Frequent occurrence of hypogonadotropic hypogonadism in type 2 diabetes
Frequent occurrence of hypogonadotropic hypogonadism in type 2 diabetes
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DOI：
10.1210/jc.2004-0804
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发表时间：
2004-11-01
影响因子：
5.8
通讯作者：
Dandona, P
中科院分区：
文献类型：
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作者：
Dhindsa, S;Prabhakar, S;Dandona, P
在横断面研究中，2型糖尿病与较低的总睾酮（T）水平相关。然而，尚不清楚该缺陷是原发性还是继发性。我们通过检测103例2型糖尿病患者血清总T、游离T（FT）、SHBG、LH、FSH和催乳素（PRL），调查了2型糖尿病性腺功能减退的患病率。通过平衡透析测量FT。FT也通过使用T和SHBG（cFT）计算。性腺功能减退症定义为FT或cFT低。平均年龄为54.7 ± 1.1岁，平均体重指数（BMI）为33.4 ± 0.8 kg/m2，平均HbA 1c为8.4 ± 0.2%。平均T为12.19 +/- 0.50 nmol/L（351.7 +/- 14.4ng/dl），SHBG为27.89 +/- 1.65 nmol/L，FT为0.250 +/- 0.014 nmol/L。33%的患者性腺功能减退。与FT水平正常的患者相比，性腺功能减退组的LH和FSH水平显著降低（LH为3.15 +/- 0.26 vs. 3.91 +/- 0.24 mIU/ml，FSH为4.25 +/- 0.45 vs. 5.53 +/- 0.40 mIU/ml; P < 0.05）。BMI与FT（r = -0.382; P < 0.01）、T（r = -0.327; P < 0.01）呈显著负相关。SHBG与BMI呈负相关（r = -0.267; P < 0.05），与年龄（r = 0.538; P < 0.001）和T呈正相关（r = 0.574; P < 0.001）。FT与cFT显著相关（r = 0.919; P < 0.001），而与SHBG无相关性。LH与FT呈正相关（r = 0.287; P < 0.05）。我们的结论是低促性腺激素性腺功能减退症常见于2型糖尿病。
Type 2 diabetes is associated with lower total testosterone (T) levels in cross-sectional studies. However, it is not known whether the defect is primary or secondary. We investigated the prevalence of hypogonadism in type 2 diabetes by measuring serum total T, free T (FT), SHBG, LH, FSH, and prolactin (PRL) in 103 type 2 diabetes patients. FT was measured by equilibrium dialysis. FT was also calculated by using T and SHBG (cFT). Hypogonadism was defined as low FT or cFT. The mean age was 54.7 +/- 1.1 yr, mean body mass index (BMI) was 33.4 +/- 0.8 kg/m(2), and mean HbA1c was 8.4 +/- 0.2%. The mean T was 12.19 +/- 0.50 nmol/liter (351.7 +/- 14.4ng/dl), SHBG was 27.89 +/- 1.65 nmol/liter, and FT was 0.250 +/- 0.014 nmol/liter. Thirty-three percent of patients were hypogonadal. LH and FSH levels were significantly lower in the hypogonadal group compared with patients with normal FT levels (3.15 +/- 0.26 vs. 3.91 +/- 0.24 mIU/ml for LH and 4.25 +/- 0.45 vs. 5.53 +/- 0.40 mIU/ml for FSH; P < 0.05). There was a significant inverse correlation of BMI with FT (r = -0.382; P < 0.01) and T (r = -0.327; P < 0.01). SHBG correlated inversely with BMI (r = -0.267; P < 0.05) but positively with age (r = 0.538; P < 0.001) and T (r = 0.574; P < 0.001). FT correlated strongly with cFT (r = 0.919; P < 0.001) but not with SHBG. LH levels correlated positively with FT (r = 0.287; P < 0.05). We conclude that hypogonadotropic hypogonadism occurs commonly in type 2 diabetes.