本文選題：2型糖尿病 + 男性�。� 參考：《鄭州大學》2017年碩士論文

【摘要】：背景前列腺增生是中老年男性常見病,嚴重的前列腺增生會引起男性尿頻、尿急、尿不適等多種癥狀,降低其生活質(zhì)量。有研究認為,2型糖尿病男性前列腺體積增大風險約為非糖尿病男性的2倍。然而,關(guān)于2型糖尿病與男性前列腺之間的關(guān)系目前說法不一。并且,2型糖尿病患者性激素與前列腺之間的關(guān)系的研究較少。目的分析中年男性2型糖尿病(type 2 diabetes,T2DM)患者合并前列腺增生(benign prostatic hyperplasia,BPH)的影響因素,為臨床疾病防治提供依據(jù)。方法收集2015年10月至2016年10月鄭州大學第一附屬醫(yī)院內(nèi)分泌科住院T2DM男性患者100例,年齡40-60歲,平均年齡(49.21±5.73)歲,均符合1999年WHO糖尿病診斷標準。由超聲醫(yī)師行經(jīng)腹超聲檢查,測量所有研究對象前列腺縱徑(a)、橫徑(b)和前后徑(c),通過公式計算前列腺體積(PV)=a(cm)×b(cm)×c(cm)×0.52,超過12.5 mL即為BPH。根據(jù)前列腺是否增生將患者分為T2DM無BPH組和T2DM合并BPH組。測定卵泡刺激素(FSH)、黃體生成素(LH)、雌二醇(E2)、總睪酮(TT)、泌乳素(PRL)、性激素結(jié)合球蛋白(SHBG)、血總膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)、甘油三酯(TG)、高密度脂蛋白膽固醇(HDL-C)、空腹血糖(FBG)、糖化血紅蛋白(HbA1c)、空腹C肽(FCP)。用空腹C肽代替空腹胰島素評價胰島素抵抗[Homa-IR(CP)]=1.5+空腹血糖(mmol/L)×空腹C肽(pmol/L)/2800,胰島β細胞功能[HOMA-islet(CP)]=0.27×空腹C肽(pmol/L)/[空腹血糖(mmol/L)-3.5]。根據(jù)Vermeulen公式計算游離睪酮(FT)=(TT-23.43FT)/[SHBG-(TT-23.43FT)]×10-9mol/L,其中TT、FT、SHBG單位為nmol/L。應用SPSS17.0軟件進行統(tǒng)計學分析,計量資料以x_±s表示,首先進行正態(tài)檢驗,兩組間比較采用t檢驗;對前列腺增生的危險因素進行l(wèi)ogistic回歸分析。P0.05為差異有統(tǒng)計學意義。結(jié)果(1)兩組間一般資料及糖脂代謝指標的比較:與T2DM無BPH組比較,T2DM合并BPH組的年齡較大[(50.33±4.46對47.53±6.94)歲,P0.05],HbA1c、HOMA-IR(CP)較高[(8.91±1.98對7.95±1.17)%,(3.26±0.82對2.86±0.61),均P0.05];而HOMA-islet(CP)、TC、LDL-C、TG、HDL-C及BMI在兩組差異均無統(tǒng)計學意義(P0.05)。(2)兩組間性激素指標的比較:與T2DM無BPH組比較,T2DM合并BPH組的TT、FT較低[(13.92±5.43對17.15±7.63)nmol/L,(0.31±0.12對0.40±0.16)nmol/L,P0.05],E2/FT較高[(106.55±58.22對72.52±33.82),P0.05];FSH、LH、E2、PRL呈升高趨勢[(28.60±9.08對27.23±8.00)mIU/ml,(5.78±3.17對5.61±2.72)mIU/ml,(5.21±2.20對4.82±2.20)pg/ml,(15.61±9.92對15.31±8.25)ng/ml],但是差異無統(tǒng)計學意義(P0.05)。(3)以有無BPH為因變量,進行二分類logistic回歸分析結(jié)果顯示:年齡、FT、HbA1c、HOMA-IR(CP)是BPH的危險因素。結(jié)論增齡、FT降低、E2/FT升高、高血糖及胰島素抵抗均可能促進中年男性T2DM患者BPH的發(fā)生發(fā)展。
[Abstract]:Background benign prostatic hyperplasia (BPH) is a common disease in middle-aged and aged men. Studies have suggested that men with type 2 diabetes are about twice as likely as non-diabetic men to increase their prostate volume. However, the relationship between type 2 diabetes and men's prostate is currently at odds. And the relationship between sex hormones and prostate in type 2 diabetes is less studied. Objective to analyze the influencing factors of benign prostatic hyperplasia (BPH) in middle-aged male patients with type 2 diabetes mellitus (T2DM) and to provide evidence for the prevention and treatment of clinical diseases. Methods from October 2015 to October 2016, 100 male patients with T2DM in Department of Endocrinology, first affiliated Hospital of Zhengzhou University, aged 40-60 years, with an average age of 49.21 鹵5.73 years, were collected. All of them met the diagnostic criteria of WHO diabetes mellitus in 1999. Transabdominal ultrasound examination was performed to measure the longitudinal and transverse diameter of prostate and the anterior and posterior diameter of prostatic gland in all subjects studied. The volume of prostate was calculated by formula (PVN) 脳 BU (cm) 脳 cu (cm) 脳 0.52and more than 12.5 mL was BPH. Patients with benign prostatic hyperplasia were divided into T2DM without BPH group and T2DM with BPH group. Determination of follicle stimulating hormone (FSH), luteinizing hormone (LHN), estradiol (E 2), total testosterone (TTT), prolactin (PRL), sex hormone binding globulin (SHBG), serum total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), high density lipoprotein cholesterol (HDL-CU), fasting blood glucose (FG). FBGG, HbA1C, fasting C-peptide, FCPC. Using fasting C-peptide instead of fasting insulin to evaluate insulin resistance (Homa-IRN CPV) 1.5 fasting glucose mmol-L) 脳 fasting C-peptide pmol-L / L / 2800, islet 尾 cell function [HOMA-isletCPN] 0.27 脳 fasting C-peptide pmol-L / L / [fasting glucose mmol-L ~ (-1) -3.5]. The free testosterone FTT-23.43 FTT / [SHBG-TT-23.43 FTT] 脳 10 ~ (-9) mol / L was calculated according to the Vermeulen formula. The statistical analysis was carried out by SPSS17.0 software. The measurement data were expressed as x _ 鹵s. First, the normal test was performed. T test was used to compare the two groups. The logistic regression analysis was used to analyze the risk factors of prostatic hyperplasia. There was significant difference between the two groups. Results 1) comparison of general data and glucose and lipid metabolism indexes between the two groups: compared with T2DM without BPH group, the age of T2DM combined with BPH group was older [50.33 鹵4.46 vs 47.53 鹵6.94 years old] HbA1cHoma IRCPP was higher [8.91 鹵1.98 vs 7.95 鹵1.17 + 0.26 鹵0.82 vs 2.86 鹵0.61, P 0.05], while HOMA-islet BPH group had no significant difference in TLDL-CG-HDL-C and BMI between the two groups. 緇勯棿鎬ф縺绱犳寚鏍囩殑姣旇緝:涓嶵2DM鏃燘PH緇勬瘮杈，

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