中老年男性2型糖尿病患者血清睾酮与动脉粥样硬化的相关性

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目的了解血清睾酮(TT)、游离睾酮(FT)与男性2型糖尿病患者合并动脉粥样硬化的相关性。方法选择2015年在新疆维吾尔自治区人民医院内分泌科住院的2型糖尿病男性患者99例,根据是否合并动脉硬化,将其分为两组:一组为合并动脉硬化患者,共60例,为动脉硬化组,其中冠状动脉粥样硬化者21例,颈动脉粥样硬化39例;另一组为无动脉硬化患者,共39例,为正常对照组。采用化学发光法测定2型糖尿病患者血清TT、性激素结合球蛋白(SHBG)、空腹血糖(FBG)、餐后2小时血糖(PBG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),采用高效色谱法测定全血糖化血红蛋白(Hb A1c),采用放射免疫法测定血清FT。对两组间生化指标进行比较,分析2型糖尿病合并动脉粥样硬化的危险因素。结果动脉硬化组的SHBG、FT水平低于正常对照组,差异有统计学意义(P均<0.05);糖尿病合并动脉粥样硬化患者,血清FT与腹围(r=-0.260,P=0.046)、年龄(r=-0.338,P=0.009)呈负相关;冠状动脉硬化组SHBG和体重大于颈动脉硬化组,差异有统计学意义(P均<0.05);Logistic回归分析结果显示年龄是糖尿病合并动脉粥样硬化的危险因素(OR=1.137,P=0.001),FT是保护因素(OR=1.335,P=0.045)。结论血清FT含量的降低,可能是2型糖尿病动脉粥样硬化发生发展的危险因素之一。 Objective To investigate the correlation between serum testosterone (TT), free testosterone (FT) and atherosclerosis in male type 2 diabetic patients. Methods A total of 99 male patients with type 2 diabetes who were hospitalized in Department of Endocrinology, People ’s Hospital of Xinjiang Uygur Autonomous Region in 2015 were divided into two groups according to whether they had atherosclerosis or not: one was combined with atherosclerosis, 60 cases were atherosclerosis Group, of which 21 cases of coronary atherosclerosis, carotid atherosclerosis in 39 cases; the other group of patients without atherosclerosis, a total of 39 cases, the normal control group. The levels of serum TT, sex hormone binding globulin (SHBG), fasting blood glucose (FBG), postprandial blood glucose (PBG), triglyceride (TG), total cholesterol (TC), low density LDL-C and HDL-C were measured. Hb A1c was measured by high performance liquid chromatography (HPLC) and serum FT was measured by radioimmunoassay. Biochemical indicators of the two groups were compared to analyze the risk factors for type 2 diabetes with atherosclerosis. Results The levels of SHBG and FT in atherosclerosis group were lower than those in normal control group (all P <0.05). The serum levels of FT and abdominal circumference (r = -0.260, P = 0.046) were significantly higher in atherosclerosis patients with diabetes mellitus , Age (r = -0.338, P = 0.009). The SHBG and body weight in coronary atherosclerosis group were significantly higher than those in carotid atherosclerosis group (all P <0.05). Logistic regression analysis showed that age was associated with diabetes mellitus The risk factors of atherosclerosis (OR = 1.137, P = 0.001) and FT were protective factors (OR = 1.335, P = 0.045). Conclusions The decrease of serum FT content may be one of the risk factors for the development of atherosclerosis in type 2 diabetes mellitus.
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