潘晓洁 彭永德 朱麒钱

　　作者单位：200080上海交通大学附属第一人民医院内分泌科(潘晓洁、彭永德);绍兴市人民医院内分泌代谢科(朱麒钱)(第一作者现在绍兴市人民医院内分泌代谢科工作)

　　通讯作者：朱麒钱，E-mail：sxzqq@126.com

　　【摘要】目的 探讨男性2型糖尿病(T2DM)患者血清总睾酮(TT)水平与肥胖、胰岛素抵抗(IR)、血糖、血脂间的关系。方法对120例男性T2DM患者进行性激素、FPG、FIns、FC-P、HbA1c、血脂水平测定。根据稳态模型评估法(HOMA)评价IR程度。结果120例男性T2DM患者中TT低下者占14%，IR占71%，BMI≥23 kg/m2者占52%。TT与BMI、FIns及WHR成负相关(r=-0.335,-0.307,-0.232,P<0.01)，与年龄、病程、血糖、FC-P、HbA1c水平等无相关性。BMI与WHR、FIns、FC-P及InHOMA-IR成正相关(r=0.489，0.348，0.356，0.301 P<0.01或P<0.05)，年龄与黄体生成素、卵泡刺激素成正相关(r=0.310，0.442，P<0.01)。结论肥胖是男性T2DM患者TT水平低下的主要影响因素，通过肥胖的介导，TT与IR及脂代谢紊乱相关。

　　【关键词】睾酮;糖尿病，2型;性腺功能减退症;肥胖;胰岛素抵抗

　　doi:10.3969/j.issn.1006-6187.2011.02.013

　　Analysis of male hypogonadism and related factors in type 2 diabetes

　　PAN Xiao-jie,PENG Yong-de,ZHU Qi-qian.Department of Endocrinology, Shanghai First People′s Hospital, Shanghai 200080, China

　　Corresponding author： ZHU Qi-qian, E-mail: sxzqq@126.com

　　【Abstract】Objective　　To evaluate the serum testosterone levels of type 2 diabetes in men and to explore the relationship of serum testosterone levels with obesity, insulin resistance, glucose and lipid metabolism.MethodsThe 120 men diagnosed as type 2 diabetes recieved measurements of serum total testosterone, LH, FSH, glucose, insulin, C peptide, HbA1c, total cholesterol, triglyeride, HDL-C, LDL-C. The HOMA-IR was used to evaluate the degree of insulin resistance.ResultsOf the subjects, 14% were with low levels of total testosterone (TT), 71% had insulin resistance , 52% were with overweight or obesity. TT negatively correlated with BMI, FIns and WHR(r=-0.335 for BMI, -0.307 for FIns, and -0.232 for WHR; all P<0.05~0.01). But there were no significant associations of TT with age, duration of diabetes, FPG, FC-P, HbA1c, TG, TC, and lnHOMA-IR. BMI was correlated strongly and positively with WHR , FIns and FC-P(r=0.489 for WHR, r=0.348 for FIns, r=0.356 for FC-P,all P<0.01), and lnHOMA-IR with(r=0.301, P<0.05). There was a positive relationship between age and gonadotropic hormone, including LH and FSH ( r=0.310 for LH, r=0.442 for FSH, all P<0.01).ConclusionsObesity is the main risk factor for hypotestosteronemia in men with type 2 diabetes. Serum testosterone is correlated with insulin resistance and dyslipidemia.

　　【Key words】Testosterone; Diabetes mellitus, type 2; Hypogonadism; Obesity; Insulin resistance