Zhang Lu-Yao, He Wei, Wan Jian-Xin, Yin Qi-Qi, Cheng Zhen, Chen Guan-Ming, Ji Wen, Li Hai, Li Yan-Bing, Liao Zhi-Hong
Department of Endocrine and Metabolic Diseases, The First Hospital Affiliated to Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
Department of Ultrasound, The First Hospital Affiliated to Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
Zhonghua Nan Ke Xue. 2016 Dec;22(12):1088-1094.
To compare the level of testosterone between type-2 diabetes mellitus (T2DM) patients and healthy controls and to investigate the status of hypogonadism and the influence of hypopgonadism on the quality of life.
We collected serum total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), and other clinical data from 166 T2DM patients aged over 30 years and 186 age-matched healthy controls. We investigated the quality of life (QoL) of the two groups of subjects using the questionnaires of Androgen Deficiency in Aging Males (ADAM), Aging Male Symptoms (AMS), 36-Item Short-Form Health Survey (SF-36), and Special Quality of Life for Diabetes Mellitus (DSQL).
The level of calculated FT (cFT) was remarkably lower in the T2DM patients than in the healthy controls (P<0.05), but no statistically significant differences were observed between the two groups in the levels of TT, bio-available testosterone (Bio-T), and SHBG. The T2DM males with hypogonadism showed significant differences from those without in age, height, systolic blood pressure, and creatinine (P<0.05). Based on the criteria of cFT <0.3 nmol/L and AMS score ≥27, the incidence rate of hypogonadism was 51.81% in the T2DM patients, 31.58% in the 30-39 yr group, 32.50% in the 40-49 yr group, 50% in the 50-59 yr group, 69.23% in the 60-69 yr group, and 77.27% in the ≥70 yr group, elevated by 77.4% with the increase of 10 years of age (OR = 1.774, P<0.001). The AMS score was significantly correlated with the scores of DSQL (r = 0.557, P<0.001) and SF-36 (r = -0.739, P<0.001) in the T2DM patients.
T2DM patients have lower levels of cFT than healthy men, accompanied with a higher incidence of hypogonadism. Age is a main risk factor of hypogonadism. Severer testosterone deficiency symptoms are associated with lower scores of QoL in T2DM males.
比较2型糖尿病(T2DM)患者与健康对照者的睾酮水平,调查性腺功能减退状况及其对生活质量的影响。
收集166例30岁以上的T2DM患者及186例年龄匹配的健康对照者的血清总睾酮(TT)、游离睾酮(FT)、性激素结合球蛋白(SHBG)及其他临床资料。采用老年男性雄激素缺乏(ADAM)问卷、老年男性症状(AMS)问卷、36项简明健康调查(SF-36)问卷及糖尿病特异性生活质量(DSQL)问卷对两组受试者的生活质量进行调查。
T2DM患者的计算游离睾酮(cFT)水平显著低于健康对照者(P<0.05),但两组在TT、生物可利用睾酮(Bio-T)及SHBG水平上差异无统计学意义。性腺功能减退的T2DM男性患者在年龄、身高、收缩压及肌酐水平方面与无性腺功能减退者相比差异有统计学意义(P<0.05)。以cFT<0.3 nmol/L及AMS评分≥27为标准,T2DM患者性腺功能减退发生率为51.81%,30~39岁组为31.58%,40~49岁组为32.50%,50~59岁组为50%,60~69岁组为69.23%,≥70岁组为77.27%,年龄每增加10岁升高77.4%(OR=1.774,P<0.001)。T2DM患者中,AMS评分与DSQL评分(r=0.557,P<0.001)及SF-36评分(r=-0.739,P<0.001)显著相关。
T2DM患者的cFT水平低于健康男性,性腺功能减退发生率更高。年龄是性腺功能减退的主要危险因素。睾酮缺乏症状越严重,T2DM男性患者生活质量评分越低。