摘要：目的 探讨不同糖耐量水平患者的皮质醇、醛固酮、胰岛素抗体与胰岛素抵抗水平的关系。方法 选择115例糖耐量增高的患者，根据糖尿病诊断标准分为糖尿病（T2DM）组(39例)、糖尿病前期（PD）组(35例)、血糖受损（IGR）组(41例)作为研究对象。所有受试对象均在空腹条件下，测定体重指数（BMI），口服75g葡萄糖耐量试验（OGTT）和胰岛素释放实验，以稳态模型公式计算胰岛素抵抗指数(HOMA-IR)，同时进行空腹血浆皮质醇、血浆醛固酮以及胰岛素抗体检测，研究胰岛素抵抗指数与皮质醇、醛固酮以及胰岛素抗体的关系。结果 T2DM组、PD组和IGR组HOMA-IR同正常糖耐量组（NGT)比较，差异有显著性(P<0．01)；血浆皮质醇（COR）与HOMA-IR呈正相关（r=0.14, P<0.05）,胰岛素抗体和血浆醛固酮与HOMA-IR无相关性。结论 糖耐量增高的患者存在胰岛素抵抗，伴有肥胖者皮质醇明显增高，皮质醇与胰岛素抵抗具有相关性。

Abstract: Objective To investigate the correlations between insulin resistance level with cortisol, aldosterone and INS-Ab in patients with various glucose tolerance levels. Method Total 115 patients with increased glucose tolerance were selected as subjects and divided into three groups based on diagnostic criteria for diabetes mellitus (DM), T2DM group (39 cases), pre-diabetes (PD) group (35 cases), and impaired glucose regulation (IGR) group (41 cases). All the subjects were carried out BMI measurement, 75g OGTT and insulin release test under fasting conditions and HOMA-IR were calculated. The levels of plasma cortisol, aldosterone and INS-Ab under fasting conditions were detected and the results were analyzed. Results There was significantly differences on HOMA-IR between T2DM, PD and IGR group with that of normal glucose tolerance group (P<0.01). The plasma cortisol was positive correlated with HOMA-IR (r=0.14, P<0.05), while INS-Ab and plasma aldosterone had no correlation with HOMA-IR. Conclusion Patients with increased glucose tolerance experience insulin resistance. The plasma cortisol may be correlated with insulin resistance in patients with concomitant obesity.