2型糖尿病合并高血压男性患者中勃起功能障碍的危险因素分析

Risk factors analysis of erectile dysfunction in male patients with type 2 diabetes mellitus and hypertension

目的探索2型糖尿病(Type 2 diabetes mellitus,T2DM)合并高血压(Hypertension,HBP)男性患者中勃起功能障碍(Erectile dysfunction,ED)发生的危险因素。方法纳入2024年1—6月本院收治的T2DM合并HBP男性患者100例作为研究对象,依据国际勃起功能障碍指数(IIEF-5)得分分为ED组(79例)和非ED组(21例)。收集两组患者临床信息和实验室资料、评估两组患者焦虑和抑郁的发病情况。采用单因素相关性分析和多因素Logistic回归分析T2DM合并HBP的男性患者中ED发生的危险因素。结果100例确诊T2DM合并HBP的男性患者中,ED的发病率为79%,单因素相关性分析显示,两组患者的HBP病程、年龄大小、BMI水平、既往吸烟史、饮酒史无统计学差异(P>0.05);两组患者的T2DM病程、HbA1c、睾酮、25羟基维生素D水平、合并焦虑及抑郁症、有饮酒史的比较,差异具有统计学意义(P<0.05),其中,ED组HbA1c大于非ED组,血浆睾酮及血清25(OH)D水平小于非ED组。多因素logistic回归分析显示,T2DM病程、糖化血红蛋白、睾酮、抑郁及焦虑症是T2DM合并HBP男性患者中发生ED的独立危险因素(P<0.05)。结论T2DM病程久、长期血糖控制不佳、低血浆睾酮浓度、抑郁及焦虑是T2DM合并HBP男性患者中ED发生的重要影响因素,故针对该些患者的疾病防治时,需注重身心同治。

Objective To explore the risk factors for erectile dysfunction(ED)in male patients with type 2 diabetes mellitus(T2DM)complicated with hypertension(HBP).Methods 100 male patients with T2DM complicated with HBP who were admitted to our hospital from January to June 2024 were included as study subjects and divided into ED group(79 cases)and non-ED group(21 cases)based on the score of the International Index of Erectile Function(IIEF-5).Clinical information and laboratory data of the two groups of patients were collected,and the incidence of anxiety and depression in the two groups was assessed.Single-factor correlation analysis and multi-factor logistic regression analysis were used to analyze the risk factors associated with ED.Results Among the 100 male patients diagnosed with T2DM and HBP,the incidence of ED was 79%.Single-factor correlation analysis showed no statistical difference in HBP duration,age,BMI level,past smoking history,and drinking history between the two groups(P>0.05).The comparison of T2DM duration,HbA1c,testosterone,25-hydroxyvitamin D levels,comorbid anxiety and depression,and drinking history between the two groups was statistically significant(P<0.05).In particular,HbA1c in the ED group was higher than in the non-ED group,and plasma testosterone and serum 25(OH)D levels in the ED group were lower than in the non-ED group.Multi-factor logistic regression analysis indicated that the duration of T2DM,HbA1c,testosterone,depression,and anxiety were independent risk factors for ED in male patients with T2DM and HBP(P<0.05).Conclusions Long-duration T2DM,poor long-term blood sugar control,low plasma testosterone concentration,and comorbid depression and anxiety are significant influencing factors for ED in male patients with T2DM and HBP.Therefore,a comprehensive approach to physical and mental health is necessary in the prevention and treatment of these patients.