2型糖尿病男性患者的勃起功能障碍和性欲低下：糖尿病药物治疗的潜在作用。
Erectile Dysfunction and Low Sex Drive in Men with Type 2 DM: The Potential Role of Diabetic Pharmacotherapy.
作者信息
Al-Kuraishy Hayder M, Al-Gareeb Ali I
机构信息
Assistant Professor, Department of Pharmacology, College of Medicine, Al-Mustansiriya University , P.O. Box 14132, Baghdad, Iraq .
出版信息
J Clin Diagn Res. 2016 Dec;10(12):FC21-FC26. doi: 10.7860/JCDR/2016/19971.8996. Epub 2016 Dec 1.
INTRODUCTION
Diabetic men with erectile dysfunction have not been widely studied. They have low testosterone levels, causing low sex drive and erectile dysfunction.
AIM
To assess the erectile dysfunction and sex drive in relation to testosterone serum levels in type 2 Diabetes Mellitus (DM) patients.
MATERIALS AND METHODS
A total of 64 patients with type 2 DM were enrolled in this cross-sectional study, according to the treatment types they were divided into three groups, group (A): 34 patients treated with metformin, group (B): 30 patients treated with sulfonylurea and group (C): 27 healthy normal non-diabetic men are taken as control. Total testosterone (TT), Free Testosterone (FT), Free Androgenic Index (FAI), Sex Hormone Binding Globulin (SHBG), lipid profile and anthropometric parameters in metformin and sulfonylurea treated patients were compared to normal healthy men along with Sexual Health Inventory for Men (SHIM).
RESULTS
Total testosterone serum levels were high in sulfonylurea treated patients as compared to metformin treated patients' p < 0.0001. Similarly, SHBG levels were significantly higher in sulfonylurea treated patients compared to metformin treated patients p < 0.0001. FT was also significantly higher in sulfonylurea treated patients compared to metformin treated patients p =0.014 and significantly low compared to the control p =0.0002. FAI was also significantly higher in sulfonylurea treated patients compared to metformin treated patients p < 0.0001. On other hand Bioavailable testosterone (BT) was low in metformin treated patients (2.75±1.12 nmol/L) compared to the control p< 0.0001. SHIM was low in metformin treated patients 10.61±3.22 which significantly differed from control and sulfonylurea treated patients p< 0.0001, intergroup differences was significant p=0.001.
CONCLUSION
Metformin leads to significant reduction in testosterone levels, sex drive and induction of low testosterone-induced erectile dysfunction, whereas; sulfonylurea leads to significant elevation in testosterone levels, sex drive and erectile function.
引言
患有勃起功能障碍的糖尿病男性尚未得到广泛研究。他们的睾酮水平较低，导致性欲低下和勃起功能障碍。
目的
评估2型糖尿病（DM）患者勃起功能障碍和性欲与血清睾酮水平的关系。
材料与方法
本横断面研究共纳入64例2型糖尿病患者，根据治疗类型将他们分为三组，A组：34例接受二甲双胍治疗的患者，B组：30例接受磺脲类药物治疗的患者，C组：27名健康正常的非糖尿病男性作为对照。将二甲双胍和磺脲类药物治疗患者的总睾酮（TT）、游离睾酮（FT）、游离雄激素指数（FAI）、性激素结合球蛋白（SHBG）、血脂谱和人体测量参数与正常健康男性以及男性性健康量表（SHIM）进行比较。
结果
与接受二甲双胍治疗的患者相比，接受磺脲类药物治疗的患者血清总睾酮水平较高，p<0.0001。同样，与接受二甲双胍治疗的患者相比，接受磺脲类药物治疗的患者SHBG水平显著更高，p<0.0001。与接受二甲双胍治疗的患者相比，接受磺脲类药物治疗的患者FT也显著更高，p=0.014，与对照组相比显著更低，p=0.0002。与接受二甲双胍治疗的患者相比，接受磺脲类药物治疗的患者FAI也显著更高，p<0.0001。另一方面，与对照组相比，接受二甲双胍治疗的患者生物可利用睾酮（BT）较低（2.75±1.12 nmol/L），p<0.0001。接受二甲双胍治疗的患者SHIM较低，为10.61±3.22，与对照组和接受磺脲类药物治疗的患者有显著差异，p<0.0001，组间差异显著，p=0.001。
结论
二甲双胍导致睾酮水平、性欲显著降低，并引发低睾酮诱导的勃起功能障碍，而磺脲类药物则导致睾酮水平、性欲和勃起功能显著升高。
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