年龄依赖性胰岛素抵抗与睾酮水平的相关性

目的探讨健康男性年龄对胰岛素抵抗的影响和胰岛素抵抗与睾酮的关系。方法在北京、上海、西安和重庆四城市调查20～78岁健康男性1080例,同时测定空腹血糖、胰岛素、总睾酮、雌二醇、黄体生成激素(LH)、卵泡刺激激素(FSH)和性激素结合球蛋白(SHBG),计算稳态模型胰岛素抵抗指数(HOMA-IR)、游离睾酮(cFT)、睾酮分泌指数(TSI)和游离睾酮指数(FTI),将空腹血糖、胰岛素和HOMA-IR与其他检验结果进行相关分析。结果空腹血糖、胰岛素和HOMA-IR与年龄(r=0.1644、0.1536和0.1587;均为P<0.01)、LH(r=0.1909、0.1310和0.1920;均为P<0.01)和FSH(r=0.1 704、0.1543和0.1907;均为P<0.01)呈显著正相关,与总睾酮(r=-0.0825、-0.2187和-0.1619;P>0.05、P<0.01和P<0.01)、cFT(r=0.1238、-0.1 567和-0.1346;P<0.01、P<0.01和P<0.05)和TSI(r=-0.2143、-0.2098和-0.2488;均为P<0.01)呈显著负相关。结论健康男性随年龄增长伴有空腹血糖、胰岛素和HOMA-IR的逐渐升高,年龄依赖性雄激素水平降低对这种胰岛素抵抗的变化可能起着重要作用。

Relationship of age-dependent decline of serum testosterone with the concomitant insulin resistance

Objective To investigate the influence of aging on insulin resistance in healthy men, and the relationship between the age-dependent decline of testosterone and insulin resistance. Methods The present study was nested on the previous investigation on age related changes of androgen in 1080 healthy men aged 20 to 78 years who were enrolled from Beijing,Shanghai,Xi'an and Chongqing in China.Fasting glucose (F-GLU) and fasting insulin (F-INS) were measured,and the homeostasis model assessment for insulin resistance (HOMA IR) was calculated.Analysis on the relationships of these figures with the concomitant measurements of total testosterone (TT),estradiol (E2),luteinizing hormone (LH),follicle stimulating hormone (FSH),sex hormone-binding globulin (SHBG),calculated free testosterone (cFT),ratio of TT/LH (testosterone secreting index:TSI) and ratio of TT/SHBG (free testosterone index:FTI) were performed.Results F-GLU,F-INS and HOMA-IR showed a significant positive correlation to age (r=0.1644,0.1536 and 0.1587, respectively;all P<0.01),LH(r=0.1909,0.1310 and 0.1920,respectively;all P<0.01) and FSH (r=0.1704,0.1543 and 0.1907,respectively;all P<0.01),and a significant negative correlation to TT (r=-0.0825,-0.2187 and-0.1619,respectively;P>0.05,P<0.01 and P<0.01, respectively),cFT(r=-0.1238,-0.1567 and-0.1346,respeetively;P<0.01,P<0.01 and P<0.05,respectively),TSI(r=-0.2143,-0.2098 and-0.2488,respectively;all P<0.01). Conclusions Aging in healthy men associates with increased levels of F-GLU,F-INS and HOMA-IR. The age-dependent decline of testosterone may play an important role in the change of insulin resistance along with aging.