血浆睾酮水平对中青年男性2型糖尿病患者罹患代谢综合征的影响

Impacts of the serum testosterone on the metabolic syndrome in young and middle-aged men with type 2 diabetes mellitus

目的 探讨血浆睾酮水平对中青年男性2型糖尿病（T2DM）患者罹患代谢综合征（MS）的影响.方法 共纳入220例年龄在18 ～50岁的男性2型糖尿病患者,按照血浆睾酮浓度四分位分组,搜集一般资料、吸烟史及人体测量学指标,检测患者空腹血糖、空腹胰岛素、血脂、糖化血红蛋白（HbAlc）水平.结果 随血浆睾酮浓度升高,MS发病率下降（P＜0.05）,吸烟者比例、年龄、糖尿病病程、腰围、体重指数（BMI）、收缩压（SBP）、舒张压（DBP）、HbAlc、HOMA-IR、三酰甘油（TG）、总胆固醇（TC）及低密度脂蛋白胆固醇（LDL-C）等均降低（P＜0.01或P＜0.05）.相关性分析显示,血浆睾酮浓度与年龄、吸烟、糖尿病病程、腰围、BMI、SBP、DBP、HbAlc、HOMA-IR、TG、TC及LDL-C等均呈负相关（P＜0.01或P＜0.05）.Logistic回归分析显示,血浆睾酮为中青年男性2型糖尿病患者罹患MS的保护性因素,其OR值为0.479（95％CI：0.249 ～0.936,P＜0.01）,在校正年龄、吸烟、糖尿病病程、HOMA-IR及HbAlc后其OR值上升为0.759（95％CI：0.598 ～ 0.963,P＜0.05）.结论 中青年男性2型糖尿病患者血浆睾酮水平与代谢综合征呈负相关,低血浆睾酮可能是其罹患谢综合征的独立危险因素.

Objective To investigate the impacts of the serum testosterone on the metabolic syndrome（MS） in young and middle-aged men with type 2 diabetes mellitus （T2DM）. Methods A total of 220 young and middle-aged（18-50） men with T2DM were recruited in this study and were divided into four groups based on serum T quartile. General information, smoking history and anthropometry data were collected. Fasting glucose, fasting insulin, blood fat and HbA1 c were detected. Results With the increas- ing of T concentration,the incidence of MS was decreased（P 〈 0.05 ） ,together with the decrease of age, smoking, course of T2DM, waist circumference, body mass index （ BMI ）, systolic blood pressure （ SBP）, diastolic blood pressure （ DBP）, HbA1 c, HOMA-IR, total cholesterol （ TC ）, tfiglyceride （ TG ）, low density lipoproteins cholesterol （ LDL-C ） （ all P 〈 0. 05 or P 〈 0.01 ）. Spearman correlation analyze indicated that serum T was negatively correlated with age, smoking, course of T2DM, waist circumference, BMI, SBP, DBP, HbA1 e, HOMA-IR, TG, TC, LDL-C （ all P 〈 0. 05 or P 〈 0.01 ）. Logistic regression analyze indicated that serum T was a protective factor of MS in young and middle-aged men with T2DM （OR = 0.479,95 % CI：0. 249-0. 936, P 〈 0.01 ）. After the adjustment of age, smoking, course of T2DM, HOMA-IR and HbAlc,the OR was 0.759（95% CI：0. 598-0. 963 ,P 〈 0.05 ）. Conclusion The serum T in young and middle-aged men with T2DM was negatively correlated with MS. Low serum T may be an independent risk factor of MS in such patients.