血清性激素及其结合蛋白水平对初诊2型糖尿病患者的诊断意义

Diagnostic significance of serum sex hormones and their binding protein levels in newly diagnosed patients with type 2 diabetes mellitus

目的探讨血清性激素及其结合蛋白水平对初诊2型糖尿病患者的诊断意义。方法选取2018年1～12月间淮安市第一人民医院分院收治的初诊2型糖尿病患者128例作为T2DM组,同时选取同期体检健康者50例为对照组,比较两组受试者血清中睾酮(T)、雌二醇(E2)、卵泡刺激素(FSH)、促黄体生成素(LH)等性激素及性激素结合球蛋白(SHBG)水平,并分析其相关性。结果 T2DM组患者的体质量指数(BMI)、空腹胰岛素(FINS)、空腹血糖(FPG)、胰岛素抵抗指数(insulin resistance index,HOMA-IR)、血尿酸(UA)等指标水平均明显高于对照组,差异均有统计学意义(P<0.05);T2DM组患者血清中T含量较对照组明显降低,而血清中E2、FSH、SHBG及E2/T值明显大于对照组,各指标比较差异均具有统计学意义(P<0.05);Pearson相关分析发现,T2DM组患者血清中SHBG水平与BMI、FINS、FPG、UA、HOMA-IR均呈负相关(r=-0.325、-0.138、-0.171、-0.216、-0.186,P<0.05);患者T水平与BMI、SHBG、E2均呈负相关(r=-0.331、-0.117、-0.246,P<0.05),患者E2水平与FINS、FPG、HOMA-IR呈正相关(r=0.431、0.231、0.435,P<0.05)。结论血清中低睾酮、高雌二醇及低SHBG水平可作为T2DM患者代谢变化的表征指标,对初诊T2DM具有一定的诊断意义,各指标对T2DM的影响机制还有待进一步研究。

Objective To explore the diagnostic significance of serum sex hormones and their binding protein levels in newly diagnosed patients with type 2 diabetes mellitus(T2 DM). Methods From January 2018 to December 2018, 128 cases of newly diagnosed patients with T2 DM admitted to Huai’an First People’s Hospital were selected as T2 DM group, and 50 healthy people who underwent physical examination in the same period were selected as the control group. The serum levels of testosterone(T), estradiol(E2), follicle stimulating hormone(FSH), luteinizing hormone(LH), and sex hormone binding globulin(SHBG) levels were compared between the two groups, and their correlations were analyzed. Results The levels of BMI, FINS, FPG, HOMA-IRUA, UA and other indicators in the T2 DM group were significantly higher than those in the control group, and the difference was statistically significant(P<0.05).In the T2 DM group, the serum T content was significantly lower than that in the control group, and the serum E2, FSH,SHBG and E2/T values were significantly higher than those in the control group(P<0.05). According to Pearson correlation analysis, the serum levels of SHBG were negatively correlated with BMI(r=-0.325), FINS(r=-0.138), FPG(r=-0.171), UA(r=-0.216), and HOMA-IR(r=-0.186) in patients with T2 DM, all differences were statistically significant(P<0.05);the T levels of patients were negatively correlated with BMI, SHBG, and E2(r=-0.331,-0.117,and-0.246, respectively;P<0.05), the E2 levels were positively correlated with FINS, FPG, and HOMA-IR(r=0.431,0.231, and 0.435, respectively;P<0.05). Conclusion Serum low testosterone, high estradiol and low SHBG levels can be used as indicators of metabolic changes in newly diagnosed T2 DM patients, which have a certain diagnostic value for newly diagnosed T2 DM. The mechanism of effects of various indicators on T2 DM remains to be further studied.