改善胰岛素抵抗对中年男性2型糖尿病患者血清睾酮水平的影响  

Effect of Insulin Resistance Improvement on Testosterone in Middle-Aged Males with Type 2 Diabetes

作　　者：王国君[1] 杨占君[2] 杜群[1] 王国萍[1] 

机构地区：[1]包头医学院第二附属医院内分泌科,内蒙古包头市014030 [2]包头医学院基础学院

出　　处：《中国全科医学》2012年第27期3118-3120,共3页Chinese General Practice

摘　　要：目的评价中年男性2型糖尿病(T2DM)患者血清性腺激素水平与胰岛素抵抗的相关性,以及改善胰岛素抵抗对血清睾酮水平的影响。方法选取86例30～65岁男性T2DM患者,测定其性腺激素水平及各项临床指标,分析血清总睾酮(TT)水平与各代谢指标的相关性。其中69例患者给予降糖及改善胰岛素抵抗治疗3个月,用配对t检验比较治疗前后患者的各项观察指标。结果 (1)相关分析显示:血清TT水平与体质指数(BMI)、腰臀比(WHR)、胰岛素抵抗指数(HOMA-IR)、空腹胰岛素(FINS)、空腹C肽(FCP)、三酰甘油(TG)呈负相关(P<0.05),与高密度脂蛋白胆固醇(HDL-C)呈正相关(P<0.01)。睾酮分泌指数(TSI)与年龄、促卵泡生成素(FSH)、HOMA-IR、WHR、BMI、FINS呈负相关(P<0.05),与HDL-C呈正相关(P<0.05)。(2)69例患者治疗前后空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、TG、HDL-C、FINS、FCP、HOMA-IR、TT、TSI、促黄体生成素(LH)及WHR比较,差异均有统计学意义(P<0.05)。结论胰岛素抵抗是影响中年男性T2DM患者睾酮水平的主要因素;而尽早开始降糖治疗,改善胰岛素抵抗,可提高中年男性T2DM患者的血清睾酮水平。Objective To evaluate the relationship between sexual hormones levels in serum and insulin resistance in middle - aged males with type 2 diabetes mellitus （ T2DM ） and the influence of improving insulin resistance on testosterone. Methods 86 T2DM male patients aged from 30 to 65 years were selected. The levels of sex hormones and each clinical index were tested and the relationship between total testosterone （TF） and each metabolic index was analyzed. 69 cases were given treatment to reduce blood glucose and improve insulin resistance for three months and paired t test was used to compare each index before and after the treatment. Results （ 1 ） Correlation analysis showed that ＇IT was negatively correlated with BMI, WHR, HOMA - IR, FINS, FCP and TG （ P 〈 O. 05 ）. Testosterone secreting index （TSI） was negatively correlated with age, FSH, HOMA - IR, WHR, BMI and FINS （ P 〈 0. 05 ）, but was positively correlated with HDL - C （ P 〈 0. 05 ）. （2） Among the 69 patients, FPG, HbA1c, TC, TG, HDL-C, FINS, FCP, HOMA-IR, TF, TSI, LHand WHR showed statistically signifi- cant differences before and after the treatment （ P 〈 0. 05 ）. Conclusion Insulin resistance is the main factor affecting testoster- one levels in middle - aged men with T2DM. Early hypoglyeemic therapy can improve insulin resistance, thus increasing the tes- tosterone levels in middle - aged men with T2DM.

关 键 词：睾酮 糖尿病 2型 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌] R588.1[医药卫生—内科学]