【摘要】 目的:比较2型糖尿病男性(T2DMM)与健康男性的雄激素水平,分析T2DMM性腺功能减退的状况以及性腺功能减退与生活质量的关系。方法:选取166例30岁以上的T2DMM患者,收集血清总睾酮、游离睾酮等全面的临床资料,采用ADAM量表、AMS量表、SF-36量表、糖尿病患者生存质量特异性量表(DSQL)研究。选择186例年龄匹配的健康男性作为对照组,比较雄激素水平。结果:在所有T2DMM患者,血清游离睾酮(c FT)水平明显低于各个同年龄组的健康男性对照(P<0.05),总睾酮水平(TT)、生物活性睾酮(Bio-T)和性激素结合球蛋白(SHBG)在两组间无统计学差异。T2DMM伴有性腺功能减退与不伴性腺功能减退患者相比,年龄、身高、收缩压、肌酐有统计学差异(P<0.05)。以AMS问卷异常(得分≥27分)同时c FT低于0.3 nmol/L为性腺功能减退的诊断标准时,T2DMM伴发性腺功能减退达51.81%,且随年龄增长伴发率上升(30~39岁,31.58%;40~49岁,32.5%;50~59岁,50%;60~69岁,69.23%;≥70岁,77.27%)。年龄是性腺功能减退的危险因素,每增加10岁,性腺功能减退风险增加77.4%(OR=1.774,P<0.001)。T2DMM患者AMS量表与SF-36量表(r=-0.7393,P<0.001)、DSQL量表(r=0.557,P<0.001)评分之间存在显著相关性。结论:T2DMM的游离睾酮低于健康男性,性腺功能减退的伴发率较高,年龄是性腺功能减退的主要危险因素。雄激素缺乏症状程度越严重,生活质量各个维度的评分越差。更多还原

【Abstract】 Objective:To compare the level of testosterone between type-2 diabetes mellitus(T2DM) patients and healthy controls and to investigate the status of hypogonadism and the influence of hypopgonadism on the quality of life. Methods: We collected serum total testosterone(TT),free testosterone(FT),sex hormone-binding globulin(SHBG),and other clinical data from 166T2DM patients aged over 30 years and 186 age-matched healthy controls. We investigated the quality of life(QoL) of the two groups of subjects using the questionnaires of Androgen Deficiency in Aging Males(ADAM),Aging Male Symptoms(AMS),36-Item ShortForm Health Survey(SF-36),and Special Quality of Life for Diabetes Mellitus(DSQL). Results: The level of calculated FT(cFT)was remarkably lower in the T2DM patients than in the healthy controls(P<0.05),but no statistically significant differences were observed between the two groups in the levels of TT,bio-available testosterone( Bio-T),and SHBG. The T2DM males with hypogonadism showed significant differences from those without in age,height,systolic blood pressure,and creatinine(P<0.05). Based on the criteria of cFT<0. 3 nmol / L and AMS score ≥27,the incidence rate of hypogonadism was 51.81% in the T2DM patients,31.58% in the 30- 39 yr group,32.50% in the 40-49 yr group,50% in the 50- 59 yr group,69.23% in the 60- 69 yr group,and 77.27% in the ≥70 yr group,elevated by 77.4% with the increase of 10 years of age(OR=1.774,P<0.001). The AMS score was significantly correlated with the scores of DSQL(r=0.557,P<0.001) and SF-36(r=- 0. 739,P<0.001) in the T2 DM patients. Conclusion: T2DM patients have lower levels of c FT than healthy men,accompanied with a higher incidence of hypogonadism. Age is a main risk factor of hypogonadism. Severer testosterone deficiency symptoms are associated with lower scores of Qo L in T2 DM males.更多还原