摘要目的:分析20～35岁青年肥胖男性游离睾酮指数与胰岛功能之间的关系。方法:选取2019年2月至10月于肥胖门诊就诊的82例青年肥胖男性作为研究对象，按照游离睾酮指数三分位数分为3个亚组。对研究对象进行口服葡萄糖耐量试验并测定其血糖和胰岛素水平，以稳态模型评估的胰岛素抵抗指数(HOMA-IR)、稳态模型评估的胰岛β细胞功能指数(HOMA-β)、胰岛素分泌指数及胰岛素敏感指数(Matsuda指数)作为胰岛细胞功能评价指标，分析游离睾酮指数与胰岛功能之间的关系。结果:青年肥胖男性人群中，随着游离睾酮指数水平升高，总睾酮、性激素结合球蛋白、Matsuda指数水平均升高，而腰围、体重指数、餐后1 h胰岛素、餐后2 h胰岛素、HOMA-IR水平则降低(均 P<0.05)；游离睾酮指数与HOMA-IR呈负相关( r＝-0.386, P＝0.016)，且经校正年龄、性别、体重指数、腰围后，相关性仍有线性趋势( P趋势＝0.034)；游离睾酮指数与Matsuda指数呈正相关( r＝0.280, P＝0.004)，但经校正上述因素后，关联性消失( P趋势＝0.623)。进一步回归分析显示，经校正后，HOMA-IR每升高1个单位，游离睾酮指数降低14.1%( OR＝0.869，95% CI0.767～0.984, P＝0.028)。 结论:游离睾酮指数是青年男性肥胖人群胰岛素抵抗状态的预测指标，但其和胰岛素敏感性之间的关联可能是由肥胖引起。

abstractsObjective:To analyze the relationship between free androgen index and insulin function in obese young men aged from 20 to 35.Methods:A total of 82 young obese men in Obesity Clinic from February to October 2019 were enrolled in the study. The subjects were divided into 3 subgroups according to free androgen index level tertiles. The blood glucose and insulin levels were tested after oral glucose tolerance test. Homeostasis model assessment for insulin resistance (HOMA-IR), homeostasis model assessment for β cell function (HOMA-β), insulin secretion index, and insulin sensitivity index (Matsuda index) were used to evaluate β cell function in oder to analyze the relationship between free androgen index and insulin function.Results:In young obese men, participants with higher free androgen index levels exhibited less waist circumference, lower body mass index, 1 h postprandial insulin, 2 h postprandial insulin, HOMA-IR level but with a higher total testosterone, sex hormone binding globulin, and Matsuda index level (all P<0.05). There was a negative correlation between the free androgen index and the HOMA-IR ( r=-0.386, P=0.016), and the correlation tended to a linear trend after adjustment for age, sex, body mass index, and waist circumference ( Ptrend=0.034). Free testosterone was positively correlated with Matsuda index ( r=0.280, P=0.004), but the correlation disappeared after adjustment ( Ptrend=0.623). The results of further regression analysis showed that the level of free testosterone index decreased by 14.1% ( OR=0.869, 95% CI0.767-0.984, P=0.028) for each increase of HOMA-IR after adjustment. Conclusion:The level of free testosterone index is a predictor of insulin resistance in obese young men, but the association between this parameter and insulin sensitivity may be caused by obesity.