男性2型糖尿病患者性腺功能减退相关因素分析

Analysis of male hypogonadism and related factors in type 2 diabetes

目的探讨男性2型糖尿病(T2DM)患者血清总睾酮(TT)水平与肥胖、胰岛素抵抗(IR)、血糖、血脂间的关系。方法对120例男性T2DM患者进行性激素、FPG、FIns、FC-P、HbA_1c、血脂水平测定。根据稳态模型评估法(HOMA)评价IR程度。结果 120例男性T2DM患者中TT低下者占14%,IR占71%,BMI≥23 kg/m^2者占52%。TT与BMI、FIns及WHR成负相关(r=-0.335,-0.307,-0.232,P<0.01),与年龄、病程、血糖、FC-P、HbA_1c水平等无相关性。BMI与WHR、FIns、FC-P及InHO-MA-IR成正相关(r--0.489,0.348,0.356,0.301 P<0.01或P<0.05),年龄与黄体生成素、卵泡刺激素成正相关(r=0.310,0.442,P<0.01)。结论肥胖是男性T2DM患者TT水平低下的主要影响因素,通过肥胖的介导,TT与IR及脂代谢紊乱相关。

Objective To evaluate the serum testosterone levels of type 2 diabetes in men and to explore the relationship of serum testosterone levels with obesity, insulin resistance, glucose and lipid metabolism. Methods The 120 men diagnosed as type 2 diabetes recieved measurements of serum total testosterone, LH, FSH, glucose, insulin, C peptide, HbA1c, total cholesterol, triglyeride, HDL-C, LDL-C. The HOMA-IR was used to evaluate the degree of insulin resistance. Results Of the subjects, 14% were with low levels of total testosterone （TT）, 71 % had insulin resistance , 52 % were with overweight or obesity. TT negatively correlated with BMI, Fins and WHR（r=-0. 335 for BMI, -0. 307 for Fins, and -0. 232 for WHR; all P〈0. 05~ 0. 01）. But there were no significant associations of TT with age, duration of diabetes, FPG, FC-P, HbA1c, TG, TC, and InHOMA-IR. BMI was correlated strongly and positively with WHR , Fins and FC-P（r=0. 489 for WHR, r=0. 348 for Fins, r=0. 356 for FC-P,all P〈0.01）, and lnHOMA-IR with（r=0. 301, P〈0.05）. There was a positive relationship between age and gonadotropic hormone, including LH and FSH （ r=0. 310 for LH, r=0. 442 for FSH, all P〈0. 01）. Conclusions Obesity is the main risk factor for hypotestosteronemia in men with type 2 diabetes. Serum testosterone is correlated with insulin resistance and dyslipidemia.