成年男性2型糖尿病患者血清游离睾酮水平及其相关因素研究  

Study on serum free testosterone level and its relevant factors in adult male patients with type 2 diabetes mellitus

作　　者：刘诗宇 曹哲 杨童悦 潘越 张媛媛[1] 温胜兰 秦贵军[1] 赵艳艳[1] Liu Shiyu;Cao Zhe;Yang Tongyue;Pan Yue;Zhang Yuanyuan;Wen Shenglan;Qin Guijun;Zhao Yanyan(Department of Endocrinology and Metabolic Diseases,The First Affiliated Hospital of Zhengzhou University)

机构地区：[1]郑州大学第一附属医院内分泌与代谢病科,郑州450052

出　　处：《重庆医科大学学报》2022年第11期1353-1358,共6页Journal of Chongqing Medical University

基　　金：国家自然科学基金资助项目(编号:81800734);河南省高等学校重点科研计划资助项目(编号:18B310040)。

摘　　要：目的:探讨男性2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清游离睾酮(free testosterone,FT)水平及其相关影响因素。方法:回顾性分析2018年2月至2019年2月郑州大学第一附属医院收治的18~70岁男性2型糖尿病患者303例,并以年龄1∶1匹配于本院体检的非糖尿病健康男性303例作为对照,比较2组间不同年龄段血清FT水平的差异。根据血清FT水平将T2DM组患者按四分位法分为Q1组、Q2组、Q3组和Q4组,采用Spearman秩相关分析FT水平的相关因素并采用logistic回归分析探讨男性T2DM患者低血清FT水平的影响因素。结果:男性T2DM患者血清FT水平明显低于同年龄组的健康男性对照,且随年龄增长而降低;Spearman秩相关分析显示,FT与年龄(r=-0.402,P<0.001)、体质指数(body mass index,BMI)(r=0.215,P=0.001)、糖尿病病程(r=-0.121,P=0.035)呈负相关,与总胆固醇(total cholesterol,TC)(r=0.115,P=0.049)、25-羟维生素D3[25-hydroxyl vitamin D3,25-(OH)D3](r=0.340,P<0.001)、促甲状腺激素(thyroid-stimulating hormone,TSH)(r=0.231,P=0.025)呈正相关;多元logistic回归分析显示,在校正年龄、城乡分布、糖尿病病程、吸烟史、饮酒史后,高BMI(OR=1.101,95%CI=1.023~1.183,P=0.009)、高糖化血红蛋白(glycosylated hemoglobin,HbA1c)(OR=1.175,95%CI=1.060~1.302,P=0.002)、低25-(OH)D3(OR=0.937,95%CI=0.900~0.975,P=0.001)及低TSH(OR=0.838,95%CI=0.710~0.989,P=0.037)是低FT水平的影响因素。结论:成年男性T2DM患者血清FT水平低于同年龄组健康男性,低FT水平与高BMI、高HbA1c、低25-(OH)D3及低TSH密切相关。Objective:To evaluate the level of serum free testosterone(FT)and to investigate the relevant factors of FT in male patients with type 2 diabetes mellitus(T2DM).Methods:A retrospective study was conducted on 303 male patients with T2DM aged between 18-70 years and another age-matched 303 healthy individuals were selected as controls. We compared the difference of demographic and clinical indicators in different FT levels. According to the serum FT level,T2DM patients were divided into Q1 group,Q2 group,Q3 group and Q4 group by quartile method. Spearman rank correlation analysis and logistic regression analysis was conducted to analyze the revalent factors of the decrease of serum FT in T2DM patients.Results:The level of serum FT in men with T2DM was significantly lower than that in control group,and decreased with age. Spearman rank correlation analysis showed that FT was negatively cor-related with age(r=-0.402,P<0.001),BMI(r=0.215,P=0.001),duration of diabetes(r=-0.121,P=0.035),and positively correlated with total cholesterol(TC)(r=0.115,P=0.049),25-(OH)D3(r=0.340,P<0.001),and thyroid-stimulating hormone(TSH)(r=0.231,P=0.025). Multivariate logistic regression analysis showed that after adjustment for age,distribution,history of diabetes,smoking and alcohol consumption,high BMI(OR=1.101,95%CI=1.023-1.183,P=0.009),high HbA1c(OR=1.175,95%CI=1.060-1.302,P=0.002),low 25-(OH)D3(OR=0.937,95%CI=0.900-0.975,P=0.001),and low TSH(OR=0.838,95%CI=0.710-0.989,P=0.037)were closely related to low FT level.Conclusion:T2DM patients have lower level of FT than healthy men and the low of serum FT level may be related to high BMI,high HbA1c,low 25-(OH)D3and low TSH.

关 键 词：2型糖尿病 游离睾酮 男性 性腺功能减退 

分 类 号：R587.1[医药卫生—内分泌]