Madhu S V, Aslam M, Aiman A J, Siddiqui A, Dwivedi S
Department of Medicine, Centre for Diabetes Endocrinology and Metabolism, University College of Medical Sciences (University of Delhi) and GTB Hospital, New Delhi, India.
Indian J Endocrinol Metab. 2017 Jan-Feb;21(1):31-37. doi: 10.4103/2230-8210.195999.
The present study is carried out to investigate hypogonadism using serum testosterone levels in male Type 2 diabetes mellitus (T2DM) subjects with and without coronary artery disease (CAD).
A total of 150 age and body mass index-matched male subjects in the age group of 30-70 years were recruited in three groups; Group A - subjects with normal glucose tolerance, Group B - T2DM subjects without CAD, and Group C - T2DM subjects with CAD ( = 50 each group). Subjects with CAD were diagnosed on the basis of electrocardiogram, treadmill testing, stress echocardiography, or coronary angiography. Total testosterone (TT), free testosterone (FT), bioavailable testosterone, calculated FT and glycemic parameters were measured and compared between all the three study groups. One-way ANOVA followed by Tukey's test and Pearson's coefficient of correlation tests were used for analysis.
Hypogonadism (TT <3 ng/ml) was observed in 40% (20/50) of subjects in Group C and 32% (16/50) of subjects in Group B as compared to only 14% (7/50) of subjects in Group A (Groups A vs. B; = 0.055, Groups A vs. C; = 0.006 and Groups B vs. C; = 0.53). Group C subjects had significantly lower levels of TT (3.55 ± 1.46 ng/ml vs. 4.73 ± 2.17 ng/ml, = 0.005), calculated FT (0.062 ± 0.0255 pg/ml vs. 0.0951 ± 0.0508 pg/ml, ≤ 0.001), and bioavailable testosterone (1.48 ± 0.65 ng/ml vs. 2.18 ± 1.20 ng/ml, ≤ 0.001) compared to control Group A subjects. There was no significant difference in any of the testosterone parameters between Groups A and B. Furthermore, an overall positive correlation was found between hypogonadism and CAD ( = 0.177, = 0.030, = 150).
We observed hypogonadism as indicated by low testosterone levels in a significant proportion of male T2DM subjects with CAD.
本研究旨在通过检测血清睾酮水平,对合并或不合并冠状动脉疾病(CAD)的男性2型糖尿病(T2DM)患者性腺功能减退情况进行调查。
共招募150名年龄和体重指数匹配的30 - 70岁男性受试者,分为三组;A组——糖耐量正常的受试者,B组——无CAD的T2DM受试者,C组——有CAD的T2DM受试者(每组50人)。根据心电图、平板运动试验、负荷超声心动图或冠状动脉造影诊断CAD患者。测量并比较三组受试者的总睾酮(TT)、游离睾酮(FT)、生物可利用睾酮、计算游离睾酮及血糖参数。采用单因素方差分析,随后进行Tukey检验和Pearson相关系数检验进行分析。
C组40%(20/50)的受试者和B组32%(16/50)的受试者出现性腺功能减退(TT <3 ng/ml),而A组仅14%(7/50)的受试者出现性腺功能减退(A组与B组比较;P = 0.055,A组与C组比较;P = 0.006,B组与C组比较;P = 0.53)。与对照组A组受试者相比,C组受试者的TT水平显著降低(3.55±1.46 ng/ml对4.73±2.17 ng/ml,P = 0.005),计算游离睾酮水平(0.062±0.0255 pg/ml对0.0951±0.0508 pg/ml,P≤0.001),生物可利用睾酮水平(1.48±0.65 ng/ml对2.18±1.20 ng/ml,P≤0.001)。A组和B组之间的任何睾酮参数均无显著差异。此外,性腺功能减退与CAD之间存在总体正相关(r = 0.177,P = 0.030,n = 150)。
我们观察到,在相当比例的患有CAD的男性T2DM受试者中,睾酮水平低表明存在性腺功能减退。