Changes Of Sex Hormone Levels In Men With Type2 Diabetes Melitus And Its Clinical Significance

Diabetes mellitus(DM) has been a globally epidemic disease, which is seriously effecting the quality of patients'life and the cost of treatment has brought enormous economic burden to society. With the increase in the incidence of DM, the incidence of sexual dysfunction in male with type 2 diabetes mellitus(T2DM) is also growing rapidly. Now, many reports indicate that there is a close relationship between the reduction of sex hormones and T2DM.Objective:To study the changes of sex hormone levels in men with T2DM, as well as the relationships between sex hormones and obesity, glucose and lipid metabolism, in order to provid a better clinical guidance to treat obesity and glycolipid metabolic disorder, and delay the development of chronic complications.Materials and methods:1. Subjects:choose 30 heathy males(group A) in medical examination center of our hospital from May 2009 to May 2010 as control group; 50 male patients with T2DM hospitalized in our Endocrine Department during the same period. 35 of them are merely T2DM(group B), the others had complication of Obesity as group C. The age of subjects rangs from 33 to 75.2. Criteria of diagnosis:The diagnosis of DM accord to the new diagnostic criteria of WHO in 1999. The diagnosis of Obesity accord to chinese adult weight standards published by Disease Control Division of Ministry of Health of china in 2003, Obesity:body mass index (BM I)≧28. all subjects have no drug history of sexual hormones and its antagonists; no gonadal and adrenal dysfunction; no hepatic and renal dysfunction. no history of serious cardiovascular and cerebrovascular diseases; no various acute diseases. no history of thyroid diseases and other endocrine diseases.3. Clinical data:The data observed includ age, fasting plasma glucose (FPG), glycosylated hemoglobin A1c (GHbA1c), body mass index (BMI), triglyeride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), estradiol (E2), testosterone (T), follicle - stimulating hormone(FSH), luteinizing hormone(LH),estradiol/ testosterone (E2 / T),testosterone secretion index (TSI).4. Method of statistics:Statistic software SAS 9.0 was used for data processing. Because the variables do not conform to the normal distribution, so the comparison between groups used wilcoxon rank sum test and results were showed by median. Relevant parameters used linear correlation analysis. P value<0.05 was considered to have statistical significance.Results:1. Comparison of the indicators among three groups:three groups have no significant differences in age. Compared to group A, FPG, HbA1c, E2, LH and E2/T of group B and C are higher, HDL-C, T and TSI of group B and C are lower; In addition, BMI, LDL-C of group B are higher than group A. Compared to group B, BMI, TC, LDL-C and E2/T of group C are higher, T and TSI are lower. While, TG and FSH of three groups have no significant differences.2. correlation analysis of sex hormones and other indicators of group B and C.Group B:T is positively related with HDL-C(P<0.05), negtively related with TG(P<0.01); E2/T is negtively related with HDL-C(P<0.01), positively related with TG(P<0.01). E2, LH, FSH and TSI have no significant correlations with other indicators. Group C:E2 is positively related with FPG and GHbA1c(P<0.05); E2/T is positively related with FPG(P<0.05), negtively related with HDL-C(P< 0.05). T,LH,FSH,TSI have no significant correlations with other indicators.Conclusions:1. There are obviously disorders of sex hormone and glycolipid metabolic disorders in men with T2DM, and those disorders are more apparent in men with T2DM and Obesity.2. Sex hormone level is one of the indicators which reflect the metabolic changes in male with T2DM. It may be associated with the occurrence and development of T2DM in male and this association is independent of obesity.3. Male serum testosterone is the beneficial factor for lipid metabolism. Increasing the serum levels of testosterone appropriately may have protective effects on blood lipid metabolism.4. Testosterone supplement therapy (TST) may be beneficial for control of T2DM, obesity and dyslipidemia, delay the occurrence and development of their chronic complications. However, the long-term safety of TST still needs further observation.