高龄男性糖尿病性肾病患者中血清睾酮的变化及临床意义

Clinical significance of serum testosterone level insenile male patients with diabetic nephropathy

目的：探讨高龄男性糖尿病性肾病（ DN）患者中血清睾酮水平表达的临床意义。方法选取2013年1月至2014年6月在沈阳军区总医院干部诊疗科住院的＞75岁的糖尿病（ DM）男性患者80例，其中诊断DN者34例，为DN组，其余46例设为非DN组。同时选择同期在沈阳军区总医院干部诊疗科参加体检的＞75岁的非DM老年人20例设为对照组。收集所有研究对象的血清睾酮、胱抑素C、24h微量白蛋白尿及肌酐标本，行双肾超声检查。结果与对照组相比，高龄男性DM患者的血清睾酮水平降低，差异有统计学意义（ P＜0.01）。DN组患者血清睾酮水平进一步低于非DN组[（13.18±3.29） vs （22.07±7.53）nmol/L，P＜0.01]，血清胱抑素C水平较非DN组增高[（2.61±0.96） vs （1.09±0.34） mg/L， P＜0.01]，且血清睾酮与血清胱抑素C水平呈负相关（ r＝-0.658， P＜0.01）。结论在高龄男性DM患者中，发生DN患者血清睾酮水平低于非DN患者，且与血清胱抑素C水平呈负相关，其指标的检测为早期提供干预策略改善预后提供帮助。

ObjectiveTo investigatethe clinical significance of serum testosterone level insenile male patients with diabetic nephropathy （DN）.MethodsA total of 80 male diabetic patients over 75 yearsoldadmitted in our department from January 2013 to June 2014 were enrolled in this study.Thirty-four of them werediagnosed asDN and then assigned as DN group, andthe other 46without renal diseaseasnon-diabetic nephropathy （NDN） group.Another20age-matchedmaleswithoutdiabetestaking physical examinationduringsame period served as controls. Their serum levels oftestosterone, cystatin C （CysC） and urine microalbumin were detected. Their kidney ultrasound images were collected. The results were compared between theDNand NDNgroups.Results Compared with control group, the serum level of testosterone was lower in diabetic male patients （P〈0.01）. The serum level of testosterone was markedly lower [（13.18±3.29）vs （22.07±7.53）nmol/L,P〈0.01], but that ofCysCwas higher [（2.61±0.96）vs （1.09±0.34）mg/L,P〈0.01] in DN group thaninNDN group. Serum level testosterone was negatively correlatedwithCysC （r=-0.658,P〈0.01）.Conclusion In the senile male diabetic patients, those with DN have lower serum testosterone level than those without, which is negatively correlatedwithCysC level. Serum testosterone levelmaybehelpful to develop early intervention strategies to improve prognosis.