2型糖尿病男性患者血清睾酮与血脂关系的探讨

Association between serum testosterone and lipid profile in men with type 2 diabetes mellitus

目的：测定2型糖尿病（ T2DM）男性患者血清睾酮和血脂水平，并校正传统混杂因素及甲状腺功能，以探讨睾酮与血脂之间的相关性。方法检测125例T2DM男性患者总睾酮（ TT）、卵泡刺激素（ FSH）、黄体生成素（ LH）、胆固醇（ TC）、甘油三酯（ TG）、低密度脂蛋白胆固醇（ LDL-C）、高密度脂蛋白胆固醇（ HDL-C）水平，并计算TT/LH（ TSI）比值。通过简单相关、偏相关及多元线性回归分析探讨睾酮与血脂之间的相关性。根据TT四分位数将T2DM男性患者分为4组（A组：TT ＜3．93 ng/mL；B组：TT 3．93～5．09 ng/mL；C组：TT 5．10～6．58 ng/mL；D组：TT ＞6．58 ng/mL），应用单因素方差分析比较组间血脂水平。结果相关及多元线性回归分析显示，TT与TG呈显著负相关（P＜0．05），与HDL-C呈显著正相关（P＜0．05）；TSI与TG呈显著负相关（P＜0．05）。 ANOVA结果显示，与最低TT水平A组相比，B、C、D组的TG水平均显著降低（P＜0．05），C、D组HDL-C水平则显著升高（P＜0．05）。结论 T2DM男性患者血清睾酮与TG呈负相关，与HDL-C 呈正相关，提示雄性激素可能对T2 DM男性患者的血脂代谢异常具有保护作用。

Objective To evaluate the association between serum testosterone level and the lipid profile, after adjusting for some traditional confounding factors and thyroid function.Methods The total testosterone （ TT） , follicle stimula-ting hormone （ FSH） , luteinizing hormone （ LH） , total cholesterol （ TC） , triglycerides （ TG） , low-density lipoprotein cholesterol （ LDL-C） and high-density lipoprotein cholesterol （ HDL-C） of 125 male patients with type 2 diabetes melli-tus （T2DM） were measured.Testosterone secretion index （TSI） was calculated by dividing TT by LH.Bivariate and partial correlation analysis, and multiple linear regression analysis were performed to explore the association between TT＆amp;nbsp;level and lipid levels.One-way analysis of variance （ ANOVA） was adopted to compare the lipid levels among four subgroups which were divided by quartile of TT （ Group A： TT ＆lt;3.93 ng/mL, Group B： TT 3.93-5.09 ng/mL, Group C：TT 5.10-6.58 ng/mL, and Group D：TT ＆gt;6.58 ng/mL）.Results TT was negatively correlated with TG （P＆lt;0.05）, and positively correlated with HDL-C （P＆lt;0.05） while TSI was negatively correlated with TG （P＆lt;0.05） in correlation analysis and multiple linear regression analysis.Compared with the group with the lowest TT level （ group A） , TG level was significantly lower in groups B, C and D, and HDL-C was significantly higher in groups C and D （P＆lt;0.05）.Conclusion Serum TT was negatively correlated with TG and positively correlated with HDL-C in male T2DM patients, suggesting that serum testosterone might be a protective factor for dyslipidemia in these patients.