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目的研究绝经后妇女2型糖尿病(T2DM)患者性激素与胰岛素抵抗的关系。方法 809例绝经后健康妇女为对照组,812例绝经后妇女T2DM患者为观察组,测雌二醇(E2)、孕酮(P)、睾酮(T)、催乳素(PRL)、黄体生成素(LH)、促卵泡激素(FSH)、E/T、空腹血糖(FBG)、餐后2 h血糖(2hPG)、空腹血清胰岛素(FINS)、糖化血红蛋白(HbA1c),计算稳态模型胰岛素抵抗指数(HOMA-IR),根据HOMA-IR水平分胰岛素抵抗组(>1,IR组)与无胰岛素抵抗组(<1,Non-IR组),研究绝经后妇女T2DM患者血清性激素水平与胰岛素抵抗的关系。结果与对照组比较,观察组患者E2、PRL、LH、FSH、E/T比值水平明显降低,FBG、2hPG、FINS、HbA1c、HOMA-IR、体质量指数水平明显上升;与Non-IR组比较,IR组患者BMI明显增加,E2、E/T比值水平明显降低,差异有统计学意义。结论绝经后妇女T2DM患者性激素严重紊乱,与胰岛素抵抗有关,绝经后妇女T2DM患者临床诊治要关注性激素水平,对性激素紊乱采取必要干预措施,防止、延缓并发症发生。
Objective To study the relationship between sex hormones and insulin resistance in type 2 diabetes mellitus (T2DM) in postmenopausal women. Methods 809 postmenopausal healthy women as control group and 812 postmenopausal women with T2DM as observation group. The levels of serum estradiol (E2), progesterone (P), testosterone (T), prolactin (PRL), luteinizing hormone FSH, E / T, FBG, 2hPG, FINS and HbA1c were measured to calculate the insulin resistance index (HOMA-IR). According to HOMA-IR level insulin resistance group (> 1, IR group) and no insulin resistance group (<1, Non-IR group), the level of serum sex hormone and insulin resistance in postmenopausal women with T2DM relationship. Results Compared with the control group, the levels of E2, PRL, LH, FSH and E / T in the observation group were significantly decreased, and the levels of FBG, 2hPG, FINS, HbA1c, HOMA-IR and body mass index increased significantly , BMI in IR group increased significantly, E2, E / T ratio decreased significantly, the difference was statistically significant. Conclusions In postmenopausal women with T2DM, the sex hormones are seriously disturbed and related to insulin resistance. The clinical diagnosis and treatment of T2DM in postmenopausal women should pay attention to the levels of sex hormones and take the necessary interventions to prevent and delay the occurrence of complications.