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2型糖尿病男性患者低雄激素状态的临床特征

Clinical Characteristics of Low Androgen Status in Males with Type 2 Diabetes Mellitus.

作者信息

Hamahara Jun, Honda Hiroyuki, Yamamoto Koichiro, Tokumasu Kazuki, Hanayama Yoshihisa, Hagiya Hideharu, Obika Mikako, Ueda Keigo, Kishida Masayuki, Otsuka Fumio

机构信息

Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.

Department of General Medicine, Okayama City Hospital.

出版信息

Acta Med Okayama. 2021 Feb;75(1):1-8. doi: 10.18926/AMO/61424.

Abstract

To determine the clinical characteristics of low androgen status in adult males with diabetes, we retrospectively analyzed the medical records of patients with type 2 diabetes mellitus in whom serum free testosterone (FT) levels were examined for 1 year. Among the 46 patients (56 ± 1.5 years old), decreases in serum FT levels to < 8.5 pg/ml (indicating the occurrence of late-onset hypogonadism [LOH]) were detected in 18 (39%). The per-centages of patients with low FT levels were high in the ≥ 50 years age group (83%), the HbA1c < 7% group (67%), and the 25 ≤ BMI < 30 kg/m2 group (56%). The serum FT levels tended to decrease age-dependently. The level of HbA1c was significantly correlated with the Heinemann Aging Male Symptoms (AMS) score (R = 0.47). The low-FT group had decreased levels of hemoglobin. Of note, the serum FSH level (R = -0.32) was negatively correlated with the serum FT level, whereas the serum TSH level (R = 0.36) was positively correlated with the serum FT level. Collectively, these results revealed that many diabetic males may have low FT levels and that the AMS score is related to the HbA1c level. A slightly anemic condition, thyroid dysfunction, and obesity (class 1) might be involved in LOH in middle-aged diabetic males.

摘要

为确定成年男性糖尿病患者雄激素水平低下的临床特征,我们回顾性分析了连续1年检测血清游离睾酮(FT)水平的2型糖尿病患者的病历。在46例患者(56±1.5岁)中,18例(39%)血清FT水平降至<8.5 pg/ml(提示迟发性性腺功能减退[LOH]的发生)。FT水平低的患者百分比在≥50岁年龄组(83%)、糖化血红蛋白(HbA1c)<7%组(67%)和25≤体重指数(BMI)<30 kg/m2组(56%)中较高。血清FT水平有随年龄增长而下降的趋势。HbA1c水平与海涅曼老年男性症状(AMS)评分显著相关(R=0.47)。FT水平低的组血红蛋白水平降低。值得注意的是,血清促卵泡生成素(FSH)水平(R=-0.32)与血清FT水平呈负相关,而血清促甲状腺激素(TSH)水平(R=0.36)与血清FT水平呈正相关。总体而言,这些结果表明许多糖尿病男性可能存在FT水平低下,且AMS评分与HbA1c水平有关。轻度贫血、甲状腺功能障碍和肥胖(1级)可能与中年糖尿病男性的LOH有关。

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