2型糖尿病男性患者性激素水平与体重指数、糖脂代谢及胰岛素抵抗相关性分析

Correlation between levels of sex hormones and BMI,glucolipid metabolism and insulin resistance in male patients with type 2 diabetes mellitus

目的:分析2型糖尿病(T2DM)男性患者性激素水平与体重指数(BMI)、糖脂代谢及胰岛素抵抗的相关性。方法:选取T2DM男性患者80例,根据BMI分别纳入T2DM肥胖组(55例,BMI≥28 kg/m^(2))和T2DM非肥胖组(25例,BMI<28 kg/m^(2)),另选择同时期男性体检健康者纳入对照组(50例)。分别比较三组一般资料、性激素指标[睾酮(T)、雌二醇(E_(2))、雌二醇/睾酮比值(E_(2)/T)]、脂代谢指标[低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、总胆固醇(TC)]、糖代谢指标[空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)]。采用Pearson法分析T2DM男性患者性激素水平与BMI、糖脂代谢指标及胰岛素抵抗的相关性。结果:T2DM肥胖组、T2DM非肥胖组、对照组BMI呈递减趋势(均P<0.05)。三组年龄比较差异无统计学意义(P>0.05)。T2DM肥胖组及T2DM非肥胖组T2DM病程比较差异无统计学意义(P>0.05)。T2DM肥胖组、T2DM非肥胖组、对照组血清T水平呈递增趋势,E_(2)和E_(2)/T水平呈递减趋势(均P<0.05)。T2DM肥胖组、T2DM非肥胖组、对照组血清HDL-C水平呈递增趋势,LDL-C水平呈递减趋势(均P<0.05)。T2DM肥胖组TC和TG水平高于其他两组(均P<0.05)。T2DM肥胖组、T2DM非肥胖组、对照组的FPG、FINS、HbA1c、HOMA-IR水平呈递减趋势(均P<0.05)。T2DM男性患者血清T与BMI、LDL-C、FPG、FINS、HbA1c、HOMA-IR呈负相关,与HDL-C呈正相关(均P<0.05);E_(2)和E_(2)/T与BMI、LDL-C、FPG、FINS、HbA1c、HOMA-IR呈正相关,与HDL-C呈负相关(均P<0.05)。结论:T2DM男性患者血清T、E_(2)及E_(2)/T水平与BMI、糖脂代谢紊乱及胰岛素抵抗密切相关。

Objective:To analyze the correlation between levels of sex hormones and body mass index(BMI),glucolipid metabolism and insulin resistance in male patients with type 2 diabetes mellitus(T2DM).Methods:A total of 80 male patients with T2DM were classified into T2DM obesity group(55 cases,BMI higher than or equal to 28 kg/m^(2))and T2DM non-obesity group(25 cases,BMI lower than 28 kg/m^(2))according to BMI,and the healthy male subjects in the same period were included in control group(50 cases).The general data,sex hormones indicators(T,E_(2),E_(2)/T),lipid metabolism indicators(LDL-C,HDL-C,TG,TC)and glucose metabolism indicators(FPG,FINS,HbAlc,HOMA-IR)were compared among the three groups.Pearson method was used to analyze the correlation between sex hormone levels and BMI,glucolipid metabolism indexes and insulin resistance in male patients with T2DM.Results:BMI of T2DM obesity group,T2DM non-obesity group and control group showed a decreasing trend(all P<0.05).There was no significant difference in age among the three groups(P>0.05).There was no significant difference in the course of T2DM between T2DM obesity group and T2DM non-obesity group(P>0.05).The serum T levels of T2DM obesity group,T2DM non-obesity group and control group showed an increasing trend,while E_(2)and E_(2)/T levels showed a decreasing trend(all P<0.05).The serum HDL-C level of T2DM obesity group,T2DM non-obesity group and control group showed an increasing trend,while the LDL-C level showed a decreasing trend(all P<0.05).The levels of TC and TG in T2DM obesity group were higher than those in other two groups(all P<0.05).The levels of FPG,FINS,HbA1c and HOMA-IR in T2DM obesity group,T2DM non-obesity group and control group showed a decreasing trend(all P<0.05).Serum T in male patients with T2DM was negatively correlated with BMI,LDL-C,FPG,FINS,HbA1c,HOMA-IR,and positively correlated with HDL-C(all P<0.05).E_(2)and E_(2)/T were positively correlated with BMI,LDL-C,FPG,FINS,HbA1c,HOMA-IR,and negatively correlated with HDL-C(all P<0.05).Conclusion:Serum T,E_(2)and E_(2)/T levels in male patients with T2DM are closely related to BMI,glucolipid metabolism disorders and insulin resistance.