摘要目的 研究老年男性糖尿病患者的性激素和雄激素受体水平的变化,探讨老年男性糖尿病患者性激素和雄激素受体与糖尿病的相关性. 方法横断面调查老年男性492例,其中健康对照组104例,平均年龄(71.4±5.2)岁;非糖尿病对照组259例,平均年龄(71.5±5.0)岁;糖尿病组129例,平均年龄(73.0±6.3)岁.测定总睾酮(TT)、游离睾酮(FT)、脱氢表雄酮硫酸酯(DHEAS)、性激素结合球蛋白(SHBG)、雌二醇(E_2)、黄体生成素(LH)、卵泡刺激素(FSH)水平,采用流式细胞术检测外周血白细胞雄激素受体(AR)水平. 结果糖尿病组TT水平显著低于两对照组,分别为(17.1±6.1)、(15.8±6.0)nmol/L和(13.8±4.7)nmol/L(P<0.01),FT、SHBG、AR阳性率、AR荧光强度健康对照组、非糖尿病对照组和糖尿病组3组间呈下降趋势.但差异无统计学意义.多元回归分析町见TT、E_2,E_2/T,SHBG与血糖水平呈负相关;SHBG与糖尿病病程呈正相关.TT和AR阳性率与糖尿病病程呈负相关.Logistic多元同归分析示年龄、腰臀围比、FSH、SHBG、AR阳性率是糖尿病的危险因素. 结论低水平的TT、SHBG和AR可能是糖尿病的危险因素,在老年男性糖尿病的发生和发展中起到一定作用.

abstractsObjective To investigate the levels of sex hormone and androgen receptor (AR), and to evaluate the relationship of sex hormone and, AR with diabetes mellitus (DM) in senile men. Methods Cross sectional study was performed on 492 elderly men, including 104 healthy personsCmean age (71.4 ±5.2) years] , 259 non-diabetes mellitus Cmean age( 71.5±5. 0) years] and 129 diabetes mellitus Cmean age ( 73. 0±6. 3) years] . The plasma concentrations of total testosterone (TT), free testosterone (FT), dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG), estradiol (E_2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were examined. The AR was tested by flow cytometry. Results The concentrations of TT were significantly lower in diabetes group than in health group and in non-diabetes group [( 17.1±6.1) nmol/L vs. (15.8± 6.0) nmol/L and ( 13.8±4.7) nmol/L, all P<0.013. Although FT, SHBG, AR% and AR fluorescence intensity showed a decreasing trend among health group, non-diabetes group and diabetes group, no significant differences could be drawn. The TT, E_2 , E_2/T and SHBG were negatively correlated with blood glucose, and SHBG was positively, and TT, AR% werenegatively correlated with the course of diabetes. Logistic multiple regression analysis demonstrated that age, WHR, FSH, SHBG and AR% were the risk factors for diabetes mellitus. Conclusions Low levels of TT, SHBG and AR may be the independent risk factors for DM in elderly men.