目的:探讨中老年男性2型糖尿病患者糖化血红蛋白控制水平对性腺激素、体重指数、血脂、内脏脂肪面积的影响,并对影响睾酮的相关因素进行分析。方法:选择90例中老年2型糖尿病男性患者,收集30例糖化血红蛋白＜7%、30例糖化血红蛋白7%~9%、30例糖化血红蛋白＞9%,分别收集患者年龄、体重指数、血脂、内脏脂肪面积、性腺激素,对三组数据进行统计学分析;再根据睾酮大于中位数(＞4.08 ng/mL)及小于等于中位数(≤4.08 ng/mL)分为两组,对两组之间体重指数、内脏脂肪面积、糖化血红蛋白、血脂等数据进行统计分析。结果:糖化血红蛋白水平与高密度脂蛋白、睾酮呈负相关(P＜0.05),而与甘油三酯、总胆固醇、低密度脂蛋白、体重指数、内脏脂肪面积、雌二醇呈正相关(P＜0.05),与促卵泡生成素、促黄体生成素、泌乳素水平无关(P＞0.05)。睾酮与体重指数、内脏脂肪面积、糖化血红蛋白、甘油三酯,总胆固醇,低密度脂蛋白水平呈负相关(P＜0.05),与高密度脂蛋白呈正相关(P＜0.05)。Logistic回归分析显示:糖化血红蛋白水平,内脏脂肪面积、体重指数、血脂异常是睾酮减少的危险因素。结论:良好的血糖控制可有效减少男性睾酮下降,促进机体脂质代谢;较高的睾酮水平对血糖、血脂代谢亦起到积极作用;糖化血红蛋白、内脏脂肪面积、体重指数、血脂异常是睾酮减少的危险因素。

Objective: To investigate the effect of glycated hemoglobin control level on gonadal hormone, body mass index, blood lipid and visceral fat area in middle-aged and elderly male patients with type 2 diabetes mellitus, and to analyze the related factors affecting testosterone. Methods: A total of 90 middle-aged and elderly male patients with type 2 diabetes mellitus were selected and divided into good blood glucose control group (30 patients, glycosylated hemoglobin＜7%), poor blood glucose control group (30 patients, glycosylated hemoglobin 7%～9%) and bad blood glucose control group (30 patients, glycosylated hemoglobin ＞9%), the age, body mass index, blood lipid, visceral fat area and gonadal hormone of the patients were collected, and the data of the three groups were statistically analyzed. According to testosterone greater than the median (≤4.08 ng/mL) and less than or equa to the median (＜4.08 ng/mL), they were divided into two groups, and the body mass index, visceral fat area, glycosylated hemoglobin, blood lipids and other data between the two groups were statistically analyzed. Results: The level of glycosylated hemoglobin was negatively correlated with high density lipoprotein and testosterone (P＜0.05), and positively correlated with triglyceride, total cholesterol, low density lipoprotein, body mass index, visceral fat area and estradiol (P＜0.05), but not with follicle stimulating hormone, luteinizing hormone and prolactin (P＞0.05). Testosterone was negatively correlated with body mass index, visceral fat area, glycosylated hemoglobin, triglyceride, total cholesterol and low density lipoprotein (P＜0.05), and positively correlated with high density lipoprotein (P＜0.05). Logistic regression analysis showed that glycosylated hemoglobin level, visceral fat area, body mass index and dyslipidemia were risk factors for testosterone reduction. Conclusion: Good blood glucose control can effectively reduce the decrease of testosterone in men, and can effectively promote the body's lipid metabolism; higher testosterone levels also play a positive role in blood glucose and lipid metabolism. Glycosylated hemoglobin, visceral fat area, body mass index, dyslipidemia are risk factors for testosterone reduction.