of FSH,LH,T,INS(-0.51、-0.49、-0.58、-0.38.p＜0.01)，but positively associated with ISI(0.45,P＜0.01)。Conclusion The study indicates that significantly lower level of estradiol,high level of testosterone and imbalance sex hormones and insulin resistance play an important role in the development of type-2 diabetes mellitus.%目的　为探讨绝经后女性2型糠尿病患者性激素水平变化及与胰岛素抵抗的关系。方法　对32例绝经1年以上女性2型糖尿病患者(Ⅰ组，平均年龄57.8±3.7岁)、25例绝经1年以上无糖尿病健康妇女(Ⅱ组，平均年龄58.3±3.2岁)及22例无糖尿病的健康育龄行经妇女(Ⅲ组，平均年龄40.9±2.6岁)的血清雌二醇(E2)、促卵泡剌激素(FSH)、促黄体生成素(LH)、睾酮(T)、血浆葡萄糖(G)、血浆胰岛素(INS)及胰岛素敏感指数(ISI)进行检测。结果　Ⅰ组E2水平较Ⅱ、Ⅲ组明显降低，FSH、LH、T水平显著增高。线性相关分析发现，E2与FSH、LH、T、INS呈显著负相关，而E2与ISI呈显著正相关，总体相关系数分别为-0.51、-0.49、-0.58、-0.38、0.45(P值均＜0.01)。结论　绝经后女性2型糖尿病患者存在严重的性激素失调，且与胰岛素抵抗并存，可能参与绝经后女性2型糖尿病的发生和发展。