改善胰岛素抵抗对中年男性2型糖尿病患者血清睾酮水平的影响.docVIP

· 3118 · · 论 著 · 改善胰岛素抵抗对中年男性2型糖尿病患者血清睾酮 水平的影响 王国君，杨占君，杜群，王国萍 【摘要】 目的 评价中年男性2型糖尿病 (T2DM) 患者血清性腺激素水平与胰岛素抵抗的相关性，以及改善 胰岛素抵抗对血清睾酮水平的影响。方法 选取86例30～65岁男性T2DM 患者，测定其性腺激素水平及各项临床指 标，分析血清总睾酮 (TT) 水平与各代谢指标的相关性。其中69例患者给予降糖及改善胰岛素抵抗治疗3个月，用配 对t 检验比较治疗前后患者的各项观察指标。 结果 (1)相关分析显示：血清TT 水平与体质指数 (BMI) 、 腰臀比 (WHR)、 胰岛素抵抗指数 (HOMA-IR)、 空腹胰岛素 (FINS)、 空腹C 肽 (FCP)、 三酰甘油 (TG) 呈负相关 (P 0.05),与高密度脂蛋白胆固醇 (HDL-C) 呈正相关 (P0.01)。 睾酮分泌指数 (TSI) 与年龄、促卵泡生成素 (FSH)、HOMA-IR、WHR、BMI、FINS 呈负相关 (P0.05), 与 HDL-C 呈正相关 (P0.05)。(2)69 例患者治 疗前后空腹血糖 (FPG)、 糖化血红蛋白 (HbA,。)、 总胆固醇 (TC)、TG、HDL-C、FINS、FCP、HOMA-IR、TT、 TSI、促黄体生成素 (LH) 及 WHR 比较，差异均有统计学意义 (P0.05)。 结论 胰岛素抵抗是影响中年男性 T2DM 患者睾酮水平的主要因素；而尽早开始降糖治疗，改善胰岛素抵抗，可提高中年男性T2DM 患者的血清睾酮水平。 【关键词】 睾酮；糖尿病，2型；胰岛素抵抗 【中图分类号】 R587.1 R588.1 【文献标识码】 A 【文章编号】1007-9572(2012)09-3118- 03 Effect of Insulin Resistance Improvement on Testosterone in Middle -Aged Males with Type 2 Diabetes WANG Guo- jun,YANG Zhan -jun,DU Qun, et al.Department of Endocrinology, the Second Affiliated Hospital of Baotou Medical College, Foundation Institute of Baotou Medical College,Baotou 014030,China 【Abstract] Objective To evaluate the relationship between sexual hormones levels in serum and insulin resistance in middle - aged males with type 2 diabetes mellitus(T2DM)and the influence of improving insulin resistance on testosterone. Methods 86 T2DM male patients aged from 30 to 65 years were selected. The levels of sex hormones and each clinical index were tested and the relationship between total testosterone(TT)and each metabolic index was analyzed. 69 cases were given treatment to reduce blood glucose and improve insulin resistance for three months and paired t test was used to compare each index before and after the treatment. Results (1)Correlation analysis showed that TT was negatively correlated with BMI,WHR, HOMA-IR,FINS,FCP and TG(P0.05).Testosterone secreting index(TSI) was negatively correlated with age,FSH, HOMA-IR,WHR,BMI and