影响成年男性2型糖尿病患者睾酮水平的相关因素

Analysis of influence factors on serum total testosterone in adult men with type 2 diabetes mellitus

目的探讨糖尿病病程、BMI、WC、慢性并发症严重程度、HbA_1c等对成年男性2型糖尿病(T2DM)患者血浆总睾酮(TT)水平的影响。方法随机收集106例成年男性T2DM患者的临床资料,并测定血浆TT。对糖尿病慢性并发症的严重程度进行定量评分。采用Pearson相关分析法,评价病程、BMI、WC、慢性并发症、HbA_1c、hsC-RP、血脂对TT的影响。结果成年男性T2DM患者TT水平和年龄、病程、HbA_1c无显著性相关(P均>0.05)。慢性并发症评分较高、WC较大的患者,TT水平降低(P均<0.05)。TC(P>0.05)和LDL-C(P<0.05)水平较高者,TT水平升高。结论慢性疾病、向心性肥胖和机体炎症状态可能引起TT水平下降,且在降脂治疗时应注意TT水平的变化。

Objective To investigate the impacts of HbAlc, body mass index （BMI）, abdominal circumference and diabetic chronic complications on the level of serum total testosterone （TT） in adult men with type 2 diabetes. Methods This cross-sectional clinical study randomly included 106 male patients with type 2 diabetes. Their levels of TT were measured. The severity of diabetic chronic complications was evaluated by a score system according to a standard criteria. The impacts of duration of diabetes, BMI, abdominal circumference, diabetic chronic complications, HhA1 c, hypersensitive-CRP and lipid profile on serum TT were analyzed by Pearson＇s correlation analysis. Results （1） There was no significant association of TT with age（r= -0.218, P= 0. 286）, duration of disease（r= 0. 029, P= 0.84） and HbA1 c （r=0. 024,P=0. 87）, separately. （2） The patients with higher total score of chronic complications （r=-0. 638,P = 0. 000） and larger abdominal circumference （r= - 0. 365, P = 0. 012） had a significantly tendency of lower level of TT. （3） The patients with higher levels of total cholesterol （r= 0. 265, P= 0. 066） and LDL-C （r= 0. 335, P= 0. 019） had a higher level of TT. Conclusions The severities of chronic complications, abdominal circumference and hs-CRP have a negative relations with TT, which indicates that chronic diseases, visceral obesity and inflammatory state might decrease the level of total testosterone. Total cholesterol and LDL-C have a positive relation with TT, which suggests that we should keep our eyes on TT when an intensive lipid-lowing therapy was conducted.