新诊断2型糖尿病男性患者总睾酮水平与尿酸水平的相关性研究  

Correlation between uric acid and total testosterone levels in male patients with newly diagnosed type 2 diabetes mellitus

作　　者：李菲[1] 闫光悦 王广宇[1] 张立娟[1] LI Fei;YAN Guangyue;WANG Guangyu;ZHANG Lijuan(Department of Endocrinology,Putuo People's Hospital,School of Medicine,Tongji University,Shanghai 200060,China)

机构地区：[1]同济大学附属普陀人民医院内分泌科,上海200060

出　　处：《同济大学学报（医学版）》2023年第4期557-561,共5页Journal of Tongji University(Medical Science)

摘　　要：目的探讨新诊断的2型糖尿病男性患者总睾酮水平与血尿酸水平的关系。方法从2018年4月—2022年12月纳入166例新诊断的2型糖尿病(type 2 diabetes mellitus,T2DM)男性患者,根据总睾酮(total testosterone,TT)的水平,分为正常睾酮(normal total testosterone,NTT)组(TT≥12 nmol/L,n=98)和低睾酮(low total testosterone,LTT)组(TT<12 nmol/L,n=68),测定一般临床指标(年龄、BMI),生化指标[总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白(low density lipoprotein,LDL)、高密度脂蛋白(high density lipoprotein,HDL)、谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate transaminase,AST)、肌酐(creatinine,Cr)、血尿酸(serum uric acid,SUA)、空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、空腹胰岛素(fasting insulin,FINS)]及性激素指标[(TT、黄体生成素(luteinizing hormone,LH)、卵泡刺激素(follicle stimulating hormone,FSH)、雌二醇(estradiol,E 2)],并计算得出稳态模型评估胰岛素抵抗指数(HOMA-IR),比较两组指标之间的统计学差异。根据SUA水平,按照三分位数法分组,比较各组性激素指标的差异;使用相关分析及多元线性回归分析综合评估TT水平与SUA之间的关系。结果与NTT组相比,LTT组BMI、SUA、ALT、FINS及HOMA-IR升高,HDL降低,两组差异有统计学意义(P<0.05);随着SUA水平升高,TT水平降低(P<0.05);相关分析显示,校正年龄、BMI、HbA1c和HOMA-IR后,SUA与TT仍呈负相关;多元线性回归分析显示,BMI、SUA与TT水平显著负相关(B=-0.343,P=0.014;B=-0.014,P=0.002),而HOMA-IR、HDL、ALT与TT水平无关。结论在新诊断的T2DM男性患者中,SUA升高是TT降低的危险因素。Objective To explore the relationship between serum uric acid and total testosterone levels in male patients with newly diagnosed type 2 diabetes mellitus(T2DM).Methods A total of 166 male patients with newly diagnosed T2DM from April 2018 to December 2022 were enrolled.According to the level of total testosterone(TT),patients were divided into normal total testosterone(NTT)groups(TT≥12 nmol/L,n=98)and low total testosterone(LTT)groups(TT<12 nmol/L,n=68).The age,body mass index(BMI),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(Cr),serum uric acid(SUA),fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),total testosterone(TT),luteinizing hormone(LH),follicle-stimulating hormone(FSH),estradiol(E 2)were documented;the homeostasis model evaluation insulin resistance index(HOMA-IR)was calculated and compared between the two groups.The sex hormone indexes were compared among patients with different SUA levels.Correlation analysis and multiple linear regression analysis were used to evaluate the relationship between total testosterone(TT)level and serum uric acid(SUA).Results Compared with the NTT group,the BMI,SUA,ALT,FINS and HOMA-IR in the LTT group increased,while HDL decreased(all P<0.05).With the increase of SUA level,TT level decreased(P<0.05);Correlation analysis showed that after adjusting for age,BMI,HbA1c and HOMA-IR,SUA was still negatively correlated with TT.Multiple linear regression analysis showed that BMI,SUA,and TT levels were significantly negatively correlated(B=-0.343,P=0.014,B=-0.014,P=0.002),while HOMA-IR,HDL,and ALT were not associated with TT levels.Conclusion Elevated SUA is a risk factor for reduced TT in male patients with newly diagnosed T2DM.

关 键 词：2型糖尿病 男性 总睾酮 血尿酸 

分 类 号：R587.1[医药卫生—内分泌]