Relationship Between Cortisol Levels And Blood Glucose,Blood Pressure And Blood Lipids In T2DM Obese Patients

Objectives To investigate the relationship between obesity and blood cortisol in patients with type 2 diabetes mellitus,the correlation between cortisol levels and blood glucose,blood pressure,blood lipids was further explored,and to provide evidence for prevention and treatment of obesity in patients with T2 DM.Methods 146 patients with type 2 diabetes mellitus were enrolled in the Department of Endocrinology Affiliated Hospital of North China University of Science and Technology,Among them,75 males and 71 females were aged from 29 to 79 years old,and the average age was(58.32±11.24).All patients were diagnosed according to the T2 DM standard established by WHO in 1999.They were divided into two groups according to body mass index: the non obesity group(BMI<25)0f 64 cases,including 30 male cases and 34 female cases;the obesity group(BMI≥25)of 82 cases,including 45 male cases and 37 female cases.To compare the two groups of patients with gender,age,course of disease,systolic blood pressure(SDP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),glycosylated hemoglobin(Hb A1c),insulin resistance index(HOMA-IR),blood lipid,Blood cortisol and Diabetes complications.All data were recorded in Excel,and SPSS 17.0 was used to analyze the data.Normal distribution of measurement data were used by mean ± standard deviation(x ±s).The two groups were compared with independent samples t-test;count data using chi-square test;correlation using Pearson correlation analysis,and calculating the correlation coefficient.Multiple linear regression analysis was used to analyze the related factors of BMI in patients with T2 DM.putting significant indicators by t-test and chi-square test into noconditional logistic regression analysis was used to analyze the risk factors of obesity in T2 DM patients.P< 0.05 was considered statistically significant.Results Two groups by chi-square test showed no difference in gender composition(P> 0.05);t-test showed that there was no significant difference in the age,course of disease between the two groups(P>0.05).Hb A1 c of the obesity group was higher than that of the non obesity group,the difference was statistically significant(P<0.05);TG and LDLC of the obesity group were higher than those in non obesity group,the difference was statistically significant(P<0.05);8:00 systolic blood pressure and diastolic blood pressure of the obesity group were higher than those of the non obesity group,and there were statistically significant differences(P<0.05).The number of patients with hypertension and coronary heart disease in the obesity group was significantly higher than that in the non obesity group by chi square test(P<0.05).The 24:00 cortisol level in the obesity group was higher than that in the non obesity group,and the difference was statistically significant(P<0.05);The number of patients with high cortisol in the obesity group was significantly higher than that in the non obesity group,and the difference was statistically significant(P<0.05).Taken BMI level as the dependent variable,the above significant indicators were included in the multiple linear regression analysis,and the results showed that: 24:00 cortisol,8:00 systolic blood pressure,TG with BMI were positively correlated(P<0.05).Taken statistically significant indicators by t-test and chi-square test as independent variables,taken whether diabetic patients obesity or not as the dependent variable,the non conditional logistic regression analysis showed that high cortisol(OR=3.250),hypertension(OR=6.776),TG(OR=1.907)were risk factors of T2 DM obesity.Pearson correlation analysis showed that blood pressure and cortisol were positively related at 8:00 and 16:00,and 24:00 cortisol was positively related to blood pressure at 8:00,and the difference was significant(P<0.05).Fasting plasma glucose was positively related to the cortisol levels of 8:00 and 24:00(P < 0.05).There was a positive correlation between pre dinner blood glucose and 16:00 cortisol levels(P<0.05).24:00 cortisol was negatively correlated with HDL-C(P<0.05).Conclusions 1)The cortisol levels in T2 DM obesity patients significantly increased at midnight 24:00.2)Increased risk of obesity in T2 DM patients when cortisol levels were elevated.3)Cortisol levels were related to blood glucose,blood pressure and blood lipid.