老年胰岛素抵抗与男性勃起功能的相关性研究

Study on the correlation of geriatric insulin resistance to male erectile function

目的探讨老年胰岛素抵抗(IR)与男性勃起功能之间的相关关系。方法选取IR指数HomA-IR>2.8的200例患者,进行相关血生化及前列腺彩色超声检测,并记录基础疾病。并用勃起功能国际指数(IIEF-5)评估这些患者的勃起功能,用统计学方法分析它们之间的相关关系。结果患ED的总发生率为47%,包括轻度ED 20.5%,中度ED 7.5%,重度ED19.0%。200例患者中高血压46例,其ED发病率37%(17/46例);肥胖24例,其ED发生率38%(9/24例);冠心病50例,其ED发生率40%(20/50例);血脂异常(LDL-C↑、HDL-C↓)30例,其ED发生率ED47%(14/30例);糖尿病分别为50例,其ED发生率68%(34/50例)。66例良性前列腺增生(BPH)患者ED总发生率39.39%(26/66例)。相关性分析显示:年龄与勃起功能评分之间呈负相关(r=-0.48,P≤0.05);血脂异常(LDL-C↑、HDL-C↓)、冠心病、高血压、肥胖、糖尿病与勃起功能评分之间呈负相关(r值分别为-0.33,-0.41,-0.45,-0.47,-0.51,P≤0.05);FBG、FINS、HomA-IR、BPH、长期服用降压药物与勃起功能评分之间呈负相关(r值分别-0.23,-0.31,-0.32,-0.41,-0.43,P≤0.05);HDL-C与勃起功能评分之间呈正相关(r=0.43,P≤0.05)。结论年龄、肥胖、冠心病、高血压、血脂异常和糖尿病是影响男性勃起功能的重要因素。其中HomA-IR上升是ED的重要的危险因素;HDL-C为保护因素。HOMA-IR、WHR、BPH、TC/HDL-C比值和HDL-C水平的检测都是预测ED发生的敏感指标。

Objective To explore the relationship between geriatric insulin resistance （IR） and male erectile function （EF）. Methods 200 patients with IR index HomA-IR 〉 2.8 accepted blood biochemistry detection and color Doppler ultrasonography in prostate to record basic disease. These patients＇ EF was evaluated with international index of EF （ IIEF-5 ） to analyze their relationship by statistic method. Results The total incidence of erectile dysfunction （ED） was 47%, including 20.5% mild ED, 7.5% moderate ED and 19.0% severe ED. Of 200 patients, the disease incidence of ED in 46 cases of hypertension, in 24 cases of adiposity, in 50 cases of coronary heart disease （CHD）, in 30 cases of abnormal serum lipid （LDL-CT↑、HDL-C↓ ） and in 50 cases of diabetes were 37% （17/46）, 38% （9/ 24 ）, 40% （ 20/50）, 47% （ 14/30 ） and 68% （ 34/50 ） respectively. The total incidence of ED was 39.39% （26/66） in 66 patients with benign prostatic hyperplasia （BPH）. Relevant analysis showed that： age, abnormal serum lipid （LDL-C T , HDL-C ,~ ）, CHD, hyperten- sion, adiposity and diabetes, FBG, FINS, HomA-IR, BPH and taking pressure lowering drugs （ r = - 0.48, - 0.33, - 0.41, - 0.45, - 0. 47, - 0.51, - 0.23, - 0.31, - 0.32, - 0.41, - 0.43, respectively, P ~0.05 ） were negatively related to EF; HDL-C was positively related to EF （r = 0. 43, P≤0.05 ）. Conclusions Age, adiposity, CHD, hypertension, LDL-C and diabetes are main factors that influence male EF, in which the increased HomA-IR is an important risk factor of ED while HDL-C is protective factor. The ratios of HOMA-IR, WHR, BPH, TC/HDL-C and the detection of HDL-C level are sensitive index of predicting EF.