南方医科大学学报

南方医科大学学报 ›› 2019, Vol. 39 ›› Issue (05): 586-.doi: 10.12122/j.issn.1673-4254.2019.05.14

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男性2 型糖尿病患者血清孕酮与临床指标及常见中医证型的相关性

杨鑫，汪悦   

  • 出版日期:2019-05-20 发布日期:2019-05-20

Correlation analysis of serum progesterone with clinical indicators and common traditional Chinese medicine syndrome types in male type 2 diabetic patients

  • Online:2019-05-20 Published:2019-05-20

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摘要： 目的分析男性2型糖尿病（T2DM）患者血清孕酮（PROG）水平与多项临床指标、常见中医证型的相关性，探讨PROG在男 性T2DM患者诊疗中的意义。方法回顾性收集2018年1月~2019年3月于南京中医药大学附属南京中医院内分泌科住院并检 测PROG的男性T2DM患者192例，按PROG水平分为孕酮正常组和孕酮升高组，比较两组间一般资料、C肽水平、血糖水平、糖 化血红蛋白、HOMA、血脂水平、性激素五项等多项临床指标的差异；按消渴常见中医证型将病例分为气阴两虚证组及湿热困脾 证组，比较两组间相关指标包括一般资料、性激素六项、C肽水平、HOMA、糖化血红蛋白、血糖水平等之间的差异；将两种孕酮 水平及两种常见中医证型相结合进行分组，共分为高孕酮气阴两虚证、高孕酮湿热困脾证、正常孕酮气阴两虚证、正常孕酮湿热 困脾证四组，比较4组间C肽水平、HOMA及性激素水平的差异。结果（1）相比于PROG正常组，PROG升高组BMI、C肽水平、 HOMA-β、HOMA2-IR低，HOMA-IS、E2、T高，年龄、病程、WHR、吸烟史、血压、血糖、血脂、HbA1c、LH、FSH、PRL无统计学差 异；（2）相比于湿热困脾证组，气阴两虚证组患者年龄大、病程长，BMI、C肽水平、HOMA-β、HOMA2-IR 低，HOMA-IS、PROG 高，吸烟史、WHR、HbA1c、血糖、性激素5项无统计学差异；（3）将两种孕酮水平与两种中医证型结合进行分组，发现4组间C肽 水平、HOMA-β、HOMA-IS、PROG、E2、T、LH、FSH均有统计学差异。其中，高孕酮气阴两虚证组C肽水平、HOMA-β、HOMA2- IR最低，HOMA-IS、PROG、E2、T、LH、FSH最高。结论男性T2DM患者中，高孕酮与胰岛β细胞功能、中医证型密切相关。

Abstract: Objective To analyze the correlation of serum progesterone (PROG) level with blood biochemical parameters and common traditional Chinese medicine (TCM) syndromes in male patients with type 2 diabetes mellitus (T2DM). Methods We collected the clinical data of 192 male patients with T2DM, who were admitted in the Department of Endocrinology, Nanjing Hospital of Chinese Medical Affiliated to Nanjing University of Chinese Medicine between January, 2018 and March, 2019. The general clinical data, C-peptide level, blood glucose level, glycated hemoglobin (HbA1c), HOMA, blood lipid level, and sex hormones were compared between the patients with normal PROG and elevated PROG levels and also between the patients with two common TCM syndromes, namely qi and Yin deficiency syndrome and damp- heat accumulation in the spleen syndrome. We further compared the sex hormones, C-peptide level, HOMA, HbA1c, and blood glucose level among the patients with the two TCM syndromes having normal or elevated PROG levels. Results Compared with those in patients with normal PROG level, BMI, C-peptide, HOMA-β, and HOMA2- IR were significantly lowered and HOMA-IS, E2, and T were significantly increased in patients with elevated PROG level; no statistical differences were found in age, disease duration, waist-to-hip ratio (WHR), smoking history, blood pressure, blood glucose, blood lipids, HbA1c, LH, FSH or PRL between the two groups. Compared with the patients with damp-heat accumulation syndrome group, the patients with qi and Yin deficiency syndrome were older and had a longer disease duration, a greater BMI, and higher levels of PROG, C-Peptide, HOMA-β, HOMA2-IR and HOMA-IS, but the smoking history, WHR, HbA1c, blood glucose, and sex hormone levels were comparable between the two groups. Among the 4 groups of patients with different PROG levels and TCM syndromes, significant differences were found in the levels of C-peptide, HOMA-β, HOMA-IS, HOMA2-IR, PROG, E2, T, LH and FSH, and the patients with qi and Yin deficiency syndrome as well as an elevated PROG level had the lowest C-peptide level, HOMA-β and HOMA2-IR and the highest HOMA-IS, PROG, E2, T, LH and FSH. Conclusion An elevated PROG level is closely related to islet cell dysfunction and TCM syndrome types in male patients with T2DM.