Division of Endocrinology, Diabetes and Metabolism, State University of New York at Buffalo, New York, USA.
Diabetes Care. 2010 Jun;33(6):1186-92. doi: 10.2337/dc09-1649. Epub 2010 Mar 3.
To determine the prevalence of subnormal testosterone concentrations in patients with obesity and with type 2 diabetes in a primary care clinic population.
Free testosterone concentrations of 1,849 men (1,451 nondiabetic and 398 diabetic) in the Hypogonadism In Males (HIM) study were analyzed. The HIM study was a U.S.-based cross-sectional study designed to define the prevalence of hypogonadism in men aged >45 years. Free testosterone was measured by equilibrium dialysis.
The prevalence of subnormal free testosterone concentrations in lean, overweight, and obese nondiabetic men was 26% (n = 275), 29% (n = 687), and 40% (n = 489), respectively (P < 0.001 for trend), and 44% (n = 36), 44% (n = 135), and 50% (n = 227), respectively, in diabetic men (P = 0.46 for trend within group and P < 0.05 compared with nondiabetic men). The mean free testosterone concentration of diabetic men was significantly lower than that of nondiabetic men. Free testosterone concentrations were negatively and significantly (P < 0.001) related to age (r = -0.37), BMI (r = -0.18), and sex hormone-binding globulin (r = -0.11) in multiple regression analysis. The average decline of free testosterone concentrations was 7.8 pg/ml per decade in nondiabetic men and 8.4 pg/ml per decade in diabetic men.
Forty percent of obese nondiabetic men and 50% of obese diabetic men aged >or=45 years have subnormal free testosterone concentrations. In view of its high prevalence, obesity is probably the condition most frequently associated with subnormal free testosterone concentrations in males. The concomitant presence of diabetes is associated with an additional increase in the prevalence of subnormal free testosterone concentrations.
在初级保健诊所人群中，确定肥胖和 2 型糖尿病患者的睾丸酮浓度异常的流行率。
对 Hypogonadism In Males（HIM）研究中的 1849 名男性（1451 名非糖尿病患者和 398 名糖尿病患者）的游离睾丸酮浓度进行分析。HIM 研究是一项基于美国的横断面研究，旨在定义 45 岁以上男性性腺功能减退症的流行率。游离睾丸酮通过平衡透析法进行测量。
在瘦、超重和肥胖的非糖尿病男性中，低游离睾丸酮浓度的患病率分别为 26%（n = 275）、29%（n = 687）和 40%（n = 489）（P < 0.001 趋势），在糖尿病男性中分别为 44%（n = 36）、44%（n = 135）和 50%（n = 227）（P = 0.46 组内趋势，P < 0.05 与非糖尿病男性比较）。糖尿病男性的平均游离睾丸酮浓度明显低于非糖尿病男性。在多元回归分析中，游离睾丸酮浓度与年龄（r = -0.37）、BMI（r = -0.18）和性激素结合球蛋白（r = -0.11）呈显著负相关（P < 0.001）。非糖尿病男性游离睾丸酮浓度平均每十年下降 7.8 pg/ml，糖尿病男性每十年下降 8.4 pg/ml。
40%的肥胖非糖尿病男性和 50%的肥胖糖尿病男性年龄≥45 岁存在游离睾丸酮浓度异常。鉴于其高患病率，肥胖可能是男性游离睾丸酮浓度异常最常见的相关疾病。糖尿病的同时存在与游离睾丸酮浓度异常的患病率增加有关。
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