Low testosterone levels are common and associated with insulin resistance in men with diabetes
Low testosterone levels are common and associated with insulin resistance in men with diabetes
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DOI：
10.1210/jc.2007-2177
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发表时间：
2008-05-01
影响因子：
5.8
通讯作者：
Jerums, George
中科院分区：
文献类型：
--
作者：
Grossmann, Mathis;Thomas, Merlin C.;Jerums, George
内容：低睾酮水平是常见的男性与2型糖尿病，可能与insulin resistance.Objective：我们调查的患病率睾酮缺乏症和睾酮和胰岛素抵抗之间的关系在一个大的队列男性与2型和1型diabetes.Design：这项研究是一项横断面调查的580名男性与2型糖尿病和69名男性与1型糖尿病。一个亚组的262名男性2型糖尿病患者，然后重新评估后，中位数为6 months.Results：43%的男性2型糖尿病患者的总睾酮减少，57%的计算游离睾酮减少。只有7%的男性1型糖尿病患者总睾酮水平较低。相比之下，20.3%的男性1型糖尿病患者的游离睾酮水平较低，与2型糖尿病患者相似（年龄-体重指数调整的比值比= 1.4; 95%置信区间= 0.7-2.9）。在1型糖尿病和2型糖尿病患者中，低睾酮水平与胰岛素抵抗独立相关。系列测量也揭示了睾酮水平的变化和insulin resistance.Conclusions之间的反比关系：睾酮缺乏症是常见的男性糖尿病患者，无论类型。睾酮水平部分受胰岛素抵抗的影响，这可能是一个重要的干预途径，而睾酮替代的效用仍有待于在前瞻性试验中建立。
Context: Low testosterone levels are common in men with type 2 diabetes and may be associated with insulin resistance.Objective: We investigated prevalence of testosterone deficiency and the relationship between testosterone and insulin resistance in a large cohort of men with type 2 and type 1 diabetes.Design: The study was a cross-sectional survey of 580 men with type 2 diabetes and 69 men with type 1 diabetes. A subgroup of 262 men with type 2 diabetes was then reassessed after a median of 6 months.Results: Forty-three percent of men with type 2 diabetes had a reduced total testosterone, and 57% had a reduced calculated free testosterone. Only 7% of men with type 1 diabetes had low total testosterone. By contrast, 20.3% of men with type 1 diabetes had low calculated free testosterone, similar to that observed in type 2 diabetes (age-body mass index adjusted odds ratio = 1.4; 95% confidence interval = 0.7-2.9). Low testosterone levels were independently associated with insulin resistance in men with type 1 diabetes as well as type 2 diabetes. Serial measurements also revealed an inverse relationship between changes in testosterone levels and insulin resistance.Conclusions: Testosterone deficiency is common in men with diabetes, regardless of the type. Testosterone levels are partly influenced by insulin resistance, which may represent an important avenue for intervention, whereas the utility of testosterone replacement remains to be established in prospective trials.