Analysis Of Serum Cortisol And Ferritin In TCM Syndromes Of Type2Diabetes Mellitus And Its Relative Risk Factors

Objective:To study the inner relationship between serum cortisol, ferritin and Tradition Chinese Medecine (TCM) syndromes of type2diabetes mellitus and its relative factors. To investigate the association of serum cortisol, ferritin and insulin resistance (IR), pancreatic islet β cell function and other correlation factors.Methods:Take the case control study. From April1st to September30th, collect107patients with type2diabetes mellitus in endocrine division of the Affiliated Hospital of Nanjing University of Chinese Medicine.At the same time, collect the healthy persons which do not have diabetes as normal control group. The serum cortisol, ferritin were measured in all persons. Accoding to the TCM symptoms diagnostic code,107type2diabetes patients were divided as3groups:Yin-deficiency with Heat-excess type38cases, Qi-Yin both deficiency type51cases and Yin-Yang both deficiency type18cases. Body heigh, weight, waist circumference(Wc), blood pressure, fasting blood glucose(FBG),fasting insulin(FINS), fasting C peptide(FC-P), total cholesterol(TC), triglyceride(TG), high density lipoprotein(HDL), lower density lipoprotein (LDL), and glycosylated hemoglobin(HbAic) were measured simultaneously. Then body mass index (BMI), Homa insulin resistance index (Homa-IR)and Homa insulin secretion(Homa-β) were calculated. Compare and analysis the level of serum cortisol, ferritin and other correlation factors in different groups.Results:(1) The levels of serum cortisol and ferritin in type2diabetes patients are both significant higher than the controls (P<0.01). Men's and woman's levels are both higher than the controls(P<0.05).(2)The levels of serum cortisol, ferritin are increased by Yin-deficiency with Heat-excess type to Qi-Yin both deficiency type then to Yin-Yang both deficiency type(P<0.05). The level of serum cortisol in Yin-deficiency with Heat-excess type is obviously lower than in Qi-Yin both deficiency type (P<0.01) and Yin-Yang both deficiency type (P<0.01). The level of serum ferritin in Yin-Yang both deficiency type is higher than in Yin-deficiency with Heat-excess type (P<0.01) and Qi-Yin both deficiency type (P<0.05). (3)The pearson analysis revealed that serum cortisol level was positively associated with the level of We, BMI, FINS, LDL and Homa-IR (P<0.05). Serum ferritin level was positively associated with the level of We, BMI, FINS, HbAic and Homa-IR (P<0.05); negatively associated with the level of age and HDL (P<0.05). The multiple stepwise regression analysis showed that serum cortisol level was positively associated with Homa-IR (P<0.01); serum ferritin level was positively associated with We, HbAlc and Homa-IR (P<0.05).(4) Accoding to the50percentiles of serum cortisol and ferritin concentration (serum cortisol was12.9ng/ml, serum ferritin was171.8μg/dl in this subject),107type2diabetes patients were respectively divided to2groups: high cortisol group (53cases) and low cortisol group (54cases), high ferritin group (53cases) and low ferritin group (54cases). The levels of We (P<0.05), FINS(P<0.01) and Homa-IR (P<0.01) in high cortisol group are higher than in low group. The levels of We (P<0.05) in high cortisol group is lower than in low group. The levels of HbAic (P<0.01) and Homa-IR (P<0.01) in high ferritin group are higher than in low group. Others have no differences (P>0.05).(5) Accoding to the obesity code (BMI≥25kg/m2) and50percentiles of serum cortisol and ferritin concentration,107type2diabetes patients were respectively divided to4groups. The level of Homa-IR in low BMI and high cortisol group are lower than in high BMI and low cortisol group (P<0.01). The level of Homa-IR in low BMI and high ferritin group are lower than in high BMI and low ferritin group (P<0.01). The level of Homa-p in different groups have no differences (P>0.05).Conclusion:(1) The levels of serum cortisol, ferritin are higher in type2diabetes mellitus apparently.(2) The level of serum cortisol, ferritin are increased by Yin-deficiency with Heat-excess type to Qi-Yin both deficiency type then to Yin-Yang both deficiency type. They may be related to course of this disease and can help judgment the progression of type2diabetes mellitus.(3)Serum cortisol, ferritin are closely related with Homa-IR. They may contribute to IR by obecity. And they can not predict IR in clinically.