Suzuki S
Showa University Fujigaoka Hospital, Faculty of Internal Medicine, Division of Endocrinology and Metabolism.
Nihon Rinsho. 1996 Oct;54(10):2709-14.
A number of endocrine disorders are associated with varying degrees of glucose intolerance. Sustained hypersecretion of hormones with actions antagonistic to insulin (e.g., GH, glucocorticoidos, catecholamines, glucagon) or which interfere with insulin secretion (e.g., catecholamines, hypokalemia) is often associated. And so, acromegaly, Cushing's syndrome, pheochromocytoma, primary aldosteronism, hyperthyroidism, glucagonoma and others are included in endocrine-associated diabetes. The glucose intolerance occurring secondary to endocrine disorders is usually moderate degree and overt diabetes with symptomatic hyperglycemia is an uncommon event, unless an underlying genetic diabetic diathesis also present in the same individual. The small subgroup of acromegalics(5-10%) with severe glucose intolerance requiring insulin therapy have low endogenous insulin levels and insulin responses that are markedly impaired. It has been suggested that these patients are really true diabetics. These are patients with NIDDM. Retinal, renal and neurological complications are uncommon in patients with endocrine-associated diabetes.
许多内分泌紊乱与不同程度的葡萄糖不耐受有关。常伴有对胰岛素有拮抗作用(如生长激素、糖皮质激素、儿茶酚胺、胰高血糖素)或干扰胰岛素分泌(如儿茶酚胺、低钾血症)的激素持续分泌过多。因此,肢端肥大症、库欣综合征、嗜铬细胞瘤、原发性醛固酮增多症、甲状腺功能亢进症、胰高血糖素瘤等都被列入内分泌相关性糖尿病。内分泌紊乱继发的葡萄糖不耐受通常为中度,除非同一个体同时存在潜在的遗传性糖尿病素质,否则有症状性高血糖的显性糖尿病并不常见。少数(5%-10%)严重葡萄糖不耐受需要胰岛素治疗的肢端肥大症患者内源性胰岛素水平低,胰岛素反应明显受损。有人认为这些患者实际上是真正的糖尿病患者。这些是2型糖尿病患者。内分泌相关性糖尿病患者很少出现视网膜、肾脏和神经并发症。