血清FGF21水平与2型糖尿病勃起功能障碍的相关性  

Correlation between erectile dysfunction and serum FGF21 level in patients with type 2 diabetes

作　　者：杨松[1] 谷媛媛[2] 王超楠 伦恒忠[4] Yang Song;Gu Yuanyuan;Wang Chaonan;Lun Hengzhong(Second Department of Endocrinology,Tai′an Central Hospital,Tai′an,271000,China;Department of Pharmacy,Tai′an Central Hospital,Tai′an 271000,China;Clinical College,Shandong First Medical University,Tai′an,271000,China;Department of Laboratory,Tai′an Central Hospital,Tai′an,271000,China)

机构地区：[1]泰安市中心医院内分泌二科,泰安271000 [2]泰安市中心医院药学部,泰安271000 [3]山东第一医科大学临床学院,泰安271000 [4]泰安市中心医院检验科,泰安271000

出　　处：《中国医师杂志》2022年第2期221-225,230,共6页Journal of Chinese Physician

基　　金：山东省医药卫生科技发展计划项目(2018WS153)。

摘　　要：目的探讨糖尿病并发勃起功能障碍(DMED)的发生与血清成纤维细胞生长因子21(FGF21)水平的相关性,分析FGF21在DMED发生中的作用,探讨其对DMED的预测和诊断价值。方法选取2017年1月至2018年6月于泰安市中心医院住院及门诊就诊的61例男性2型糖尿病患者为研究对象,分为2型糖尿病勃起功能障碍组(DMED组,n=30),2型糖尿病组(DM组,n=31),同时选取32例健康体检人群为对照组。收集所有研究对象的一般资料、对患者进行查体、生殖器检查及抽血进行生化分析,用国际勃起功能指数-5(IIEF-5)问卷测定勃起功能,用特全自动生化分析仪检测血清FGF21水平。Spearman相关分析IIEF-5评分与FGF21及其他指标的相关性。多元线性回归分析影响DMED的相关危险因素。采用受试者工作特征(ROC)曲线分析FGF21水平对DMED的预测价值。结果(1)DMED组、DM组、对照组的血清FGF21水平分别为(112.5±9.2)pg/ml、(103.9±6.2)pg/ml、(91.9±3.9)pg/ml,差异均有统计学意义(均P<0.05)。(2)Spearman相关分析显示:IIEF-5评分与FGF21、年龄、吸烟、饮酒、收缩压、舒张压、HbA1c、空腹血糖、TC、TG、LDL-C、FINS、HOMA-IR呈负相关(均P<0.05),与HDL-C、睾酮呈正相关(均P<0.05)。血清FGF21水平与吸烟、饮酒、收缩压、舒张压、HbA1c、空腹血糖、TC、TG、LDL-C、FINS、HOMA-IR呈正相关(均P<0.05),与HDL-C、睾酮呈负相关(均P<0.05)。(3)多元线性回归分析显示FGF21、HbA1c、HOMA-IR与IIEF-5是勃起功能的独立危险因素(均P<0.05)。(4)根据ROC曲线,FGF21水平的最佳截断值为102.75 pg/ml,此时对DMED的预测灵敏度为0.867,特异度为0.714。结论血清FGF21水平与糖尿病发病及DMED的发生有密切关系,是DMED发病的独立危险因子。Objective To study the correlation between the occurrence of diabetes mellitus complicated with erectile dysfunction(DMED)and serum fibroblast growth factor-21(FGF21)level,analyze the role of FGF21 in the occurrence of DMED,and explore its predictive and diagnostic value for DMED.Methods 61 male patients with type 2 diabetes in Tai′an Central Hospital from January 2017 to June 2018 were selected as subjects.They were divided into 2 groups:DMED group(n=30)and type 2 diabetes mellitus group(DM group,n=31).And 32 healthy persons were selected as control group.The general data of all subjects were collected,physical examination,genital examination and blood sampling were carried out for biochemical analysis.The erectile function was measured by International Erectile Function Index-5(IIEF-5)questionnaire,and serum FGF21 level was detected by automatic biochemical analyzer.The correlation between IIEF-5 score with FGF21 and other indicators were analyzed by Spearman correlation analysis.Multiple linear regression analysis was used to analyze the related risk factors affecting DMED.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of FGF21 level for DMED.Results(1)The serum level of FGF21 in the DMED group,DM group,control group were(112.5±9.2)pg/ml,(103.9±6.2)pg/ml and(91.9±3.9)pg/ml respectively,with significant differences(all P<0.05).(2)Spearman correlation analysis showed that IIEF-5 score was negatively correlated with FGF21,age,smoking,drinking,systolic blood pressure,diastolic blood pressure,glycated hemoglobin A1c(HbA1c),fasting plasma glucose(FPG),total cholesterol(TC),total glyceride(TG),low density lipoprotein cholesterol(LDL-C),fasting insulin(FINS),homeostasis model insulin resistance index(HOMA-IR),and positively correlated with high density lipoprotein cholesterol(HDL-C)and testosterone(all P<0.05).The serum FGF21 level was positively correlated with smoking,drinking,systolic blood pressure,diastolic blood pressure,HbA1c,FPG,TC,TG,LDL-C,FINS,HOMA-IR,and negatively

关 键 词：糖尿病 2型 勃起功能障碍 成纤维细胞生长因子21 

分 类 号：R587.2[医药卫生—内分泌] R698.1[医药卫生—内科学]