2型糖尿病男性患者血清睾酮水平低下对非酒精性脂肪肝的影响

doi:10.6040/j.issn.1671-7554.0.2015.1355

摘要/Abstract

摘要： 目的探讨2型糖尿病(T2DM)男性患者血清总睾酮水平与非酒精性脂肪肝(NAFLD)的相关性。方法以199例T2DM男性患者为研究对象,应用腹部超声进行NAFLD的诊断及分型,根据超声诊断结果将研究对象分为NAFLD组及非NAFLD组,并根据超声检查结果将NAFLD组分为轻度NAFLD组及中-重度NAFLD组。用电化学发光法检测患者血清总睾酮(TT)水平,并检测患者相关血清学指标,分析睾酮水平与NAFLD的相关性。结果 (1) NAFLD组的男性T2DM患者血清总睾酮水平低于非NAFLD组［3.29(2.54~4.21)vs 4.91(3.48~5.99), P<0.01］。 (2) 中-重度NAFLD患者血清总睾酮水平低于轻度患者(3.06±1.11 vs 3.65±1.45, P=0.049)。结论男性T2DM患者血清总睾酮水平低下者更易患NAFLD,睾酮水平低下为NAFLD的独立危险因素。

关键词: 非酒精性脂肪肝, 血清总睾酮, 胰岛素抵抗, 2型糖尿病

Abstract: Objective To investigate the correlation between serum total testosterone(TT)and non-alcoholic fatty liver disease(NAFLD)in male patients with type 2 diabetes mellitus(T2DM). Methods A total of 199 male patients with T2DM were enrolled in the study. According to results of abdomen ultrasound, the subjects were divided into NAFLD group and non-NAFLD group. The NAFLD group was further divided into mild subgroup and moderate-severe subgroup according to the severity of NAFLD. The TT level was measured using electrochemiluminescent method. The other serological indicators were measured by Olympus automatic biochemistry analyzer. The correlation of TT and NAFLD was analyzed. Results The TT level of NAFLD group was lower than that of non-NAFLD group［3.29(2.54-4.21)vs 4.91(3.48-5.99), P<0.01］. The TT level of the moderate-severe subgroup was lower than that of the mild subgroup(3.06±1.11 vs 3.65±1.45, P=0.049). Conclusion Male T2DM patients with low TT level are at high risk of NAFLD. Low TT level is an independent risk factor for NAFLD in T2DM male patients.

Key words: Nonalcoholic fatty liver disease, Total serum testosterone, Insulin resistance, Type 2 diabetes mellitus

中图分类号:

R588

林栋,管庆波. 2型糖尿病男性患者血清睾酮水平低下对非酒精性脂肪肝的影响[J]. 山东大学学报（医学版）, 2016, 54(7): 33-37.

LIN Dong, GUAN Qingbo. Association of serum testosterone level and non-alcoholic fatty liver disease in male patients with T2DM[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(7): 33-37.

参考文献

[1] Suzuki A, Angulo P, Lymp J, et al. Chronological development of elevated aminotransferases in a nonalcoholic population[J]. Hepatology, 2005, 41(1): 64-71.
[2] Medina J, Fernandez-Salazar LI, Garcia-Buey L, et al. Approach to the pathogenesis and treatment of nonalcoholic steatohepatitis[J]. Diabetes Care, 2004, 27(8): 2057-2066.
[3] Choi SY, Kim HJ, Kang JH, et al. The relation between non-alcoholic fatty liver disease and the risk of coronary heart disease in Koreans[J]. Am J Gastroenterol, 2009, 104(8): 1953-1960.
[4] Rohrmann S, Shiels MS, Lopez DS, et al. Body fatness and sex steroid hormone concentration in US men: result from NHANES III[J]. Cancer Causes & Control, 2011, 22(8): 1141-1151.
[5] Kim S, Kwon H, Park JH, et al. A low level of serum total testosterone is independently associated with non-alcoholic fatty liver disease[J]. BMC Gastroenterol, 2012, 12: 69[M8]. doi: 10.1186/1471-230X-12-69.
[6] Tian GX, Sun Y, Pang CJ, et al. Oestradiol is a protective factor for non-alcoholic fatty liver disease in health man[J]. Obes Rev, 2012, 13(4): 381-387.
[7] Farsell GC, Chitturi S, Lau GK, et al. Guidelines for the assessment and management of non-alcoholic fatty liver disease in the Asia-Pacific region: executive summary[J]. J Gastroenterol Hepatol, 2007, 22(6): 775-777.
[8] Fan JG, Falrell GC. Epidemiology of non-alcoholic fatty liver disease in China[J]. J Hepatol, 2009, 50(1): 204-210.
[9] Kim D, Choi SY, Park EH, et al. Nonalcoholic fatty liver disease is associated with coronary artery calcification[J]. Hepatology, 2012, 56(2): 605-613.
[10] Kalra S, Vithalani M, Gulati G, et al. Study of prevalence of nonalcoholic fatty liver disease(NAFLD)in type 2 diabetes patients in india(SPRINT)[J]. J Assoc Physicians India, 2013, 61(7): 448-453.
[11] Prashanth M, Ganesh HK, Vima MV, et al. Prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus[J]. J Assoc Physicians India, 2009, 57: 205-210.
[12] Tolman KG, Fonseca V, Dalpiaz A, et al. Spectrum of liver disease in type 2 diabetes and management of patients with diabetes and liver disease[R]. Diabetes Care, 2007, 30(3): 734-743.
[13] Farrell GC, Chitturi S, Lau GK, et al. Asia-Pacific Working Party on NAFLD. Guidelines for the assessment and management of non-alcoholic fatty liver disease in the Asia-Pacific region: executive summary[J]. J Gastroenterol Hepatol, 2007, 22(6): 775-777.
[14] Yialamas MA, Dwyer AA, Hanley E, et al. Acute sex steroid withdrawal reduces insulin sensitivity in healthy men with idiopathic hypogonadotropic hypogonadism[J]. J Clin Endocrinol Metab, 2007, 92(11): 4254-4259.
[15] Grossmann M, Thomas MC, Panagiotopoulos S, et al. Low testosterone levels are common and associated with insulin resistance in men with diabetes[J]. J Clin Endocrinol Metab, 2008, 93(5): 1834-1840.
[16] Saad F, Gooren L. The role of testosterone in the metabolic syndrome: a review[J]. J Steroid Biochem Mol Biol, 2009, 114(1-2): 40-43.
[17] Holmlng A, Bjdrntorp P. The effects of cortisol on insulin sensitivity in muscle[J]. Acta Physiol Stand, 1992, 144(4): 425-431.
[18] 李霞, 周智广, 亓海英, 等. 用空腹C肽代替胰岛素改良Homa公式评价胰岛素抵抗和胰岛β细胞功能[J]. 中南大学学报(医学版), 2004, 29(4): 419-423. LI Xia, ZHOU Zhiguang, QI Haiying, et al. Replacement of insulin by fasting C-peptide in modified homeostasis model assessment to evaluate insulin resistance and islet cell function[J]. J Cent South Univ(Med sci), 2004, 29(4): 419-423.
[19] Alkhouri N, Eng K, Lopez R, et al. Non-high-density lipoprotein cholesterol(non-HDL-C)levels in children with nonalcoholic fatty liver disease(NAFLD)[J]. Springerplus, 2014, 3: 407.
[20] Cao W, Zhao C, Shen C, et al. Cytokeratin 18, alanine aminotransferase, platelets and triglycerides predict the presence of nonalcoholic steatohepatitis[J]. PLoS One, 2013, 8(12): 82092.
[21] Hamilton EJ, Gianatti E, Strauss BJ, et al. Increase in visceral and subcutaneous abdominal fat in men with prostate cancer treated with androgen deprivation therapy[J]. Clin Endocrinol(Oxf), 2011, 74(3): 377-383.
[22] Schroeder ET, Zheng L, Ong MD, et al. Effects of androgen therapy on adipose tissue and metabolism in older men[J]. J Clin Endocrinol Metab, 2004, 89(10): 4863-4872.
[23] Miller KK. Androgen deficiency: effects on body composition[J]. Pituitary, 2009, 12(2): 116-124.
[24] Fried1 KE, Hannan CJ Jr, Jones RE, et al. High density lipoprotein cholesterol is not decreased if an aromabzable androgen is administered[J]. Metabolism, 1990, 39(1): 69-74.
[25] Xu X, De Pergola G, Bjdrntorp P. The effects of androgens on the regulation of lipolysis in adipose precursor cells[J]. Endocrinology, 1990, 126(2): 1229-1234.
[26] Krotkiewski M, Björntorp P, Sjöström L, et al. Impact of obesity on metabolism in men and women. Importance of regional adipose tissue distribution[J]. J Clin Invest, 1983, 72(3): 1150-1162.

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