男性高尿酸血症患者性腺功能减退的危险因素分析  

Analysis of risk factors for hypogonadism in male patients with hyperuricemia

作　　者：程晓宇[1] 马利丹[1] 刘甜[1] 李鑫德[1] 辛颖[1] 陈颖[1] 孙瑞霞[1] Cheng Xiaoyu;Ma Lidan;Liu Tian;Li Xinde;Xin Ying;Chen Ying;Sun Ruixia(Department of Endocrinology and Metabolic Diseases,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院内分泌代谢病科,266003

出　　处：《中华内分泌代谢杂志》2020年第7期586-592,共7页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金(81801434)。

摘　　要：目的探讨男性高尿酸血症(HUA)患者合并性腺功能减退的危险因素。方法入选HUA男性患者245例,均测量身高、体重、腰围、血压,测定空腹血尿酸、三酰甘油(TG)、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、谷丙转氨酶(ALT)、谷草转氨酶、谷氨酰转肽酶、血尿素氮、肌酐、空腹血糖(FPG)、空腹胰岛素(FINS)以及性激素,计算体重指数(BMI)、游离睾酮(FT)、稳态模型评估的胰岛素抵抗指数(HOMA-IR),并进行男性雄激素缺乏调查表(ADAM)及男性老龄化症状调查表(AMS)问卷调查。根据FT水平及ADAM、AMS问卷结果分为性腺功能减退组(102例)和性腺功能正常组(143例)。分析2组不同代谢指标的差异及与性腺功能减退的相关性。结果与性腺功能正常组相比,性腺功能减退组腰围、血尿酸、BMI、FPG、FINS、HOMA-IR、TG、ALT明显升高,雌二醇水平明显降低(均P<0.05);合并非酒精性脂肪肝、高脂血症及肥胖的比例明显升高(均P<0.05)。Logistic回归分析显示,血尿酸、BMI、腰围、HOMA-IR、TG是男性HUA患者性腺功能减退的危险因素;多元回归方程分析显示,在校正其他因素后血尿酸仍是性腺功能减退的危险因素。结论男性HUA患者常合并性腺功能减退,其中血尿酸、BMI、腰围、HOMA-IR、TG是性腺功能减退的危险因素。Objective To explore the risk factors for hypogonadism in male patients with hyperuricemia(HUA).Methods A total of 245 male patients with HUA were enrolled.Height,weight,waist circumference(WC),blood pressure,serum uric acid(SUA),triglyceride(TG),total cholesterol,low density lipoprotein-cholesterol,high density lipoprotein-cholesterol,alanine aminotransferase(ALT),aspartate aminotransferase,glutamyltranspeptidase,blood urea nitrogen,serum creatinine,fasting blood glucose(FPG),fasting insulin(FINS)and sex hormones were measured in all patients.And then body mass index(BMI),free testosterone(FT),and homeostasis model assessment of insulin resistance index(HOMA-IR)were calculated.Male androgen deficiency questionnaire(ADAM)and male aging symptom questionnaire(AMS)were conducted.The patients were divided into hypogonadism group(n=102)and normal gonadal function group(n=143)according to FT level as well as ADAM and AMS questionnaires.The differences in different metabolic indicators between the two groups and the correlation with hypogonadism were analyzed.Results Compared with the normal gonadal function group,WC,SUA,BMI,FPG,FINS,HOMA-IR,TG,and ALT were significantly increased,while estradiol level was significantly reduced in the hypogonadism group(all P<0.05).The proportions of nonalcoholic fatty liver,hyperlipidemia,and obesity were significantly increased in the hypogonadism group(all P<0.05).Logistic regression analysis showed that SUA,BMI,WC,HOMA-IR,and TG were independent risk factors for hypogonadism in male HUA patients.Multivariate regression analysis showed that SUA still was a risk factor after adjusting for other factors.Conclusion Male patients with HUA were often accompanied by hypogonadism.SUA,BMI,WC,HOMA-IR,and TG were risk factors for hypogonadism in male patients with HUA.

关 键 词：高尿酸血症 男性 性腺功能减退 睾酮 

分 类 号：R589.7[医药卫生—内分泌]