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. 2016 Dec;22(12):1088-1094.

[Hypogonadism and the quality of life in male patients with type-2 diabetes mellitus]

[Article in Chinese]
Lu-Yao Zhang  1 , Wei He  2 , Jian-Xin Wan  3 , Qi-Qi Yin  4 , Zhen Cheng  1 , Guan-Ming Chen  1 , Wen Ji  1 , Hai Li  1 , Yan-Bing Li  1 , Zhi-Hong Liao  1
Affiliations
  • PMID: 29282913

[Hypogonadism and the quality of life in male patients with type-2 diabetes mellitus]

[Article in Chinese]
Lu-Yao Zhang et al. Zhonghua Nan Ke Xue. 2016 Dec.

Abstract
in English, Chinese

Objective: To compare the level of testosterone between type-2 diabetes mellitus (T2DM) patients and healthy controls and to investigate the status of hypogonadism and the influence of hypopgonadism on the quality of life.

Methods: We collected serum total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), and other clinical data from 166 T2DM patients aged over 30 years and 186 age-matched healthy controls. We investigated the quality of life (QoL) of the two groups of subjects using the questionnaires of Androgen Deficiency in Aging Males (ADAM), Aging Male Symptoms (AMS), 36-Item Short-Form Health Survey (SF-36), and Special Quality of Life for Diabetes Mellitus (DSQL).

Results: The level of calculated FT (cFT) was remarkably lower in the T2DM patients than in the healthy controls (P<0.05), but no statistically significant differences were observed between the two groups in the levels of TT, bio-available testosterone (Bio-T), and SHBG. The T2DM males with hypogonadism showed significant differences from those without in age, height, systolic blood pressure, and creatinine (P<0.05). Based on the criteria of cFT <0.3 nmol/L and AMS score ≥27, the incidence rate of hypogonadism was 51.81% in the T2DM patients, 31.58% in the 30－39 yr group, 32.50% in the 40－49 yr group, 50% in the 50－59 yr group, 69.23% in the 60－69 yr group, and 77.27% in the ≥70 yr group, elevated by 77.4% with the increase of 10 years of age (OR = 1.774, P<0.001). The AMS score was significantly correlated with the scores of DSQL (r = 0.557, P<0.001) and SF-36 (r = －0.739, P<0.001) in the T2DM patients.

Conclusions: T2DM patients have lower levels of cFT than healthy men, accompanied with a higher incidence of hypogonadism. Age is a main risk factor of hypogonadism. Severer testosterone deficiency symptoms are associated with lower scores of QoL in T2DM males.

目的： 比较2型糖尿病男性（T2DMM）与健康男性的雄激素水平，分析T2DMM性腺功能减退的状况以及性腺功能减退与生活质量的关系。方法： 选取166例30岁以上的T2DMM患者，收集血清总睾酮、游离睾酮等全面的临床资料，采用ADAM量表、AMS量表、SF-36量表、糖尿病患者生存质量特异性量表（DSQL）研究。选择186例年龄匹配的健康男性作为对照组，比较雄激素水平。结果: 在所有T2DMM患者，血清游离睾酮（cFT）水平明显低于各个同年龄组的健康男性对照(P<0.05)，总睾酮水平(TT)、生物活性睾酮(Bio-T）和性激素结合球蛋白（SHBG）在两组间无统计学差异。T2DMM伴有性腺功能减退与不伴性腺功能减退患者相比，年龄、身高、收缩压、肌酐有统计学差异(P<0.05)。以AMS问卷异常（得分≥27分）同时cFT低于0.3 nmol/L为性腺功能减退的诊断标准时，T2DMM伴发性腺功能减退达51.81%,且随年龄增长伴发率上升（30~39岁,31.58%; 40~49岁,32.5%; 50~59岁,50%; 60~69岁,69.23%; ≥70岁,77.27%）。年龄是性腺功能减退的危险因素，每增加10岁，性腺功能减退风险增加77.4%（OR=1.774, P<0.001）。T2DMM患者AMS量表与SF-36量表（r= －0.7393, P <0.001）、DSQL量表（r=0.557,P<0.001）评分之间存在显著相关性。结论： T2DMM的游离睾酮低于健康男性，性腺功能减退的伴发率较高，年龄是性腺功能减退的主要危险因素。雄激素缺乏症状程度越严重，生活质量各个维度的评分越差。.

Keywords: free testosterone; hypogonadism; male; type-2 diabetes mellitus.

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