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2型糖尿病男性患者血清内源性雄激素浓度低与动脉僵硬度之间的关系。

Relationship between low serum endogenous androgen concentrations and arterial stiffness in men with type 2 diabetes mellitus.

作者信息

Fukui Michiaki, Ose Hiroyuki, Kitagawa Yoshihiro, Yamazaki Masahiro, Hasegawa Goji, Yoshikawa Toshikazu, Nakamura Naoto

机构信息

Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi-Hirokoji, Kyoto, Japan.

出版信息

Metabolism. 2007 Sep;56(9):1167-73. doi: 10.1016/j.metabol.2007.04.011.

Abstract

The aim of this study was to evaluate the relationship between arterial stiffness determined by pulse wave velocity (PWV) and serum endogenous androgen concentrations as well as major cardiovascular risk factors in men with type 2 diabetes mellitus. Serum free testosterone and dehydroepiandrosterone sulfate (DHEA-S) concentrations were measured in 268 men with type 2 diabetes mellitus. Relationships between PWV and serum endogenous androgen concentrations as well as major cardiovascular risk factors, including age, blood pressure, serum lipid concentration, glycemic control (hemoglobin A(1c)), body mass index, and degree of albuminuria, were evaluated. Positive correlations were found between PWV and age (r = 0.491, P < .0001), duration of diabetes (r = 0.320, P < .0001), systolic blood pressure (r = 0.292, P < .0001), and log (urinary albumin excretion) (r = 0.269, P < .0001). Inverse correlations were found between serum free testosterone concentration and PWV (r = -0.228, P = .0003) and between serum DHEA-S concentration and PWV (r = -0.252, P = .0002) in men with type 2 diabetes mellitus. Pulse wave velocity was significantly greater in patients with lower concentrations of free testosterone (<10 pg/mL) than in patients with higher concentrations of free testosterone (1864 +/- 359 vs 1736 +/- 327 cm/s; P = .0053). Pulse wave velocity also was significantly greater in patients with lower concentrations of DHEA-S (<1000 ng/mL) than in patients with higher concentrations of DHEA-S (1843 +/- 371 vs 1686 +/- 298 cm/s; P = .0008). Multiple regression analysis identified both serum free testosterone concentration (beta = -.151, P = .0150) and serum DHEA-S concentration (beta = -.200, P = .0017) as independent determinants of PWV. In conclusion, serum endogenous androgen concentrations are inversely associated with arterial stiffness determined by PWV in men with type 2 diabetes mellitus, which is true for men in general based on other works.

摘要

本研究旨在评估通过脉搏波速度(PWV)测定的动脉僵硬度与2型糖尿病男性患者血清内源性雄激素浓度以及主要心血管危险因素之间的关系。对268例2型糖尿病男性患者测定血清游离睾酮和硫酸脱氢表雄酮(DHEA-S)浓度。评估PWV与血清内源性雄激素浓度以及主要心血管危险因素(包括年龄、血压、血脂浓度、血糖控制(糖化血红蛋白A1c)、体重指数和蛋白尿程度)之间的关系。发现PWV与年龄(r = 0.491,P <.0001)、糖尿病病程(r = 0.320,P <.0001)、收缩压(r = 0.292,P <.0001)和log(尿白蛋白排泄)(r = 0.269,P <.0001)呈正相关。在2型糖尿病男性患者中,发现血清游离睾酮浓度与PWV呈负相关(r = -0.228,P =.0003),血清DHEA-S浓度与PWV呈负相关(r = -0.252,P =.0002)。游离睾酮浓度较低(<10 pg/mL)的患者的脉搏波速度显著高于游离睾酮浓度较高的患者(1864±359 vs 1736±327 cm/s;P =.0053)。DHEA-S浓度较低(<1000 ng/mL)的患者的脉搏波速度也显著高于DHEA-S浓度较高的患者(1843±371 vs 1686±298 cm/s;P =.0008)。多元回归分析确定血清游离睾酮浓度(β = -.151,P =.0150)和血清DHEA-S浓度(β = -.200,P =.0017)均为PWV的独立决定因素。总之,血清内源性雄激素浓度与2型糖尿病男性患者通过PWV测定的动脉僵硬度呈负相关,基于其他研究,这在一般男性中也是如此。

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