CAJ | 학술논문

目的：探讨既往无冠心病（CHD）病史的青年男性2型糖尿病患者血浆睾酮（T）水平与心血管疾病（CVD）危险因子及Framingham风险评分（FRV）的关系。方法将120例患者按照血浆T浓度三分位分组，比较各组间CVD危险因子，如体重指数（BMI）、腰围、吸烟、血脂谱、糖化血红蛋白（HbA1c）、血尿酸、24 h 尿微量白蛋白定量（UMA）、颈动脉内膜中层厚度（CIMT）、简易稳态模型法计算的胰岛素抵抗指数（HOMA-IR）及FRV非低危组（中危及高危组）比例等；分析血浆T与CVD各危险因子的相关性及其对FRV非低危组发生率的影响。结果随着血浆T浓度升高，BMI、腰围、血压、CIMT、HbA1c、HOMA-IR、超敏C反应蛋白（hs-CRP）、UMA、TG、TC、LDL-C及FRV非低危组比例等均降低（均P＜0.05或P＜0.01），HDL-C浓度增加（P＜0.05）；吸烟者比例、糖尿病病程、血尿酸及CVD家族史阳性者比例呈下降趋势，但是差异无统计学意义。相关性分析显示血浆T与BMI、腰围、CIMT、CAP、HbA1c、HOMA-IR、hs-CRP、UMA、血脂及FRV等均相关（均P＜0.05或P＜0.01）。Logistic 回归分析显示血浆T是青年男性2型糖尿病患者FRV非低危组的保护性因素，其OR值为0.581（95%CI：0.478～0.704， P＜0.01），在校正BMI、腰围、HbA1c、HOMA-IR、TG、TC、HDL-C及LDL-C后其OR值为0.787（95%CI：0.710～0.874，P＜0.01）。结论青年男性2型糖尿病患者血浆T与多个CVD危险因子负相关，低血浆T可能是青年男性2型糖尿病患者CVD独立危险因子。
목적：탐토기왕무관심병（CHD）병사적청년남성2형당뇨병환자혈장고동（T）수평여심혈관질병（CVD）위험인자급Framingham풍험평분（FRV）적관계。방법장120례환자안조혈장T농도삼분위분조，비교각조간CVD위험인자，여체중지수（BMI）、요위、흡연、혈지보、당화혈홍단백（HbA1c）、혈뇨산、24 h 뇨미량백단백정량（UMA）、경동맥내막중층후도（CIMT）、간역은태모형법계산적이도소저항지수（HOMA-IR）급FRV비저위조（중위급고위조）비례등；분석혈장T여CVD각위험인자적상관성급기대FRV비저위조발생솔적영향。결과수착혈장T농도승고，BMI、요위、혈압、CIMT、HbA1c、HOMA-IR、초민C반응단백（hs-CRP）、UMA、TG、TC、LDL-C급FRV비저위조비례등균강저（균P＜0.05혹P＜0.01），HDL-C농도증가（P＜0.05）；흡연자비례、당뇨병병정、혈뇨산급CVD가족사양성자비례정하강추세，단시차이무통계학의의。상관성분석현시혈장T여BMI、요위、CIMT、CAP、HbA1c、HOMA-IR、hs-CRP、UMA、혈지급FRV등균상관（균P＜0.05혹P＜0.01）。Logistic 회귀분석현시혈장T시청년남성2형당뇨병환자FRV비저위조적보호성인소，기OR치위0.581（95%CI：0.478～0.704， P＜0.01），재교정BMI、요위、HbA1c、HOMA-IR、TG、TC、HDL-C급LDL-C후기OR치위0.787（95%CI：0.710～0.874，P＜0.01）。결론청년남성2형당뇨병환자혈장T여다개CVD위험인자부상관，저혈장T가능시청년남성2형당뇨병환자CVD독립위험인자。
Objective To investigate the relationship between serum testosterone and cardiovascular disease(CVD) risk in young male type 2 diabetes mellitus patients without coronary heart disease history. Methods A total of 120 patients were divided into 3 groups based on serum T concentration. The CVD risk factors, such as body mass index(BMI), waist circumference, smoking, blood fat, HbA1c, serum uric acid, 24 hours urine micro-albumin quantitation(UMA), carotid intima-medial thickness(CIMT), homeostasis model assessment of insulin resistance(HOMA-IR), and the incidence of non-low-risk group based on Framingham risk value(FRV) were compared among the groups. The correlation of serum T and CVD risk factors, and the impact of serum T on the incidence of non-low-risk group based on FRV were also analyzed. Results With the increased concentration of serum T, BMI, waist circumference, systolic pressure, diastolic blood pressure, CIMT, HbA1c, UMA, TG, TC, LDL-C and the FRV non-low-risk group incidence were all decreased, together with the increased content of HDL-C significantly (all P<0.01 or P<0.05). There were no significant differences in smoking, diabetes duration, serum uric acid and the CVD positive family history ratio among the groups. The correlation analysis indicated that serum T correlated significantly with BMI, waist circumference, CIMT, CAP, HbA1c, HOMA-IR, hs-CRP, UMA, blood lipid and FRV. Logistic regression indicated that serum T was the protective factor of FRV non-low-risk group(OR=0.581 95% CI: 0.478-0.704, P<0.01). After the adjustment of BMI, waist circumference, HbA1C, HOMA-IR and blood fat, its OR was 0.787(95%CI:0.710-0.874, P<0.01). Conclusion The serum T inversely correlated with many CVD risk factors in young male T2DM patients. Low serum T may be an independent risk factor of CVD in such persons.