Testosterone concentrations in diabetic and nondiabetic obese men.
Testosterone concentrations in diabetic and nondiabetic obese men.
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DOI：
10.2337/dc09-1649
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发表时间：
2010-06
期刊：
影响因子：
16.2
通讯作者：
Dandona P
中科院分区：
文献类型：
--
作者：
Dhindsa S;Miller MG;McWhirter CL;Mager DE;Ghanim H;Chaudhuri A;Dandona P
确定初级保健诊所人群中肥胖和2型糖尿病患者睾酮浓度低于正常值的患病率。在男性性腺功能减退症（HIM）研究中，分析了1,849名男性（1,451名非糖尿病患者和398名糖尿病患者）的游离睾酮浓度。HIM研究是一项美国-基于横断面研究，旨在确定年龄>45岁男性性腺功能减退症的患病率。通过平衡透析测定游离睾酮。在非糖尿病的瘦、超重和肥胖男性中，游离睾酮浓度低于正常值的患病率分别为26%（n = 275）、29%（n = 687）和40%（n = 489（P < 0.001的趋势），和44%（n = 36），44%（n = 135）和50%（n = 227），分别在糖尿病男性（P = 0.46的组内趋势和P < 0.05与非糖尿病男性相比）。糖尿病男性的平均游离睾酮浓度显著低于非糖尿病男性。在多元回归分析中，游离睾酮浓度与年龄（r =-0.37）、BMI（r =-0.18）和性激素结合球蛋白（r =-0.11）呈显著负相关（P < 0.001）。非糖尿病男性的游离睾酮浓度平均下降为每十年7.8 pg/ml，糖尿病男性为每十年8.4 pg/ml。40%的肥胖非糖尿病男性和50%的肥胖糖尿病男性年龄≥45岁，游离睾酮浓度低于正常值。鉴于肥胖的高患病率，肥胖可能是男性游离睾酮浓度低于正常值的最常见原因。糖尿病的伴随存在与游离睾酮浓度低于正常水平的患病率额外增加相关。
To determine the prevalence of subnormal testosterone concentrations in patients with obesity and with type 2 diabetes in a primary care clinic population. Free testosterone concentrations of 1,849 men (1,451 nondiabetic and 398 diabetic) in the Hypogonadism In Males (HIM) study were analyzed. The HIM study was a U.S.-based cross-sectional study designed to define the prevalence of hypogonadism in men aged >45 years. Free testosterone was measured by equilibrium dialysis. The prevalence of subnormal free testosterone concentrations in lean, overweight, and obese nondiabetic men was 26% (n = 275), 29% (n = 687), and 40% (n = 489), respectively (P < 0.001 for trend), and 44% (n = 36), 44% (n = 135), and 50% (n = 227), respectively, in diabetic men (P = 0.46 for trend within group and P < 0.05 compared with nondiabetic men). The mean free testosterone concentration of diabetic men was significantly lower than that of nondiabetic men. Free testosterone concentrations were negatively and significantly (P < 0.001) related to age (r = −0.37), BMI (r = −0.18), and sex hormone–binding globulin (r = −0.11) in multiple regression analysis. The average decline of free testosterone concentrations was 7.8 pg/ml per decade in nondiabetic men and 8.4 pg/ml per decade in diabetic men. Forty percent of obese nondiabetic men and 50% of obese diabetic men aged ≥45 years have subnormal free testosterone concentrations. In view of its high prevalence, obesity is probably the condition most frequently associated with subnormal free testosterone concentrations in males. The concomitant presence of diabetes is associated with an additional increase in the prevalence of subnormal free testosterone concentrations.