| Aldosterone is the most effective mineralocorticoid ,it is secretory by adrenal cortex zona glomerulosa. Now it is proved that cerebral, blood vessel, cardiac can Synthetic aldosterone, and play an important part. Aldosterone is more and more important for human body, people also pay more attention to it. In the study regional of diabetes, it becomes a new hotspot these years.In recent years, the diabetes incident decrease sharply, it has becomed the third killer for harm human health, it is chronic non-communicable diseases which harmful to the public. In the people of diabetes, type 2 diabetes mellitus is over 95%, and the most two important attack process of type 2 is insulin resistance and insulin B secretory cut. So study and explore the relevant factors between them has important significance.In this study, we use radioimmunity method measure the level of aldosterone, study the relationship between insulin B secret function and insulin resistance.1. Research goals:To explore the relationship between adrenal glands mineralocorticoid aldosterone with diabetes insulin resistance and secretion function of insulin B cell.2. Method:2.1 General data2.1.1 source: the patients are type 2 diabetes mellitus which hospitalization from Jan 2005 to Jun 2006, all of them are according to WHO diabetes diagnose standards; sum to 71cases in all, All patients curing with insulinize, 25 cases for regular insulin (animal insulin) therapy, 46 cases for recombination human insulin therapy. Age of 50.25±26.01; among them, male for 41cases, female for 30cases; disease course of 1—5years for 30cases,male for 21cases, female for 9 cases; disease course of 6～15 years for 11 cases, male for 6 cases, female for 5 cases; disease course over 16 years for 30 cases, male for 17 cases, female for 13 cases; body weight index MBI>25 for 39 cases; body weight index MBI＜25 for 32 cases; control group is normal healthy people 30 cases, age of 46±13; male for 19 cases, female for 11 cases; body weight index, MBI>25 for 19cases; body weight index, MBI＜25 for 11 cases.2.1.2 Diagnosis standards: type 2 diabetes mellitus (china 1999 new standards);2.13 Determination standards for insulin resistance: use therecognition HOWA formula to calculate insulin resistance index(HOWA-IR): HOWA-ER=fasting plasma glucose X fasting insulin/22.5. According to the report from Wenying—Yang, HOWA-IR≥2.69 as the "insulin resistance" standards. 2.1.4 body weight index (MBI) express by kg/m~2. (standards: policy group for WHO asia -pacificring type 2 diabetes mellitus, the third edition of 2003) .2.2 Analysis method: competitive radioimmunity (kit)2.2.1 Determine the level of aldosterone: general diet for trial person; lying: before get up (6:00-8:00 am), extract the venous blood.2.2.2 Measure the secretory level of islet cells B C- peptide:2.2.3 Measure the insulin secretory function:Measure the secretory level of islet cells B C- peptide and the insulin secretory function: all of the object, in need of oral glucose 75g, blood was taken in 0,60,120,180min respectively, serum should be measured at serum fasting,60,120,180min respectively and the level of insulin.2.3 Statistical method: the express method for measurement data use equal count±standard deviation (X±S), equal count between the two groups was compared with t-test. Consider P<0.05 exist statistics diversity.3 Result3.1 The course of diseases about diabetics Attack course according to the actual diagnose for diabetes, arrangement with different age and course of diseases, cases were observed, to explain the relationship between age and course of diseases.In the early attack of diabetes (≤5years) patients for 30 cases, late stage (≥16years) patients for 30 cases, 6—15years for 11cases in all.3.2 The relationship between C- peptide Secretory and diabetes mellitus courseIn the early attack of diabetes, C- peptide increased, Secretory decrease in late stage.Statistical analysis, variance homogeneity test,; Diabetes course≤5years, 2h,3h C- peptide cost compare with control groups, 2h, t =3.06; 3h, t' =16.15, P<0.01, both of them had significant difference.During early days , C- peptide increased notability.33 The relationship between insulin secretion and diabetes courseDuring different course,diabetes scretory different level of insulin,in the early time,insulin scretory high level, late stage the level decline.The same change with C- peptide. Insulin level≤5 years compare with≥16 years, t ' = 10.16 , P < 0.01; had significant difference.This proved that the insulin level was obviously high in the level of the insulin of later period in early days ;Insulin level course of illness≤5years 3h ,compare with control group, t' =5.649, P < 0.01,there is significant difference. Hint type2 diabetes insulins secrete to delay.3.4 The relationship between insulin resists and the diabetes course of illnessDiabetes Mellitus during different stage, Insulin sensitive index is more than diagnose standards (HOWA-IR≥2.68); this proved that duri- ng different course, exist insulin resistance, further more, the insulin resisted severity in early days. This also hints to have something to do with "dawn phenomenon" of the diabetes. The diabetic start som etim es appearing high blood sugar in the dawn, Keep on no- on 8-9:00, this named " dawn phenomenon ". The reason generally thought the anti- hormone level to increase insi de body, at that time segment at the right moment with aldo sterone scretory high level, aldosterone may be one of the important factors which results in " dawn phenom- en- on".3.5 The relationship between aldosterone and insulin,C-peptide,insulin resistanceObserve the relationship between aldosterone and insulin level and C-peptide level, the aldosterone level of earlier period to increase high, insulin level increased ,too; At the later period the aldosterone and insulin level decreased, DM course≤5years ALD compare with control groups, t' =4.542, P<0.01, has significant difference, DM course≤5yearsFC-P compared with control groups, t =12.88, P<0.01, has significant difference. DM course≤5years compared with≥16years ALD control groups, t' =10. 51; P<0.01, has significant difference; relativity analysis manifestation aldosterone and insulin secrete to have a highly related matched control, r =-0.529; P<0.01 ; this proved that aldosterone and insulin level increased all and obviously in early days.We can consider that it is relate to aldosterone anta gonism.3.6 The relationship between aldosterone and sugar content of bloodThere are some relate between aldosterone and sugar content of blood. The patient after cures, aldosterone and sugar content of blood increase.By chi square test, attack year<5years ALD, abnormal is higher than >16 years , statistics significant difference, P<0.01 After curing ALD decreased, t' =7.599 , p<0. 01, statistics significant difference. Adosterone and blood sugar variety have certain relativity.3.7 The relationship between aldosterone and weight index number, insulin resistsThe weight index number is the measurement of the content of the diabetic fat and a kind of method of the valuation.CMA diabe tology branch advice BMI With 24 and 28 is the diagnosis partition of excess and obese orders. The result expresses that Weight excess or the sufferer of obese not only the insulin level is high, aldosterone also had high level,the insulin holdout index number also increases obviously. The anti- level of the relativity analysis manifestation aldosterone variety and insulin has height related. Aldosterone has positive correlation with anti- insulin, r =0.4570 P<0.01. Diabetes set With normal set comparison, P<0.01, significant difference.4. Conclusion4.1 radioimmunity analysis method mensurate aldosteron level and islandβcell to secrete function.study the relation of type 2 diabetes mellitus and insulin secrete. Results show that, The earlier period aldosteron level been increases in the diabetes, aldosteron level decrease at late time, relativity analysis manifestation that aldosteron level have height related with isletβSecretory function.4.2 Results show that, no matter attack early days or late stage, Insulin sensitivity the index number is all big the standard is in the diagnosis, different stage of the being tak en bad of diabetes all exists anti- insulin, And the insulin re sisted severity in early days. Weight excess or the sufferer of obese, aldosteron and insulin level heighten. Insulin resista nce index increase ,too. Further proved aldo steron resists a medium function in the insulin. Positive cor relation.4.3 The aldosteron secretes quantity to descend obvi ously at the diabetes later period; The insulin secretes level also descend. Indicate that aldosteron and isletβSecretory function descend. It has statistics meaning.4.4 There are some relationship between aldosterone and blood glucose. At high blood sugar, aldosterone level inc rease,but after curing by insulin, Blood sugar control at no rmal category, aldosterone level also decrease,≤5years compare with before and after ,has significant differenc e This prove the correlation between aldosterone and blood glucose change.4.5 The diabetic start sometimes appearing high blo- od sugar in the dawn, Keep on noon 8-9:00,this named "dawn phenomenon". The reason generally thought the anti- hormone level to increase inside body, at that time segment at the right moment with aldosterone scret ory high level, aldosterone may be one of the important factors which results in "dawn phenomenon".4.6 This topic measuresed the relation between the ald osterone and insulin antibody, Have no detection to there is statistics meaning. This proved that aldosterone participates insulin resistance function, and it is independent with antib odies producted by insulin. |
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