Study of the diurnal rhythm of cortisol secretion and insulin resistance in the type 2 diabetes mellitus patients with depression
10.3760/cma.j.issn.1008-6315.2015.10.008
- VernacularTitle:2型糖尿病并发抑郁患者血浆皮质醇分泌节律和胰岛素抵抗的研究
- Author:
Qiurong YU
;
Fei YAO
;
Zhong YANG
- Publication Type:Journal Article
- Keywords:
Type 2 Diabetes mellitus;
Depression;
Cortisol;
Adrenocorticotropin;
Rhythm of cortisol secretion;
Insulin resistance
- From:
Clinical Medicine of China
2015;31(10):890-894
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the changes of the diurnal rhythm of cortisol secretion and insulin resistance of the type 2 diabetes mellitus(T2DM) patients with depression.Methods The 216 cases outpatient and inpatientof Department of Endocrinology of the Second People's Hospital Changshou, Clinical Psychology of City Mental Health Center of Changshou ,were divided into depression without T2DM group(D group,44 cases), T2DM without depression group(DM group, 124 cases) and the T2DM with depression group(DM-D group,48 cases).And 40 healthy people were from the medical center and as the normal control(NC) group.The levels of fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), Fins, fasting C peptide (FC-P), rhythm in cortisol(Cor) secretion at 3 time points (8:00, 16:00,24:00) and plasma adrenocorticotropin(ACTH) were detected for studies.Results Compared with the D group, DM group and NC group, there were increases of FPG,HbA1c,insulin resistance index (HOMA-IR) in the DM-D group ((11.51 ±2.05) vs.(5.18 ±0.22), (9.47±3.46), (5.11±0.25) mmol/L;(10.28±2.12)％ vs.(5.36±0.34)％, (8.89±2.21)％, (5.53 ±0.32) ％;3.78± 1.08 vs.1.58 ± 0.21,2.70 ± 1.54, 1.14 ± 0.24).Plasma cortisol levels and ACTH levels at time points of 8:00,16:00 in the DM-D group were higher than the group D, DM group and NC group, while insulin sensitivity index(ISI) in the DM-D group was lower than the D group,DM group and NC group (-4.41 ±0.27 vs.-3.57±0.13,-3.92±0.60,-3.22±0.22) ,and the differences were significant (P＜0.05).The loss of normal diurnal rhythm of cortisol secretion were significantly more often inDM-D group than in D group and in DM group(77.1％ vs.50.0％ ,47.6％ ,P＜0.05).The multiple stepwise regression analysis showed that 8:00 Cor and ISI were the related factors for the Hamilton Depression Scale (HAMD) score(95％CI:2.355-3.867, -7.903-2.780,P＜0.001).Logistic regression analysis showed that the level of 8:00 Cor was significant risk factor of the T2DM patients with depression(OR=3.024,95％CI: 1.613-5.668,P=0.002).Conclusion The T2DM patients with depression have higher plasma cortisol level, more abnormal rhythm of cortisol secretion and higher level of insulin resistance.The high level of plasma corfisol maybe significantly related to depression in T2DM patients.
