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睾酮替代疗法对伴有2型糖尿病的肥胖性腺功能减退男性的血糖控制、血管功能及代谢综合征组分的影响

The impact of testosterone replacement therapy on glycemic control, vascular function, and components of the metabolic syndrome in obese hypogonadal men with type 2 diabetes.

作者信息

Groti Kristina, Žuran Ivan, Antonič Blaž, Foršnarič Lidija, Pfeifer Marija

机构信息

a Department of Endocrinology, Diabetes and Metabolic Diseases , University Medical Center , Ljubljana , Slovenia.

b Department of Angiology, Endocrinology and Rheumatology , General Hospital Celje , Celje , Slovenia.

出版信息

Aging Male. 2018 Sep;21(3):158-169. doi: 10.1080/13685538.2018.1468429. Epub 2018 Apr 30.

Abstract

OBJECTIVE

This study set out to assess effects of testosterone replacement therapy (TRT) on parameters of metabolic syndrome and vascular function in obese hypogonadal males with type 2 diabetes mellitus (DM2).

STUDY DESIGN

Fifty-five obese hypogonadal diabetic males on oral hypoglycemic treatment were enrolled into this one-year, double-blind, randomized, placebo-controlled clinical study. Group T (n = 28) was treated with testosterone undecanoate (1000 mg i.m. every 10 weeks) while group P (n = 27) received placebo.

METHODS

Anthropometrical and vascular measurements - flow-mediated dilatation (FMD) and intima media thickness (IMT) - biochemical and hormonal blood sample analyses were performed at the start of the study and after one year. Derived parameters (BMI, HOMA-IR, calculated free testosterone (cFT) and bioavailable testosterone (BT)) were calculated.

RESULTS

TRT resulted in reduction of HOMA-IR by 4.64 ± 4.25 (p < .001), HbA1c by 0.94 ± 0.88% points (p < .001), and an increase in FMD by 2.40 ± 4.16% points (p = .005).

CONCLUSION

TRT normalized serum testosterone levels, improved glycemic control and endothelial function while exerting no ill effects on the study population.

摘要

目的

本研究旨在评估睾酮替代疗法(TRT)对患有2型糖尿病(DM2)的肥胖性腺功能减退男性的代谢综合征参数和血管功能的影响。

研究设计

55名接受口服降糖治疗的肥胖性腺功能减退糖尿病男性被纳入这项为期一年的双盲、随机、安慰剂对照临床研究。T组(n = 28)接受十一酸睾酮治疗(每10周肌肉注射1000mg),而P组(n = 27)接受安慰剂治疗。

方法

在研究开始时和一年后进行人体测量和血管测量——血流介导的血管舒张(FMD)和内膜中层厚度(IMT)——以及生化和激素血样分析。计算得出相关参数(BMI、HOMA-IR、计算游离睾酮(cFT)和生物可利用睾酮(BT))。

结果

TRT使HOMA-IR降低了4.64±4.25(p < .001),糖化血红蛋白(HbA1c)降低了0.94±0.88个百分点(p < .001),FMD增加了2.40±4.16个百分点(p = .005)。

结论

TRT使血清睾酮水平正常化,改善了血糖控制和内皮功能,同时对研究人群没有不良影响。

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