Haffner S M, Karhapää P, Mykkänen L, Laakso M
Department of Medicine, University of Texas Health Science Center, San Antonio 78284-7873.
Diabetes. 1994 Feb;43(2):212-9. doi: 10.2337/diab.43.2.212.
Although many studies have suggested that increased androgenicity is associated with insulin resistance and hyperinsulinemia in both pre- and postmenopausal women, relatively few data are available on this relationship in men. We examined the association of body mass index (BMI), waist-to-hip ratio (WHR), sex hormone-binding globulin (SHBG), total and free testosterone, dehydroepiandrosterone sulfate (DHEA-SO4), and estradiol with insulin concentrations and whole-body glucose disposal in 87 men from a population-based study in Kuopio, Finland. BMI was significantly correlated with fasting insulin (r = 0.46), total whole-body glucose disposal (r = -0.30), glucose oxidation (r = -0.21), and nonoxidative glucose disposal (r = -0.25). WHR also was significantly associated with fasting insulin (r = 0.61), total whole-body glucose disposal (r = -0.54), glucose oxidation (r = -0.23), and nonoxidative whole-body glucose disposal (r = -0.50). SHBG and total and free testosterone were significantly associated with insulin concentrations and total and nonoxidative glucose disposal but not with glucose oxidation. DHEA-SO4 and estradiol were not associated with insulin, glucose concentrations, or whole-body glucose disposal in univariate analysis. In multivariate analysis, total whole-body glucose disposal was associated negatively with WHR and positively associated with total testosterone and SHBG; nonoxidative whole-body glucose disposal was associated negatively with WHR and positively associated with total and free testosterone. Glucose oxidation was significantly associated only with WHR. In conclusion, higher WHR and lower testosterone were strongly associated with a decrease in total and nonoxidative whole-body glucose disposal in men.
尽管许多研究表明，雄激素水平升高与绝经前和绝经后女性的胰岛素抵抗及高胰岛素血症相关，但关于男性中这种关系的数据相对较少。我们在芬兰库奥皮奥一项基于人群的研究中，对87名男性的体重指数（BMI）、腰臀比（WHR）、性激素结合球蛋白（SHBG）、总睾酮和游离睾酮、硫酸脱氢表雄酮（DHEA-SO4）以及雌二醇与胰岛素浓度和全身葡萄糖处置情况之间的关联进行了研究。BMI与空腹胰岛素显著相关（r = 0.46）、与全身总葡萄糖处置显著相关（r = -0.30）、与葡萄糖氧化显著相关（r = -0.21）以及与非氧化葡萄糖处置显著相关（r = -0.25）。WHR也与空腹胰岛素显著相关（r = 0.61）、与全身总葡萄糖处置显著相关（r = -0.54）、与葡萄糖氧化显著相关（r = -0.23）以及与非氧化全身葡萄糖处置显著相关（r = -0.50）。SHBG、总睾酮和游离睾酮与胰岛素浓度以及总葡萄糖处置和非氧化葡萄糖处置显著相关，但与葡萄糖氧化无关。在单变量分析中，DHEA-SO4和雌二醇与胰岛素、葡萄糖浓度或全身葡萄糖处置均无关联。在多变量分析中，全身总葡萄糖处置与WHR呈负相关，与总睾酮和SHBG呈正相关；非氧化全身葡萄糖处置与WHR呈负相关，与总睾酮和游离睾酮呈正相关。葡萄糖氧化仅与WHR显著相关。总之，较高的WHR和较低的睾酮水平与男性全身总葡萄糖处置和非氧化葡萄糖处置的降低密切相关。
