20~35岁青年肥胖男性游离睾酮指数与胰岛功能指标的关联性分析

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。

Relationship between free androgen index and insulin function in obese young men aged from 20 to 35

Objective 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(P_trend=0.034).Free testosterone was positively correlated with Matsuda index(r=0.280,P=0.004),but the correlation disappeared after adjustment(P_trend=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.