糖尿病与男性生殖内分泌

Diabetes Mellitus and Male Reproductive Endocrinology

睾丸主要功能是产生精子、分泌雄激素,男性性激素主要是以睾酮为主的雄激素,还包括卵泡刺激素、黄体生成激素、雌二醇、泌乳素等生殖激素。糖尿病是一种以长期高血糖为主要特征的代谢综合征,由于胰岛素缺乏或胰岛素生物作用障碍导致糖代谢紊乱,同时伴有脂肪、蛋白质、水、电解质等代谢障碍,其中2型糖尿病(T2DM)占90%以上。长期患糖尿病可导致各种组织,特别是眼、肾、心脏、血管、神经的慢性损害和功能障碍,男性糖尿病患者还可能伴有生殖内分泌系统损害。糖尿病患者雄激素浓度较正常人低,性激素异常,可表现为勃起功能障碍、性欲减退等症状,而雄激素降低又通过一系列的生理、生化影响,加重患者的代谢紊乱,并成为动脉粥样硬化及冠心病的危险因素之一。综述男性糖尿病患者的生殖内分泌异常,以期为糖尿病及其并发症的治疗提供参考。

Two functions of testis are sperm production and steroidogenesis. Those hormones related to male reproduction include testosterone,follicle stimulating hormone,luteinizing hormone,estradiol and prolactin.Diabetes mellitus（DM） is the metabolic syndrome characterized by hyperglycaemia due to insufficient insulin,which is accompanied by metabolic disorders of fat,protein,water and electrolyte. More than 90% DM are type 2diabetes（T2DM）. Long-term diabetes can lead to dysfunction and chronic damage in various tissues,especially in eye, kidney,heart,blood vessel and nerve. Male patients with DM are often accompanied with dysfunction of reproductive endocrinology. Androgen level in male DM patients is lower than that in normal men. The symptoms in those patients with lowered hormones include erectile dysfunction and loss of libido, while the metabolic disorders were aggravated by physiological and biochemical mechanisms. All those risk factors are related to atherosclerosis and coronary heart disease（CHD）. We herein reviewed the dysfunction of male reproductive endocrinology in patients with DM,so as to provide reference for the treatment of diabetes.