血清总睾酮与血糖升高进展的关系：一项 15 年的前瞻性队列研究。
The association between serum total testosterone and progression of hyperglycemia: a 15-year prospective cohort study.
机构信息
Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, I.R. Iran.
出版信息
Andrology. 2019 Mar;7(2):148-155. doi: 10.1111/andr.12568. Epub 2019 Jan 21.
BACKGROUND
The association between low testosterone concentration and increased risk of hyperglycemia in men has been demonstrated in observational and interventional studies. However, considering a variety of confounding factors, limited population-based studies have so far been conducted. Also, no information is available regarding the effect of testosterone on progressive development of dysglycemia.
OBJECTIVE
To examine the effect of total testosterone on development of pre-diabetes/diabetes in normoglycemic middle-aged and older men.
MATERIALS AND METHODS
Data were obtained from the Tehran Lipid and Glucose Study, a community-based prospective cohort of an Iranian population. Analyses were conducted on 903 normoglycemic eligible men aged 30-70 years. An illness-death model was applied to estimate the probabilities of three transitional phases of normoglycemia→diabetes, normoglycemia→pre-diabetes, and pre-diabetes→diabetes.
RESULTS
Over a median follow-up of 12 years, 0.9% individuals developed diabetes. Per unit increase (ng/mL) in testosterone concentration, the transition rate from normoglycemia to pre-diabetes decreased by 6% [hazard ratios (HRs): 0.94 (95% confidence interval (CI): 0.90, 0.99)]. However, no effect for testosterone on the progression of diabetes from normoglycemia or pre-diabetes was observed [HRs: 0.79 (95% CI: 0.44, 1.41) and 0.98 (95% CI: 0.84, 1.16), respectively]. High body mass index was a strong predictor of hyperglycemia within all transitions.
DISCUSSION
Independent of major confounding factors, low testosterone was associated with normoglycemia progression to pre-diabetes, but not with pre-diabetes to diabetes, which might indirectly highlight the stronger impact of other risk factors after occurrence of pre-diabetes.
CONCLUSION
Low testosterone concentrations in men are associated with progression from normoglycemia to pre-diabetes, but not from pre-diabetes to diabetes.
背景
在观察性和干预性研究中已经证明，低睾酮浓度与男性发生高血糖的风险增加有关。然而，考虑到各种混杂因素，到目前为止，进行的基于人群的研究有限。此外，关于睾酮对糖调节受损进行性发展的影响尚无信息。
目的
检查总睾酮对血糖正常的中老年男性发生糖尿病前期/糖尿病的影响。
材料和方法
数据来自德黑兰血脂和血糖研究，这是一项基于伊朗人群的社区前瞻性队列研究。对 903 名年龄在 30-70 岁之间的血糖正常合格男性进行了分析。应用疾病死亡模型估计血糖正常→糖尿病、血糖正常→糖尿病前期和糖尿病前期→糖尿病三种过渡阶段的概率。
结果
在中位数为 12 年的随访期间，0.9%的人发生了糖尿病。睾酮浓度每增加（ng/mL）单位，血糖正常向糖尿病前期的转变率下降 6%[风险比（HRs）：0.94（95%置信区间（CI）：0.90，0.99)]。然而，没有观察到睾酮对血糖正常或糖尿病前期向糖尿病进展的影响[HRs：0.79（95% CI：0.44，1.41）和 0.98（95% CI：0.84，1.16）]。高体重指数是所有转变中发生高血糖的一个强有力的预测因素。
讨论
在排除主要混杂因素后，低睾酮与血糖正常向糖尿病前期的进展有关，但与糖尿病前期向糖尿病的进展无关，这可能间接强调了其他危险因素在发生糖尿病前期后的更强影响。
结论
男性低睾酮浓度与血糖正常向糖尿病前期的进展有关，但与糖尿病前期向糖尿病的进展无关。
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