特发性低促性腺激素性性腺功能减退症的临床危险因素分析

Analysis of Clinical Risk Factors for Idiopathic Hypogonadotropic Hypogonadism

目的分析特发性低促性腺激素性性腺功能减退症(IHH)患者的临床指标危险因素。方法选取云南省第一人民医院内分泌科2008年1月至2021年12月确诊为IHH的患者120例(男性82例,女性38例,其中卡尔曼综合征15例)为病例组,年龄(22.43±6.08)岁,选取性腺功能正常的健康人群95例(男性75例,女性20例)为对照组,年龄(21.47±2.67)岁;收集病例组与对照组的一般临床资料,剔除部分数据缺失的患者,分析病例组与对照组指标是否具有统计学差异,对有统计学意义的进行多因素分析;病例组中,收集IHH患者的骨密度共48例(骨密度降低组31例(男性22例,女性9例),骨密度正常组17例(男性6例,女性11例);分析导致IHH患者骨密度异常的危险因素。结果病例组与对照组年龄、体重、E2、Testo、LH、FSH、CHOL、血糖差异有统计学意义(P<0.05),性别、身高、TSH、T3、T4、FT3、FT4、TG、HDL-C、LDL-C无统计学差异(P>0.05);无序二元Logistic回归分析显示E2、Testo是患者发生IHH的保护因素(P<0.05)。IHH患者中骨密度减低组与骨密度正常组比较:2组中性别、年龄有统计学差异(P<0.05),E2、Prog、Testo、PRL、LH、FSH无统计学差异,无序二元Logistic回归分析显示年龄是IHH患者发生骨密度减低的危险因素,性别是IHH患者发生骨密度减低的保护因素(P<0.05)。结论IHH会导致患者血糖、血脂及骨密度减低,E2、Testo是患者发生IHH的保护因素,年龄是IHH患者发生骨密度减低的危险因素,性别是保护因素。

Objective To analyze the clinical risk factors in idiopathic hypogonadotropic hypogonadism patients(IHH).Methods We selected 120 patients with hypogonadism from the Endocrinology Department of the First People's Hospital of Yunnan Province from January 2008 to December 2021(82 males,38 females,including 25 Kalman syndrome patients;22.43±6.08 years)as the case group.We also selected 95 healthy patients with normal gonadal function(75 males and 20 females21.47±2.67 years)as the control group.General clinical data of patients in the case group and control group were collected,excluding the patients with some missing data.We analyzed whether the indicators were statistically different between the case and control groups by multivariate analysis.The data on the bone mineral density of 48 IHH patients,including 31 patients with reduced bone mineral density(22 males,9 Females)and 17 patients with normal bone mineral density(6 males,11 females),were collected in the case group.The risk factors leading to abnormal BMD were analyzed in IHH patients.Results There were significant differences in age,weight,E2,Testo,LH,FSH,CHOL and blood glucose(P<0.05),and no significant differences in gender,height,TSH,T3,T4,FT3,FT4,TG,HDL-C,LDL-C(P>0.05).Unordered binary Logistic regression analysis showed that E2 and Testo were the protective factors for IHH patients(P<0.05).Comparison between the IHH patients for the reduced BMD group and the IHH patients for the normal BMD group:there were significant differences in sex and age(P<0.05),while E2,Prog,Testo,PRL,LH,L H,FSH was not significant.Disordered binary Logistic regression analysis showed that age was the risk factor for BMD in IHH patients,and sex was the protective factor for BMD in IHH patients(P<0.05).Conclusions IHH can lead to decrease of blood glucose,lipid and bone density.E2 and T are the protective factors for IHH,age is the risk factor for decreased bone density in IHH patients,and gender is the protective factor.