新诊断 2 型糖尿病男性患者接受强化胰岛素和二甲双胍治疗后血清睾酮的快速变化。
Rapid Changes in Serum Testosterone in Men With Newly Diagnosed Type 2 Diabetes With Intensive Insulin and Metformin.
机构信息
Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China.
Department of Medicine, National University of Singapore, Singapore.
出版信息
Diabetes Care. 2021 Apr;44(4):1059-1061. doi: 10.2337/dc20-1558. Epub 2021 Feb 3.
OBJECTIVE
To investigate the effect of metformin on testosterone levels in men with type 2 diabetes mellitus (T2DM).
RESEARCH DESIGN AND METHODS
Seventy men with newly diagnosed drug-naive T2DM and HbA >9.0% (75 mmol/mol) were treated with intensive insulin pump therapy for 5 days to achieve glucose normalization. They were randomized to control (continued on intensive insulin only) and metformin (plus metformin) groups (1:1) for 1 month. Testosterone was measured at baseline, randomization, and after 1-month treatment.
RESULTS
Total, free, and bioavailable testosterone increased significantly within 5 days (all < 0.001). After 1 month, compared with the control group, the metformin group had lower total (12.7 vs. 15.3 nmol/L), free (0.20 vs. 0.24 nmol/L), and bioavailable (4.56 vs. 5.31 nmol/L) testosterone (all < 0.05).
CONCLUSIONS
In men with T2DM, 1-month oral metformin may decrease serum testosterone levels independent of blood glucose control. The effects of long-term metformin on testosterone in men need further study.
目的
研究二甲双胍对 2 型糖尿病（T2DM）男性患者睾酮水平的影响。
研究设计与方法
70 例新诊断、未用药的 T2DM 男性患者，HbA >9.0%（75 mmol/mol），接受强化胰岛素泵治疗 5 天以实现血糖正常化。他们被随机分为对照组（继续强化胰岛素治疗）和二甲双胍组（加用二甲双胍）（1:1），治疗 1 个月。在基线、随机分组时和治疗 1 个月后测量睾酮。
结果
5 天内总睾酮、游离睾酮和生物可利用睾酮均显著升高（均<0.001）。1 个月后，与对照组相比，二甲双胍组总睾酮（12.7 对 15.3 nmol/L）、游离睾酮（0.20 对 0.24 nmol/L）和生物可利用睾酮（4.56 对 5.31 nmol/L）水平均较低（均<0.05）。
结论
在 T2DM 男性中，1 个月的口服二甲双胍可能会降低血清睾酮水平，而不依赖于血糖控制。长期二甲双胍对男性睾酮的影响需要进一步研究。
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