Mikhaĭlichenko V V, Tiktinskiĭ O L, Sil'nitskiĭ P A, Vorokhobina N V, Aleksandrov V P
Urol Nefrol (Mosk). 1993 Mar-Apr(2):47-50.
The examination of 217 males suffering from diabetes mellitus revealed copulative dysfunction in 111 (51.1%) of them. The investigation of sex, gonadotropic hormones, testicular reserves, sexual constitution and sexual formula was carried out in 22-55-year-old males with sexual dysfunction and healthy controls. It was an erectile phase of the sexual cycle that suffered most frequently. Reduced libido was observed in 19% of the patients. All the diabetes examined showed constitutional predisposition to impaired potency. The patients had high serum concentrations of prolactin, lutropin and dihydroepiandrosterone in low testosterone and insignificantly elevated follitropin and estradiol. There was also low gonadal resistance to choriogonin stimulation. These findings and literature data lead to the conclusion that insulin insufficiency entailing hyperglycemia brings about a rise in prolactin and dihydroepiandrosterone levels which may reduce the sensitivity of the receptors and lutropin in the testes and inhibit testosterone secretion. This is confirmed by inactive gonadal response to stimulation of chorionic gonadotropin. Spermatogenic disorders observed in 25% of the patients were associated with sexual affections and local structural changes (hypotrophy) of the testes.
对217名糖尿病男性患者的检查发现，其中111人（51.1%）存在性交功能障碍。对22至55岁性功能障碍男性患者及健康对照者进行了性别、促性腺激素、睾丸储备、性体质和性公式的调查。性周期的勃起阶段受影响最为频繁。19%的患者出现性欲减退。所有接受检查的糖尿病患者均显示出性功能受损的体质易感性。患者血清催乳素、促黄体生成素和二氢表雄酮浓度较高，睾酮水平较低，促卵泡生成素和雌二醇略有升高。对绒毛膜促性腺激素刺激的性腺抵抗也较低。这些发现和文献数据得出结论，胰岛素不足导致高血糖，进而使催乳素和二氢表雄酮水平升高，这可能会降低睾丸中受体和促黄体生成素的敏感性，并抑制睾酮分泌。这一点通过性腺对绒毛膜促性腺激素刺激的无反应得到证实。25%的患者出现的生精障碍与性功能障碍及睾丸局部结构变化（萎缩）有关。
