Li Y, Zhang M, Liu X, Cui W, Rampersad S, Li F, Lin Z, Yang P, Li H, Sheng C, Cheng X, Qu S
Department of Endocrinology & Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Nanjing Medical University, Nanjing, China.
Andrology. 2017 Jul;5(4):739-743. doi: 10.1111/andr.12360. Epub 2017 May 3.
This study aims to compare the prevalence of hypogonadism between male patients with early-onset type 2 diabetes mellitus (T2DM) and late-onset type 2 diabetes. A total of 122 male patients with early-onset T2DM (diagnosis age ≤40 years) and 100 male patients with late-onset T2DM (diagnosis age >40 years) were recruited from our in-patient department between 1 January 2013 and 28 December 2015. Serum FSH, LH, testosterone, lipid profile, uric acid, HbA1c, and beta-cell function were determined in blood samples. The diagnosis of hypogonadism was based on the levels of LH, FSH, and total testosterone. The mean onset age was 29.86 ± 6.31 and 54.47 ± 9.97 years old in the early-onset group and late-onset group, respectively. Compared with late-onset T2DM, those with early-onset T2DM had a higher proportion of new-onset diabetes, were more likely to be obese, and had worse glycemic control, lipid control, and lower sex hormone-binding globulin (SHBG). The prevalence of hypogonadism was much higher in the early-onset group than in the late-onset group (48.0% vs. 26.7%, p < 0.05). The rate of secondary hypogonadism in the early-onset group and late-onset group were 44.3% and 25.0%, respectively (p < 0.05). Obesity, waist circumference, and SHBG were significantly associated with serum total testosterone level in all, early-onset, and late-onset T2DM. Both all and early-onset T2DM groups had positive correlations between total testosterone and fasting C-peptide, total cholesterol, triglycerides, and uric acid. Our results indicate that in a population of admission to a large urban hospital in China, the prevalence of hypogonadism was higher in the patients with early-onset T2DM than that of late-onset T2DM. This prevalence might be attributable to greater obesity, worse lipid control, and lower SHBG levels in those patients.
本研究旨在比较早发型2型糖尿病(T2DM)男性患者和晚发型2型糖尿病患者性腺功能减退的患病率。2013年1月1日至2015年12月28日期间,从我院住院部招募了122例早发型T2DM男性患者(诊断年龄≤40岁)和100例晚发型T2DM男性患者(诊断年龄>40岁)。测定血样中的血清促卵泡生成素(FSH)、促黄体生成素(LH)、睾酮、血脂谱、尿酸、糖化血红蛋白(HbA1c)和β细胞功能。性腺功能减退的诊断基于LH、FSH和总睾酮水平。早发型组和晚发型组的平均发病年龄分别为29.86±6.31岁和54.47±9.97岁。与晚发型T2DM相比,早发型T2DM患者新发糖尿病的比例更高,更易肥胖,血糖控制、血脂控制更差,性激素结合球蛋白(SHBG)更低。早发型组性腺功能减退的患病率远高于晚发型组(48.0%对26.7%,p<0.05)。早发型组和晚发型组继发性性腺功能减退的发生率分别为44.3%和25.0%(p<0.05)。肥胖、腰围和SHBG在所有T2DM、早发型T2DM和晚发型T2DM中均与血清总睾酮水平显著相关。所有T2DM组和早发型T2DM组的总睾酮与空腹C肽、总胆固醇、甘油三酯和尿酸之间均呈正相关。我们的结果表明,在中国一家大型城市医院的住院患者中,早发型T2DM患者性腺功能减退的患病率高于晚发型T2DM患者。这种患病率可能归因于这些患者中更高的肥胖率、更差的血脂控制和更低的SHBG水平。