黑棘皮病患者与非黑棘皮病患者总睾酮水平与胰岛素抵抗的相关性

[Correlation between total testosterone levels and insulin resistance in patients with acanthosis nigricans and non-acanthosis nigrican].

作者信息

Zhang L, Li G, Su L, DU L, Zhou D, Cheng X, Lin Z, Qu S

机构信息

Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital of Nanjing Medical University, Shanghai 200072, China.

Department of Endocrinology, Changzhou Cancer Hospital of Soochow University, Changzhou 213000, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2021 Dec 20;41(12):1780-1786. doi: 10.12122/j.issn.1673-4254.2021.12.04.

DOI:10.12122/j.issn.1673-4254.2021.12.04

PMID:35012908

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8752425/

Abstract

OBJECTIVE

To investigate the correlation of the total testosterone (TT) level with insulin secretion and resistance in patients with acanthosis nigricans (AN) and non-acanthosis nigricans (NAN).

METHODS

This study was conducted in a total of 639 overweight patients (body mass index ≥24 kg/m), including 137 female AN patients, 277 female NAN patients, 129 male AN patients, and 146 male NAN patients. Each group was further divided into 4 subgroups according to the quartile of TT level for comparison of insulin secretion and insulin resistance parameters.

RESULTS

Both female and male patients with AN showed obvious hyperinsulinemia with increased area under the curve for insulin (AUC-INS) ( < 0.05), increased homeostatic model assessment of insulin resistance (HOMA-IR) index ( < 0.05) and decreased whole-body insulin sensitivity index (WBISI) ( < 0.01) as compared with those in NAN groups, but these parameters did not show significant variations with the change of TT levels. In female patients with NAN, insulin secretion level increased progressively as the TT level increased; the AUC-INS increased ( < 0.01) and WBISI decreased significantly ( < 0.05) when the TT levels increased to Q4. In male patients with NAN, insulin secretion level increased progressively as the TT levels decreased, and the AUC-INS increased ( < 0.05) and the WBISI decreased significantly ( < 0.05) when the TT levels decreased to Q1.

CONCLUSIONS

The TT level has a significant effect on insulin resistance and insulin secretion, but its effect varies between genders and is more significant in NAN patients than in AN patients.

摘要

目的

探讨黑棘皮病（AN）患者和非黑棘皮病（NAN）患者总睾酮（TT）水平与胰岛素分泌及抵抗的相关性。

方法

本研究共纳入639例超重患者（体重指数≥24 kg/m²），其中女性AN患者137例、女性NAN患者277例、男性AN患者129例、男性NAN患者146例。根据TT水平四分位数将每组患者进一步分为4个亚组，以比较胰岛素分泌和胰岛素抵抗参数。

结果

与NAN组相比，AN组的女性和男性患者均表现出明显的高胰岛素血症，胰岛素曲线下面积（AUC-INS）增加（P<0.05），胰岛素抵抗稳态模型评估（HOMA-IR）指数升高（P<0.05），全身胰岛素敏感性指数（WBISI）降低（P<0.01），但这些参数并未随TT水平变化而呈现显著差异。在NAN组女性患者中，胰岛素分泌水平随TT水平升高而逐渐增加；当TT水平升至Q4时，AUC-INS增加（P<0.01），WBISI显著降低（P<0.05）。在NAN组男性患者中，胰岛素分泌水平随TT水平降低而逐渐增加，当TT水平降至Q1时，AUC-INS增加（P<0.05），WBISI显著降低（P<0.05）。