Objective To study the characteristics of diurnal rhythm of cortisol secretion in depression patients with diabetes. Methods Two groups including depressed patients with newly diagnosed diabetes (case group, n = 30 ), depressed patients with normal glucose metabolism (control group, n = 30 ), undertook the assessment of rhythm in cortisol secretion at 3 time point ( 8:00,16:00,24:00 ) and fasting plasma glucose,2h plasma glucose after 75g glucose loading measurement before administration. Results It was showed that the plasma cortisol levels in test group at time point of 8:00, 16:00, 24:00 were significantly higher than those in control group [ ( 607 ± 269 ) nmol/L vs (485 ± 178 ) nmol/L; (416 ± 178 ) nmol/L vs ( 290 ± 154 ) nmol/L; ( 376 ±264)nmol/L vs (173 ± l 17) nmol/L; all P ＜0.05 ]. The loss of normal diurnal rhythm of cortisol secretion were significantly more often in case group than in control group ( 73.3％ vs 46.7％, P ＜0. 05 ). Plasma cortisol levels at 8:00, 24:00 were positively correlated with fasting plasma glucose in test group ( r = 0. 338, 0.418; both P ＜0.05). Conclusion Depressed patients with diabetes have higher plasma and abnormal rhythm of cortisol secretion cases. This may play a very important role in the pathomechanism of diabetes in depression.%目的 探讨同时伴有糖尿病的抑郁症患者皮质醇分泌节律的特点,及其在抑郁症患者所发生的糖尿病病理机制中的意义.方法 确诊糖尿病的抑郁症30例(观察组)测定8:00、16:00、24:00血浆皮质醇浓度,同时测定空腹血糖、糖负荷后2h血糖,并与正常糖代谢的抑郁症30例(对照组)进行对照.结果 ①观察组8:00、16:00、24:00血浆皮质醇浓度分别为(607±269)nmol/L、(416±178)nmol/L、(376±264)nmol/L,显著高于对照组(485±178)nmol/ L、(290±154)nmol/ L、(173±117)nmol/L,差异有统计学意义(P均＜0.05)0②观察组皮质醇分泌节律消失者为73.3%,显著高于对照组的46.7%(P＜0.05).③观察组8:00、24:00的血浆皮质醇浓度与空腹血糖值正相关(r值分别为0.338、0.418,P＜0.05).结论 下丘脑-垂体-肾上腺轴功能紊乱可能是抑郁患者产生糖尿病的重要机制之
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