1型糖尿病的青少年患者睾酮水平测定的临床意义  

Clinical Significance of Measurement of Testosterone Levels in Adolescents with Type 1 Diabetes Mellitus

作　　者：王素妍 蔡填[1] 李桂平[1] 赖玉林[1] WANG Suyan;CAI Tian;LI Guiping(Department of Endocrinology,the Third People’s Hospital of Huizhou City,Guangdong Province 516002)

机构地区：[1]广东省惠州市第三人民医院内分泌科

出　　处：《医学理论与实践》2019年第23期3771-3773,共3页The Journal of Medical Theory and Practice

基　　金：惠州市科技计划项目(2017Y161)

摘　　要：目的:探讨1型糖尿病的青少年患者睾酮水平测定的临床意义。方法:随机选取我院2017年9月-2018年12月收治的1型糖尿病患者30例,均为青少年,测定血清睾酮水平和性激素六项,另选取血糖正常的青少年30例为对照组,分析其与血糖、体重指数(BMI)、胰岛素敏感性等因素的相关性,并对1型糖尿病患者根据血睾酮水平四分位法的三个切点值(10、15、20nmol/L)分为四组,分别为≤10nmol/L、10~15nmol/L、15~20nmol/L和≥20nmol/L,阐述糖代谢的受损与睾酮水平变化的相关性。结果:1型糖尿病组的总睾酮明显低于对照组,而雌二醇和性激素结合球蛋白明显高于对照组,差异具有统计学意义(P<0.05),其余指标比较差异无统计学意义(P>0.05);1型糖尿病患者的血睾酮水平,根据四分位法的三个切点值(10、15、20nmol/L),分为四组,四组的空腹胰岛素和胰岛素抵抗指数比较差异无统计学意义(P>0.05),与≤10nmol/L组比较,血睾酮15~20nmol/L组和≥20nmol/L组的空腹血糖和糖化血红蛋白(HbA1c)降低,而BMI升高,差异具有统计学意义(P<0.05)。Pearson相关分析显示,血清总睾酮与BMI呈正相关(r=0.745,P=0.001),而与血糖和HbA1c呈负相关(r=-0.547和-0.822,P=0.001)。结论:1型糖尿病的青少年患者存在明显的睾酮水平异常以及性激素代谢紊乱,且低睾酮水平与糖代谢异常存在密切关系。Objective:To investigate the clinical significance of testosterone level measurement in adolescents with type 1 diabetes mellitus.Methods:Randomly selected from September 2017 to December 2018 in our hospital were 30 patients with type 1 diabetes,are all teenagers,the determination of serum testosterone and sex hormone six,another selection teenagers 30 cases as control group of normal blood glucose analysis with blood glucose,body mass index(BMI)and insulin sensitivity factors such as correlation,this paper damage of sugar metabolism relevance to changes in testosterone levels.According to the blood testosterone level,patients with type 1 diabetes were divided into four groups according to the three cut-off point values(10,15,20 nmol/L)of the quartile method,which were≤10 nmol/L,10~15 nmol/L,15~20 nmol/L and≥20 nmol/L.Results:The total testosterone in type1 diabetes group was significantly lower than that in the control group,while estradiol and sex hormone binding globulin were significantly higher than those in the control group,with statistically significant differences(P<0.05),and no statistically significant differences in other indicators(P>0.05).With type 1 diabetes blood testosterone levels,depending on the three point of tangency quarterback method(10,15,20 nmol/L),divided into four groups,four groups of fasting insulin and insulin resistance index is no statistically significant difference(P>0.05),compared with≤10 nmol/L group,blood testosterone 15~20 nmol/L group and≥20 nmol/L reduced fasting blood glucose and HbA1c,and higher BMI,statistically significant difference(P<0.05).Pearson correlation analysis showed that serum total testosterone was positively correlated with BMI(r=0.745,P=0.001),and negatively correlated with blood glucose and HbA1c(r=-0.547 and-0.822,P=0.001).Conclusion:There are obvious abnormal testosterone levels and disturbance of sex hormone metabolism in adolescents with type 1 diabetes,and low testosterone levels are closely related to abnormal glucose metabolism.

关 键 词：1型糖尿病 青少年 睾酮 

分 类 号：R587.1[医药卫生—内分泌]