曹庆^1,2,,
田艳霜^1,2,
明明^1,2,
杜伟鹏^1,2,
李敏¹,
郭小勇^1,,
1. 内蒙古科技大学包头医学院第二附属医院 内分泌科，内蒙古 包头 014030
2. 内蒙古科技大学包头医学院研究生院，内蒙古 包头 014040

基金项目: 包头医学院创新团队发展计划项目（byjj-efytd-005）；内蒙古自治区 “十四五”社会公益领域重点研发和成果转化计划项目（2023YFSH0041）；内蒙古自治区卫健委项目（202202254）；包头市卫健委项目（Wsjkwkj008）；包头医学院研究生科研创新项目（bycx2023020）；包头医学院秦文斌教育基金项目（BYJJ-QWB202221）


详细信息 作者简介: 曹 庆（1996-），女，硕士研究生。E-mail：1547292535@qq.com






通讯作者: 郭小勇，副主任医师。E-mail：182019198@btmc.edu.cn 中图分类号: R587.1


摘要:目的探究男性2型糖尿病（T2DM）患者腹型肥胖与性激素之间的关系。方法选择包头医学院第二附属医院内分泌科收治的100例男性T2DM患者，根据内脏脂肪面积（VFA）分为正常内脏脂肪组（VFA＜100 cm²，23例）和高内脏脂肪组（VFA≥100 cm²，77例），收集患者一般资料并检测空腹血糖、血脂、肝功能及性激素水平，包括总睾酮（TT）、孕激素（P）、催乳素（PRL）、黄体生成素（LH）、卵泡刺激素（FSH）、雌二醇（E₂），计算出睾酮分泌指数（TSI）。采用t检验、U检验以及χ²检验比较正常内脏脂肪组及高内脏脂肪组患者性激素水平、糖脂代谢等相关指标的差异。采用Pearson或Spearman相关分析探讨血清TT水平与各变量之间的相关性。采用多因素logistic回归分析男性T2DM患者血清TT水平的影响因素。结果与正常内脏脂肪组相比，高内脏脂肪组的年龄、体重指数（BMI）、腰围（WC）、皮下脂肪、收缩压（SBP）、舒张压（DBP）、甘油三酯（TG）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、糖化血红蛋白（HbA1c）以及脂肪肝患病率明显升高（均P＜0.05），而TT、TSI显著降低（均P＜0.05）；相关性分析显示，TT与HDL-C、TSI呈正相关（均P＜0.05），与年龄、BMI、VFA、皮下脂肪、WC、TG以及HbA1c呈负相关（均P＜0.05）。多因素logistic回归分析显示，VFA和HbA1c为性腺功能减退的独立危险因素（均P＜0.05）。结论 男性T2DM患者常常存在性腺功能减退，特别是腹型肥胖的患者更加显著，VFA和HbA1c是性腺功能减退的危险因素。
关键词: 2型糖尿病/
男性/
睾酮/
内脏脂肪面积/
肥胖


Abstract:Objective To investigate the correlation between abdominal obesity and sex hormones in male patients with type 2 diabetes.Methods A total of 100 male patients with type 2 diabetes mellitus, who were admitted to the Department of Endocrinology in the Second Affiliated Hospital of Baotou Medical College, were enrolled and divided into normal visceral fat group (VFA＜100 cm², 23 cases) and high visceral fat group (VFA ≥100 cm², 77 cases) according to visceral fat area. The general data were collected and serum levels of blood glucose, lipids, liver function and sex hormones including testosterone (TT), progesterone (P), prolactin (PRL), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol (E₂) were measured. Testosterone secretion index (TSI) was calculated. t test, U test and χ² test were used to compare the sex hormone levels, glycolipid metabolism and other related indicators between the normal visceral fat group and the high visceral fat group. Pearson or Spearman correlation analysis was used to analyze the correlation between serum testosterone level and various variables, and multiple logistic regression analysis was used to analyze the influencing factors of serum testosterone level in male patients with type 2 diabetes mellitus.Results Compared with the normal visceral fat group, age, body mass index (BMI), waist circumference (WC), subcutaneous fat, systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), glycated hemoglobin (HbA1c) and prevalence of fatty liver were significantly higher in the high visceral fat group (all P＜0.05), while TT and TSI were significantly lower (all P＜0.05). Spearman correlation analysis showed that TT was positively correlated with HDL-C, TSI (all P＜0.05) while negatively correlated with age, BMI, VFA, subcutaneous fat, WC, TG and HbA1c (all P＜0.05). Multiple logistic regression analysis revealed that VFA and HbA1c were independent risk factors for hypogonadism (all P＜0.05).Conclusion Hypogonadism often occurs in male patients with type 2 diabetes mellitus, especially in patients with abdominal obesity. VFA and HbA1c are risk factors for hypogonadism in male type 2 diabetic patients.
Keywords:type 2 diabetes mellitus/
male/
testosterone/
visceral fat area/
obesity

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