不同减重效果对2型糖尿病并肥胖中年男性患者性激素水平及代谢组分的影响  

Impacts of different weight-loss effects on sex hormones levels and metabolic components in middle-aged obese male patients with type 2 diabetes mellitus

作　　者：黄建皓[1] 卢杰 玉颜庆[1] 颜晓东[1] HUANG Jian-hao;LU Jie;YU Yan-qing;YAN Xiao-dong(Department of Endocrinology,the People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院内分泌科,南宁市530021

出　　处：《广西医学》2020年第15期1962-1966,共5页Guangxi Medical Journal

基　　金：广西医药卫生科研课题(Z2016587);广西科学研究与技术开发计划(桂科攻15277013)。

摘　　要：目的探讨不同减重效果对2型糖尿病(T2DM)并肥胖中年男性患者性激素水平及代谢组分的影响。方法纳入50例T2DM并肥胖中年男性患者,给予降糖治疗及减重干预。干预6个月后根据体质指数分为减重达标组(体质指数<28 kg/m^2)23例和减重未达标组(体质指数≥28 kg/m^2)27例。对比干预前后两组患者体重、体质指数、腰围、性激素水平、糖化血红蛋白(HbA1c)、血脂指标水平。结果干预后,减重达标组患者体重、体质指数、腰围均下降(均P<0.05),减重未达标组体质指数较治疗前下降(P<0.05),但体重、腰围治疗前后差异并无统计学意义(均P>0.05);且减重达标组体重、体质指数均低于减重未达标组(均P<0.05)。减重达标组的总睾酮水平较干预前增加且高于减重未达标组(P<0.05)。干预后,两组的HbA1c、LDL-C、三酰甘油均较干预前降低,减重达标组的载脂蛋白B水平亦低于干预前(均P<0.05),同时减重达标组的总胆固醇水平低于减重未达标组(均P<0.05)。结论减重达标可以提高中年男性T2DM合并肥胖患者睾酮水平,并改善脂代谢紊乱。Objective To investigate the impacts of different weight-loss effects on sex hormones levels and metabolic components in middle-aged obese male patients with type 2 diabetes mellitus(T2DM).Methods Fifty middle-aged obese male patients with T2DM were enrolled,and received anti-diabetic therapy and weight-loss intervention.After six months of intervention,the patients were divided into weight-loss with standard group(body mass index<28 kg/m^2,n=23)and weight-loss without standard group(body mass index≥28 kg/m^2,n=27)according to their body mass index.Before and after intervention,related indices of both groups were compared,including weight,body mass index,waist circumference,as well as levels of sex hormones,hemoglobin A1c(HbA1c)and blood lipids indicators.Results After intervention,the weigh-loss with standard group yielded decreased weight,body mass index and waist circumference(all P<0.05),and the weight-loss without standard group achieved a declined body mass index than the pretreatment(P<0.05),showing no statistical significant difference in weight or waist circumference before and after treatment(all P>0.05);moreover,the weight and body mass index in the weight-loss with standard group were lower than those in the weight-loss without standard group(all P<0.05).The weight-loss with standard group exhibited a higher total testosterone level as compared with pre-intervention and the weight-loss without standard group(all P<0.05).After intervention,the levels of HbA1c,LDL-C and TG in both groups were lower than the levels before intervention,and the weight-loss with standard group had a decreased apolipoprotein B level as compared with pre-intervention and a decreased total cholesterol level as compared with the weight-loss without standard group(all P<0.05).Conclusion Weight-loss reaching the standard can increase testosterone level in middle-aged obese men with T2DM and improve disorders of lipid metabolism.

关 键 词：2型糖尿病 肥胖 减重 达标 性激素 代谢组分 男性 中年 

分 类 号：R587.1[医药卫生—内分泌]