2型糖尿病女性患者伴性功能障碍的特点及其危险因素分析

Features and risk factors of female sexual dysfunction in type 2 diabetic patients

目的探讨T2DM女性患者性功能障碍的特点,并分析其发生的危险因素。方法选取T2DM女性患者227例,根据是否伴女性性功能障碍(FSD)分为单纯糖尿病组(DM)组[女性性功能指数问卷(FSFI)评分≥25]144例和糖尿病FSD组(DM+FSD组,FSFI评分<25)83例,另选取同期于我院体检中心体检健康女性80名作为健康对照(NC)组。采用FSFI问卷评估各组性功能,Logistic回归分析糖尿病女性患者伴FSD的危险因素。结果 T2DM女性患者中,FSD的发生率为36.6%(83/227);与NC组比较,DM+FSD组和DM组卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(TSTO)升高,雌二醇(E2)降低(P<0.01);DM+FSD组与DM组比较,差异无统计学意义(P>0.05);与NC组比较,DM组和DM+FSD组性欲[(4.59±1.22)vs(3.76±0.90)vs(2.54±0.58)分]、性唤起[(4.81±1.00)vs(3.57±0.85)vs(2.30±0.42)分]、阴道润滑[(5.14±0.83)vs(4.46±1.32)vs(3.35±0.29)分]、性高潮[(4.02±1.25)vs(3.40±1.86)vs(2.75±0.68)分]4个维度评分及总分[(28.13±5.78)vs(24.71±6.33)vs(17.94±4.15)分]均降低(P<0.05或P<0.01)。DM+FSD组性满意度[(3.45±1.68)vs(4.94±0.93)、(4.99±0.86)分]和性疼痛[(3.55±0.50)、(4.58±0.47)vs(4.58±0.62)分]2个维度评分低于DM组和NC组(P<0.05),DM组和NC组比较,差异无统计学意义(P>0.05);Logistic回归分析显示,年龄、BMI及HbA_1c为糖尿病伴FSD的危险因素(P=0.029、0.001、0.022)。结论糖尿病FSD的发生率较高,年龄、BMI、HbA_1c是其主要危险因素。

Objective To investigate the features of female sexual dysfunction （FSD） in type 2 diabetic patients （T2DM）and to analyze its risk factors. Methods According to FSFI indexes in the sexual function questionnaire,227 female T2DM patients were divided into DM group without FSD [n=144,FSFI≥25] and DM＋FSD group[n=83,FSFI＆lt;25]. 80 healthy women served as normal controls. The risk factors for FSD were analyzed using logistic regression analysis. Results The occurrence of FSD was 36.6%（83/227） in female T2DM patients. The levels of FSH,TSTO and LH were higher,and E2 was lower in DM＋FSD group and DM group than those in NC group（P〈0.01）,but there was no statistical significance between DM＋FSD group and DM group（P＆gt;0.05）. The score of sexual desire[（2.54±0.58） vs （3.76±0.90） vs （4.59±1.22） score],sexual arousal[（2.30±0.42） vs （3.57±0.85） vs （4.81±1.00） score],vaginal lubricate[（3.35±0.29） vs （4.46±1.32） vs （5.14±0.83） score],orgasm[（2.75±0.68） vs （3.40±1.86） vs （4.02±1.25）score] and total score [（17.94±4.15） vs （24.71±6.33） vs （28.13±5.78） score] were lower in DM＋FSD group and DM group than those in NC group. The score of sexual satisfaction[（3.45±1.68） vs （4.94±0.93）,（4.99±0.86）score] and pain[（3.55±0.50） vs （4.58±0.47）,（4.58±0.62）score] were lower in DM＋FSD group than those in DM group and NC group（P〈0.05）,but there was no statistical significance between DM group and NC group（P＆gt;0.05）. Logistic regression analysis showed that age,BMI and HbA1c were risk factors for FSD in T2DM patients （P=0.029,0.001,0.022,respectively）. Conclusion The occurrence of FSD is common in female type 2 diabetic patients. BMI and HbA1c are the main risk factors for FSD.