糖尿病勃起功能障碍患者血清瘦素的表达及意义

Expression level and value of serum leptin in type 2 diabetic patients with erectile dysfunction

目的观察糖尿病勃起功能障碍患者血清瘦素的表达水平,并探讨其临床意义。方法选取男性糖尿病患者255例,根据国际勃起功能指数-5(IIEF-5)评分将研究对象分为勃起功能障碍(ED)组(IIEF-5≤21分)137例和单纯糖尿病组(DM,IIEF-5>21)118例,另选体检健康男性(NC)100名。收集各组临床资料,检测血清瘦素和性激素水平。糖尿病ED患者血清瘦素水平与其他指标的相关性采用Pearson相关性分析和多元逐步回归分析。结果ED组FPG、FIns、2 hPG、HbA_1c、TC、HDL-C、HOMA-IR高于DM组和NC组(P<0.05或P<0.01);与NC组比较,ED组和DM组总睾酮(TT)[(11.19±4.12)vs(18.51±4.66)vs(14.74±4.71)nmol/L]、LH[(4.53±2.64)vs(13.81±2.69)vs(8.46±2.97)U/L]、FSH[(10.20±4.12)vs(20.68±4.11)vs(13.21±3.58)U/L]及瘦素[(7.04±5.36)vs(19.45±9.15)vs(12.06±6.47)ng/ml]水平升高,SHBG[(56.19±14.00)vs(38.25±10.12)vs(46.21±12.44)nmol/L]水平降低(P<0.05或P<0.01);Pearson相关性分析显示,血清瘦素水平与BMI、FIns、HOMA-IR呈正相关,与TT呈负相关(P<0.05或P<0.01);多元逐步回归分析显示,BMI和TT为ED患者血清瘦素水平的影响因素(P=0.000)。结论糖尿病ED患者血清瘦素水平升高。BMI和TT可能是糖尿病ED患者血清瘦素水平的影响因素。

Objective To investigate the expression level and value of serum leptin in type 2 diabetic patients with erectile dysfunction. Methods A total of 255 male patients with diabetes were enrolled in this study and divided into two groups according to the scores of IIEF-5 ： ED group （n= 137, IIEF-5≤21） and DM without ED group（n= 118, IIEF-5〉21）, And healthy men were selected as normal control group （NC group,n= 100）. The clinical data were collected in all the subjects and the serum levels of leptin and sex hormones were tested. Correlation between serum leptin and other index were analyzed by Pearson correlation analysis and multiple stepwise regression analysis. Results FPG, Fins, 2 hPG, HbA1 c, TC, HDLC and HOMA-IR were higher in ED group than in DM without ED group and NC group （P〈0.05 or P〈0.01）. The serum levels of TT[（18. 51±4. 66） vs （14.74±4.71） vs （11.19±4. 12） nmol/L] ,LH P（13. 81±2. 69） vs （8.46±2.97） vs （4.53±2.64） U/L],FSHF（20. 68±4.11） vs （13.21±3.58） vs （10.20±4.12） U/L] and leptin [（19.45±9.15） vs （12.06±6.47） vs （7.04±5.36） ng/ml] increased, and the SHBG decreasedn（38. 25±10.12） vs （46.21±12.44） vs （56.19±14.00） nmol/L] in ED group and DM without ED group than in NC group（P〈0.05 or P〈0.01）. Pearson correlation analysis showed that serum leptin level was positively correlated with BMI, Fins, and HOMA-IR, while negatively correlated with TT（P〈0. 05 or P〈0. 01）. Multiple stepwise regression analysis showed that BMI and TT were influencing factors for serum leptin level in patients with El） （P=0. 000）. Conclusion The serum level of leptin increases in DM patients with ED. BMI and TT may be influencing factors for serum leptin level in patients with ED.