2型糖尿病男性患者睾酮水平与代谢指标相关性分析

目的探讨2型糖尿病男性患者睾酮水平与血糖、血脂、尿酸及胰岛素等代谢性指标的相关性。方法选择2型糖尿病男性患者205例，根据总睾酮水平，分为正常睾酮（TT）组（TT≥12 nmol/L，n=135）和低TT组（TT<12 nmol/L，n=70），测定一般指标〔体质量、腰围、体质量指数（BMI）〕、生化指标〔血糖、血脂、血尿酸（SUA）、胰岛素〕，以及性激素指标〔包括总睾酮、黄体生成素(LH)、卵泡刺激素（FSH）、雌二醇（E2）、性激素结合球蛋白(SHBG)〕，并计算得出稳态模型评估胰岛素抵抗指数(HOMA-IR），比较两组一般指标和生化指标的差异，并根据HOMA-IR及SUA水平，分别采用四分位法分组，比较各组的性激素指标的差异。结果与正常TT组相比，低TT组年龄、SUA、BMI、腰围及HOMA-IR升高，两组间比较差异有统计学意义（P<0.05）。随着HOMA-IR上升，TT、LH、SHBG水平下降（P<0.05）；随着SUA水平升高，TT、LH、FSH、SHBG水平降低（P<0.05）。Logistic回归分析显示，SUA升高（比值比=0.996）和BMI增加（比值比=0.872）是发生性腺功能减退症（TT<12 nmol/L）的危险因素，而年龄、收缩压不是其危险因素（P>0.05）。结论2型糖尿病男性患者发生性腺功能减退症与SUA水平及肥胖相关。

英文摘要:

ObjectiveTo determine the effect of testosterone on serum glucose, lipid, uric acid and insulin metabolism in male patients with type 2 diabetes mellitus. Methods A total of 205 male patients with type 2 diabetes participated in this study. They were divided into two groups: those with normal testosterone (TT) （TT≥12 nmol/L, n=135） and those with low TT （TT<12 nmol/L, n=70). Their body mass, waist circumference (WC), body mass index (BMI), blood glucose,total cholesterol (TC),triglycerides (TG),serum uric acid (SUA), insulin, testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), and sex hormone binding globulin (SHBG) were measured. The insulin resistance index (HOMA-IR) of the participants was calculated using a homeostasis model. Sex hormone levels were compared across the four groups divided by HOMA-IR and SUA in quartiles. ResultsThe participants with low TT had higher age, SUA, BMI, WC, and HOMA-IR (P<0.05). TT and SHBG decreased with increased HOMA-IR index (P<0.05). TT, LH, FSH and SHBG decreased with increased SUA (P<0.05). The logistic regression model showed that SUA and BMI were predictors of hypogonadism. Conclusion Male patients with type 2 diabetes who are prone to hypogonadism,are possibly related to increased SUA and obesity.

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