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目的:比较2型糖尿病男性(T2DMM)与健康男性的雄激素水平,分析T2DMM性腺功能减退的状况以及性腺功能减退与生活质量的关系。方法:选取166例30岁以上的T2DMM患者,收集血清总睾酮、游离睾酮等全面的临床资料,采用ADAM量表、AMS量表、SF-36量表、糖尿病患者生存质量特异性量表(DSQL)研究。选择186例年龄匹配的健康男性作为对照组,比较雄激素水平。结果:在所有T2DMM患者,血清游离睾酮(c FT)水平明显低于各个同年龄组的健康男性对照(P<0.05),总睾酮水平(TT)、生物活性睾酮(Bio-T)和性激素结合球蛋白(SHBG)在两组间无统计学差异。T2DMM伴有性腺功能减退与不伴性腺功能减退患者相比,年龄、身高、收缩压、肌酐有统计学差异(P<0.05)。以AMS问卷异常(得分≥27分)同时c FT低于0.3 nmol/L为性腺功能减退的诊断标准时,T2DMM伴发性腺功能减退达51.81%,且随年龄增长伴发率上升(30~39岁,31.58%;40~49岁,32.5%;50~59岁,50%;60~69岁,69.23%;≥70岁,77.27%)。年龄是性腺功能减退的危险因素,每增加10岁,性腺功能减退风险增加77.4%(OR=1.774,P<0.001)。T2DMM患者AMS量表与SF-36量表(r=-0.7393,P<0.001)、DSQL量表(r=0.557,P<0.001)评分之间存在显著相关性。结论:T2DMM的游离睾酮低于健康男性,性腺功能减退的伴发率较高,年龄是性腺功能减退的主要危险因素。雄激素缺乏症状程度越严重,生活质量各个维度的评分越差。
OBJECTIVE: To compare androgen levels in type 2 diabetic men (T2DMM) and healthy men and analyze the relationship between hypogonadism in T2DMM and the relationship between hypogonadism and quality of life. Methods: A total of 166 patients with T2DMM over 30 years old were enrolled in this study. Comprehensive clinical data such as total testosterone and free testosterone were collected. ADAM, AMS, SF-36 and DSQL )the study. A total of 186 age-matched healthy males were chosen as control group to compare the level of androgen. Results: The level of serum free testosterone (c FT) was significantly lower in all T2DMM patients than in healthy male controls (P <0.05), total testosterone (TT), bio-T and sex hormone binding Globulin (SHBG) was not statistically different between the two groups. There was a significant difference in age, height, systolic blood pressure and creatinine between T2DMM patients with hypogonadism and those without hypogonadism (P <0.05). When the AMS questionnaire was abnormal (score ≥27) and c FT was lower than 0.3 nmol / L as the diagnostic criteria for hypogonadism, T2DMM associated with hypogonadism reached 51.81% and increased with age (30-39 years , 31.58%; 40-49 years old, 32.5%; 50-59 years old, 50%; 60-69 years old, 69.23%; 70 years old, 77.27%). Age is a risk factor for hypogonadism. With each 10-year increase, the risk of hypogonadism is increased by 77.4% (OR = 1.774, P <0.001). There was a significant correlation between AMS scale of T2DMM and SF-36 scale (r = -0.7393, P <0.001) and DSQL scale (r = 0.557, P <0.001) Conclusion: The free testosterone in T2DMM is lower than that in healthy men, and the incidence of hypogonadism is higher. Age is the main risk factor for hypogonadism. The more severe the symptoms of androgen deficiency, the poorer the scores of quality of life in all dimensions.