摘要
【目的】探究新疆地区男性高尿酸血症(HUA)患者合并性腺功能减退的相关危险因素。【方法】收集新疆维吾尔自治区人民医院内分泌与代谢病科2021年6月至2022年12月收治的217例男性HUA患者的临床资料,符合性腺功能减退症诊断标准的患者作为病例组(98例),性腺功能正常者作为对照组(119例),分析两组不同代谢指标的差异及男性性腺功能减退的相关性。【结果】①与性腺功能正常组相比,性腺功能减退组的年龄、腰围(WC)、体质量指数(BMI)、空腹血糖(FPG)、空腹胰岛素(FINS)、稳态模型评估的胰岛素抵抗指数(HOMA-IR)、谷丙转氨酶(ALT)、血尿酸(SUA)、性激素结合球蛋白(SHBG)水平显著升高,而γ-谷氨酰转移酶(GGT)、25-羟基维生素D[25(OH)D]、孕酮(P)、雌二醇(E_(2))、脱氢表雄酮(DHEA)、血清游离三碘甲腺原氨酸(FT3)水平显著降低(P<0.05)。其合并肥胖(OB)、非酒精性脂肪肝(NAFLD)、高脂血症(HLP)、高血压(HBP)、冠心病(CHD)、服用血管紧张素受体拮抗剂(ARB)及阿司匹林的比例显著升高(P<0.05)。②相关性分析显示:游离睾酮(FT)与年龄、WC、BMI、FPG、FINS、HOMA-IR、SUA、SHBG、ALT呈负相关,与25(OH)D、P、E_(2)、DHEA、FT3呈正相关(P<0.05)。③logistic回归分析显示,年龄、高血压、BMI、SUA、ALT、25(OH)D、HOMA-IR、WC均是性腺功能减退的独立危险因素(P<0.05);多因素校正后,结果发现SUA仍是性腺功能减退的独立危险因素[OR 95%CI为1.009(1.004,1.015),P=0.001]。【结论】男性HUA患者常存在性腺功能减退,其中年龄、高血压、BMI、SUA、ALT、25(OH)D、HOMA-IR、WC是性腺功能减退的独立危险因素。
【Objective】To explore the risk factors of hypogonadism in male hyperuricemia(HUA)patients in Xinji⁃ang.【Methods】Clinical data of 217 male patients with HUA admitted to the Department of Endocrinology and Metabolism of the People's Hospital of Xinjiang Uygur Autonomous Region from June 2021 to December 2022 were collected.Patients meeting the diagnostic criteria for hypogonadism were included in the case group(98 cases),and patients with normal go⁃nadism were included in the control group(119 cases).The differences of different metabolic indexes between the two groups and the correlation of male hypogonadism were analyzed.【Results】Compared with those in normal gonadal function group,in hypogonadism group,age,waist circumference(WC),body mass index(BMI),the levels of fasting blood glu⁃cose(FPG),fasting insulin(FINS),insulin resistance index assessed by homeostasis model(HOMA-IR),alanine aminotransferase(ALT),blood uric acid(SUA)and sex hormone binding globulin(SHBG)were significantly increased;the levels ofγ-glutamyltransferase(GGT),25-hydroxyvitamin D[25(OH)D],progesterone(P),estradiol(E2),dehydro⁃epiandrosterone(DHEA)and serum free triiodothyronine(FT3)were significantly decreased(P<0.05);and the propor⁃tion of patients with obesity(OB),non-alcoholic fatty liver(NAFLD),hyperlipidemia(HLP),hypertension(HBP),coronary heart disease(CHD)and use of angiotensin receptor antagonist(ARB)and aspirin was significantly increased(P<0.05).Correlation analyses showed that free testosterone(FT)was negatively correlated with age,WC,BMI,FPG,FINS,HOMA-IR,SUA,SHBG and ALT,but positively correlated with 25(OH)D,P,E2,DHEA and FT3(P<0.05).Logistic regression analysis showed that age,hypertension,BMI,SUA,ALT,25(OH)D,HOMA-IR and WC were inde⁃pendent risk factors for hypogonadism(P<0.05).After multivariate adjustment,SUA remained an independent risk fac⁃tor for hypogonadism[OR=1.009,95%CI(1.004,1.015),P=0.001].【Conclusions】Male HUA patients are often ac⁃companied with hypogonadism.Age,hypertension,BMI,SUA,ALT,25(OH)D,HOMA-IR and WC are independent risk factors of hypogonadism.
作者
王涵
陈园
WANG Han;CHEN Yuan(Department of Endocrinology and Metabolism,People's Hospital of Xinjiang Uygur Autonomous Region//Xinjiang Clinical Research Center for Diabetes,Urumqi 830000,China)
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2023年第5期893-900,共8页
Journal of Sun Yat-Sen University:Medical Sciences
作者简介
第一作者:王涵,主治医师,研究方向:内分泌腺疾病及代谢病,E-mail:329919029@qq.com;通信作者:陈园,主任医师,E-mail:1609904469@qq.com。
