Association of serum testosterone with different classes of glucose metabolism and the mediation effect of obesity: The Henan Rural Cohort Study
Association of serum testosterone with different classes of glucose metabolism and the mediation effect of obesity: The Henan Rural Cohort Study
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血清睾酮与不同类别糖代谢的关联及肥胖的中介作用：河南农村队列研究
DOI：
10.1002/dmrr.3133
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发表时间：
2019-07-01
影响因子：
8
通讯作者：
Mao, Zhenxing
中科院分区：
文献类型：
--
作者：
Liu, Xue;Jiang, Jingjing;Mao, Zhenxing
目的：探讨血清睾酮与空腹血糖受损（IFG）和2型糖尿病（T2DM）的关系，并计算肥胖状况在两者关系中的解释比例。材料与方法：采用病例对照研究，包括2775名受试者。采用液相色谱-串联质谱法测定血清睾酮。采用条件logistic回归和多变量线性回归估计睾酮与不同血糖状态之间的关系。以腰围（WC）作为中介来评估中介效应。结果：在对多个变量进行调整后，血清睾酮水平与男性T2DM呈负相关(每1单位自然对数转换，奇数比(OR) = 0.73, 95%可信区间（CI）： 0.56, 0.96；Tertile 3 vs Tertile 1, OR = 0.46, 95% CI:0.29, 0.72)，而雌性阳性（每单位自然对数变换，OR = 1.56, 95% CI:1.32, 1.84; Tertile 3 vs Tertile 1, OR = 3.55, 95% CI: 2.22, 5.66）。在男性中，较高的睾酮水平往往与较低的空腹血糖水平和较弱的HOMA2-IR以及较强的HOMA2-ss相关。在女性中观察到相反的结果。此外，在男性和女性中，WC在睾酮与IFG和T2DM之间的关系中发挥了全部和部分的中介作用。结论：血清睾酮水平对男性和女性IFG和T2DM的影响相反。随着血清睾酮水平的升高，血糖异常的进展在男性中减少，而在女性中增加。此外，WC在睾酮和IFG与T2DM的关系中发挥了全部或部分的中介作用。
Aims: We aimed to investigate the association of serum testosterone with impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM) and calculate the proportion explained by obesity status on the relationship. Materials and Methods: A case-control study including 2775 participants was performed. Serum testosterone was quantified by liquid chromatography-tandem mass spectrometry. Conditional logistic regression and multivariable linear regression were performed to estimate the relationships between testosterone and different glucose status. Waist circumference (WC) was used as a mediator to estimate the mediation effect. Results: After adjusting for multiple variables, serum testosterone levels were negatively associated with T2DM in males (per 1 unit natural log-transformed, odd ratio (OR) = 0.73, 95% confidence interval (CI): 0.56, 0.96; Tertile 3 vs Tertile 1, OR = 0.46, 95% CI:0.29, 0.72) while were positively in females (per 1 unit natural logtransformed, OR = 1.56, 95% CI:1.32, 1.84; Tertile 3 vs Tertile 1, OR = 3.55, 95% CI: 2.22, 5.66). In males, a higher testosterone tended to be associated with a lower fasting plasma glucose level and a weaker HOMA2-IR but a stronger HOMA2-ss. Opposite findings were observed in females. Furthermore, WC played a full and partial mediating role in the relationship between testosterone and IFG and T2DM both in males and females. Conclusion: Serum testosterone levels had opposite effects on IFG and T2DM in males and females. With higher serum testosterone levels, the dysglycemia progression was decreased among males while increased among females. In addition, WC played a full and partial mediating role in the relationship between testosterone and IFG and T2DM.