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目的:探讨绝经后Ⅱ型糖尿病患者雌激素水平的改变与糖尿病、高血压、血脂异常等代谢疾病之间的关系。方法:选取2012年1月~2013年1月间在该院内分泌科住院治疗的绝经后Ⅱ型糖尿病患者82例,分为单纯糖尿病组(A组)51例、合并高血压组(B组)31例;选取同期来该院体检中心进行常规体检的健康绝经后女性40例为对照组(C组),对比三组患者间相关生化指标。结果:A、B两组除雌二醇(E2)外各生化指标均高于C组,E2低于C组,差异均有统计学意义(P<0.05);B组与A组相比,空腹胰岛素(FINS)、胰岛素低抗指数(HOMA-IR)显著偏高,差异有统计学意义(P<0.01)。A组中HOMA-IR与总胆固醇(TC)、FINS、低密度脂蛋白(LDL-C)之间呈正相关(P<0.05),E2与HOMA-IR、FINS、TC、甘油三酯(TG)和LDL-C之间呈负相关(P<0.05)。B组中HOMA-IR与FINS之间呈正相关(P<0.01),E2与HOMAIR、收缩压(SBP)、FINS之间呈负相关,与高密度脂蛋白(HDL-C)呈正相关(P<0.05)。结论:绝经后雌激素减少与糖尿病、高血压、血脂异常等代谢疾病密切相关,雌激素替代疗法对于绝经Ⅱ型糖尿病患者病情的控制及并发症的预防能够起到良好的效果。
Objective: To investigate the relationship between estrogen levels and diabetes, hypertension, dyslipidemia and other metabolic diseases in postmenopausal type. Methods: From January 2012 to January 2013, 82 patients with postmenopausal type 2 diabetes mellitus admitted to Department of Endocrinology of our hospital from January 2012 to January 2013 were divided into simple diabetic group (group A), 51 patients with hypertension group (group B) 31 cases were selected; 40 healthy postmenopausal women with routine physical examinations during the same period as the control group (C group) were selected to compare the biochemical indicators among the three groups. Results: The biochemical indexes except estradiol (E2) in group A and group B were higher than those in group C and E2 were lower than those in group C (P <0.05). Compared with group A, FINS and HOMA-IR were significantly higher (P <0.01). There was a positive correlation between HOMA-IR and total cholesterol (TC), FINS and LDL-C (P <0.05), E2 and HOMA-IR, FINS, TC, triglyceride (TG) And LDL-C was negatively correlated (P <0.05). There was a positive correlation between HOMA-IR and FINS (P <0.01), E2 and HOMAIR, SBP and FINS in group B, but negatively correlated with HDL-C (P < 0.05). Conclusion: The decrease of postmenopausal estrogen is closely related to the metabolic diseases such as diabetes, hypertension and dyslipidemia. Estrogen replacement therapy can play a good effect on the control of the disease and the prevention of complications in menopausal type.