中老年男性部分雄激素缺乏症与血糖及血脂关系

陈坚; 王瑜敏; 朱佩武; 潘钦石

doi:10.11847/zgggws1108803

中老年男性部分雄激素缺乏症与血糖及血脂关系

Correlations between partial androgen deficiency and glucose and lipid profiles in middle-aged and elder men

摘要

摘要:
目的了解中老年男性部分雄激素缺乏症（PADAM）与血糖及血脂的关系，为PADAM的预防控制提供参考依据。
方法于2011年1月 — 2015年10月在浙江省温州医科大学附属第一医院体检中心整群抽取7 153名≥20岁男性体检者，本研究抽取其中4 291名≥40岁男性体检者作为研究对象，按照测定的血清睾酮（T）水平并结合临床症状分为PADAM病例组和对照组，比较2组人群T水平以及血糖和血脂相关指标差异，分析PADAM与血糖及血脂相关指标的关系。
结果 4 291名≥40岁男性体检者中，病例组PADAM患者754例（17.57 %），对照组非PADAM者3 537人（82.43 %）；病例组PADAM患者的血糖（GLU）、甘油三酯（TG）、非高密度脂蛋白胆固醇（non-HDL-C）、血浆致动脉硬化指数（AIP，× 100对数值）、动脉硬化指数（ASI）平均水平分别为5.70 mmol/L、2.02 mmol/L、3.87 mmol/L、2.29、3.57，均高于对照组非PADAM者的5.50 mmol/L、1.60 mmol/L、3.78 mmol/L、2.14、3.27 （均P < 0.05），而T、高密度脂蛋白胆固醇（HDL-C）平均水平分别为9.67 nmol/L、2.84 mmol/L，均低于对照组非PADAM者的15.35 nmol/L、 2.96 mmol/L （均P < 0.01）；相关分析结果显示，T水平与GLU、TG、non-HDL-C、AIP（× 100对数值）和ASI均呈负相关（均P < 0.001），与HDL-C呈正相关（r = 0.17，P = 0.002）；多因素logistic回归分析结果显示，年龄、GLU和AIP（× 100对数值）是PADAM患病的危险因素。
结论 PADAM与血糖及血脂具有相关性，T水平低下会导致GLU、TG、non-HDL-C、AIP（× 100对数值）和ASI水平升高而HDL-C水平降低。

Abstract:
Objective To examine relationships between partial androgen deficiency and glucose and lipid profile in middle-aged and elder men and to provide a reference for the prevention and control of partial androgen. deficiency in aged men (PADAM).
Methods Blood samples were collected from 4 291 men aged≥40 years selected from 7 153 male health examinees aged≥20 years from the First Affiliated Hospital of Wenzhou Medical University between January 2011 and October 2015 and were divided into a case group and a control group based on their serum testosterone (T) levels and clinical symptoms of PADAM. Serum testosterone, blood glucose and lipid profiles were determined in all the participants and compared between the case and control group; correlations between the occurrence of PADAM and glucose and lipid profiles were analyzed.
Results Of the 4291 men aged≥40 years, 754 (17.57%) were identified as PADAM cases. Compared with those of the controls, the cases with PADAM had significantly higher blood glucose (GLU, 5.70 vs. 5.50 mmol/L), triglyceride (TG, 2.02 vs. 1.60 mmol/L), non high density lipoprotein cholesterol (non-HDL-C, 3.87 vs. 3.78 mmol/L), plasma atherogenic index (AIP, 2.29 vs. 2.14 presented as logarithmic value of AIP plus 100), arterial stiffness index (ASI, 3.57 vs. 3.27 ) (all P < 0.05) and significantly lower serum testosterone (9.67 vs. 15.35 nmol/L) and high density lipoprotein cholesterol (HDL-C, 2.84 vs. 2.96 mmol/L) (all P < 0.01). Serum testosterone level was correlated reversely with GLU, TG, non-HDL-C, AIP, and ASI (all P < 0.001) and positively with HDL-C (r = 0.17, P = 0.002). The results of logistic regression analysis showed that age, GLU,and AIP were the risk factors of PADAM.
Conclusion PADAM is correlated with glucose and lipid profiles; low serum testosterone can lead to elevated GLU, TG, non-HDL-C, AIP, and ASI l and decreased HDL-C among middle-aged and elder men.

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